Enabling adult diabetes self-management in a Kenyan context: a design science research approach
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Date
2023
Authors
Opisa, Esther Asenahabi
Journal Title
Journal ISSN
Volume Title
Publisher
University of the Free State
Abstract
Diabetes is one of the non-communicable conditions of which the prevalence is increasing globally, with a particularly sharp increase experienced in low and middle-income countries (LMICs). If diabetes is not managed properly, it can lead to physical complications, and increase the financial burden on the individual, the health care system and the government. Since diabetes is a chronic condition, self-management is key in the control of this condition. However, it is evident that most people diagnosed with diabetes exhibit an uncontrolled condition. This is an indication that diabetes self-management (DSM) is suboptimal among people diagnosed with diabetes.
The main aim of this study was to design a context-specific product that would enable DSM by adults in Kenya. This study was anchored on the integrated model of behaviour prediction (IMBP) theory, with IMBP distal variables forming the foundation for designing the product.
This study was designed using a pragmatic approach, informed by design science research (DSR). DSR comprises three cycles that are closely related. The three cycles are relevancy, design and rigour. In the relevancy cycle, the problem was investigated. Preliminary design requirements (PDRs) and design requirements (DRs) were derived. The PDRs and DRs formed part of the acceptance criteria of the product. In the design cycle, the product was finalised and its practicability determined. The iterative nature of the prototype product was due to the synthesis of data obtained during the relevancy cycle. In the rigour cycle, the prototype product was evaluated against certain evaluation criteria. The final product was then designed. These three cycles were adapted as the phases of the study. Applying the general methodology of design science research (DSR) to the current study yielded three executable phases of the research study: 1) the problem explication phase, 2) the design phase, and 3) the evaluation phase.
A multiple method design was used. In the first phase, the problem explication phase, a literature overview, a scoping review and Kawa group discussions were conducted. The findings of these three methods involve a list of four IMBP distal variables, nine PDRs and six DRs respectively. In the second phase, the design phase, surveys and design were the two methods that were applied. The surveys yielded additional 13 DRs, giving a total of 19 DRs. This phase gave rise to a prototype product and the evaluation criteria that were used by diabetes experts in the third phase of the study. The third phase, the evaluation phase, involved expert reviews. Four diabetes experts evaluated the prototype product using the evaluation criteria. Their feedback was analysed and the findings factored in the development of the final product. The final product is a DSM guide that will be used mainly by adults diagnosed with diabetes, either on their own or with the aid of health care providers during clinic visits. In this last phase, design principles were also articulated, based on the DRs that emerged throughout the study.
This study makes a contribution to the body of knowledge in DSR, by unearthing design principles that other researchers can use to design similar studies elsewhere. Additionally, the DSM guide that emerged in this study may contribute to improved DSM by adults diagnosed with diabetes in Kenya. A context-specific DSM product was developed through the application of the DSR approach. Alongside the DSM product, the researcher also extracted DRs and design principles, which are the knowledge contribution of this study to DSR.
Description
Thesis (Ph.D.(Nursing))--University of the Free State, 2023
Keywords
Design principles, Diabetes, Diabetes self-management, Distal variables, Enable, Adults, Health care providers, Preliminary design requirements, Design requirements, Product