The role of courage in the experience of patients with diabetes complications

Abstract

<p>Over ten million Americans have diabetes mellitus, a chronic metabolic disease with multiple complications. The person with diabetes complications may experience progressive debilitation from such serious conditions as blindness, kidney failure, nerve damage and cardiovascular disease. These complications are progressive and life-threatening, requiring treatments which may be painful, exhausting and often unsuccessful. The patients have multiple tasks to perform in order to cope with this devastating physical illness. They are thrust into a unique emotional experience which has not been investigated by nurses. The experience necessitates drawing upon patients' inner resources. Nursing research into their experience is essential. In an effort to illuminate the experience of the patient with disabling complications of diabetes so that nurses may be better able to assist individuals through the experience, a phenomenological exploration and philosophical analysis of the role of courage was conducted. Courage has been viewed as a virtue, a gift, a potential to be developed. The role of courage in facing certain complications of chronic illness bears exploration. The study of courage and its development, with related nursing implications, may better help the patient to face life and death. The related literature for this study included courage, psychosocial adjustment to diabetes and chronic illness, phenomenology, coping and diabetes pathophysiology and complications. The phenomenological method, an inductive, descriptive research method concerned with the investigation and description of all phenomena, was used. The research design consisted of a qualitative approach, using a small sample of middlescent diabetic patients with disabling complications. These patients were interviewed in home settings. The transcripts of these patient interviews were subjected to thematic analysis in order to generate descriptive profiles of the meaning of courage for these patients. Five theme categories were derived which described the various dimensions of courage in the experience of the patients: philosophical, health care, physical, psychological, and interpersonal. The study of courage was found to have an impact on the practice of nursing and implications were drawn for improved nursing intervention for this group of patients.</p>