Lived experiences and perceptions of social support in diabetes self-management among patients, families, and friends in Ethiopia

Type 2 diabetes is a major health issue in Ethiopia, where misunderstandings about its causes and treatment are widespread. Many people believe it is caused by emotional, significant life events and supernatural forces, which leads to stigma and poor management. Limited access to healthcare and cultural factors further contributed to inadequate self-care and dependence on alternative medicines. Involving family and friends in diabetes management can lead to better results by sharing care responsibilities and helping to overcome obstacles to effective management. This study explored the lived experiences and perceptions of social support in diabetes self-management among individuals with type 2 diabetes, families, and friends in Ethiopia. A phenomenological study approach was utilised through in-depth interviews and focus group discussions with purposive sampling of 22 participants, including individuals with type 2 diabetes, their families, friends, and caregivers. Reflexive thematic analysis was used to analyse the data. A total of twenty-two individuals participated in the study, including (n = 15) individuals with type 2 diabetes, (n = 2) family members or caregivers, (n = 2) friends, and (n = 3) neighbours. Three major themes were identified regarding the perception and experiences of social support and self-management: (1) Cultural and perceptual understanding of type 2 diabetes and its self-management. (2) Supportive environment and psychosocial dynamics in diabetes self-management. (3) Challenges in diabetes self-management. Perceptions of type 2 diabetes were influenced by individuals' social circumstances and cultural beliefs, with some lacking knowledge of its causes and management. There was often conflicting advice from family members and social networks regarding diabetes self-management due to beliefs in traditional remedies and cultural practices, resulting in pressure to abandon prescribed medications. Social support and engagement with families, friends, and community organisations help individuals with type 2 diabetes enhance coping mechanisms and self-management abilities. However, challenges included economic pressure and unavailability of access to essential medications, dysfunctional health insurance, inadequate instruction from healthcare professionals, and cultural and religious factors that further affect individuals with type 2 diabetes's ability to manage diabetes effectively. The study reveals that diabetes experiences and perceptions are influenced by cultural beliefs, traditional practices, and understandings, underscoring the need for educational interventions in diabetes care. Family and community members play crucial roles in managing diabetes, while religious practices aid in coping mechanisms and lifestyle changes.