Dietary self-care and negative emotions inType 2 diabetes: ‘I break it and then I feel guilty and then I don’t go back

Aims: To understand the experiences of maintaining good dietary self-care required of people with Type 2 diabetes and the meaning of negative emotions in the context of dietary self-care. This is explored by examining situations resulting in negative emotions, types of negative emotions experienced and coping with negative emotions and poor dietary self-care. Methods: The interpretative phenomenological analysis (IPA) approach was used to explore in-depth dietary self-care and negative emotions. Thirteen people with Type 2 diabetes from the Endocrinology and Diabetes Centre of the Birmingham Heartlands Hospital, Birmingham, UK, were interviewed to gain in-depth insight into their experiences. Transcripts of interviews were analysed using IPA to generate meaningful themes. Results: Three super-ordinate themes were identified: dietary self- care – a constant challenge; negative emotions – a cause or a consequence; and coping with negative emotions and learning to live with ‘the diet’. Situations involving poor diet were identified to understand the context of negative emotions. While perceived dietary restrictions resulted in frustration, anger and depression, maintaining dietary self-care resulted in irritation, annoyance, regret, guilt, anger and depression, and the consequence of poor dietary self-care was frustration, depression and anger. Patients rationalised to coping with these negative emotions and poor dietary self-care, acknowledging the importance of good dietary self-care. Conclusions: This study fills a gap in literature, contributing largely to the understanding of negative emotions and dietary self- care. It proposes a possible cycle of poor dietary self-care and negative emotions and suggests the need to break this cycle (where one exists) to maintain good dietary self-care.