BETWEEN KNOWING AND DOING: A PHENOMENOLOGICAL EXPLORATION OF SELF-MANAGEMENT BARRIERS AMONG PEOPLE WITH TYPE 2 DIABETES

Abstract

Background: Type 2 diabetes mellitus (T2DM) requires sustained self-management, yet understanding care recommendations does not ensure consistent action. Here, the knowing–doing gap concerns patients’ experiences of difficulty enacting understood care, extending attention beyond adherence to everyday circumstances. Although previous studies identify individual and social barriers, how these intersect in patients’ experiences of translating understanding into action remains insufficiently understood.

Objective: To explore how people with T2DM experience difficulties translating their understanding of recommended care into consistent daily self-management.

Methods: A descriptive phenomenological study was conducted in Pasar Rebo, East Jakarta, from March to July 2025. Twelve participants with T2DM who could communicate effectively and consented to participate were recruited through purposive sampling until data saturation. Semi-structured, in-depth interviews were analyzed using Colaizzi’s seven-step method. Trustworthiness was addressed through credibility, dependability, confirmability, and transferability.

Results: Six themes emerged: knowing but finding it difficult to do; struggling against oneself; daily life demands overriding the care plan; family and social environment as both supporters and barriers; living with diabetes as a burden that never ends; and needing more than just knowing. Across participants’ accounts, understood care became difficult to sustain amid personal struggles, competing responsibilities, social circumstances, and the continuing burden of care. General understanding also coexisted with uncertainty about practical implementation.

Conclusion: Participants experienced the knowing–doing gap as difficulty sustaining understood care within everyday circumstances. These findings highlight the relevance of patients’ lived contexts when considering self-management support, without establishing the effectiveness of specific interventions.