Intro to Qualitative Research in Primary Care

Transcript

I Thanks so much Mr P for agreeing to be interviewed and I would

just like to find out how long have you had diabetes, Mr P?

P About, it’s got to be at least twelve years, something like that,

twelve or fourteen year.

I So how has it been so far, having diabetes obviously is –

P Well it’s very hard, like, because what I used to eat I can’t eat
really, like meat and whatever, I can’t really eat, but with having
this, you’ve got to cut down on everything so it doesn’t bung your
sugar up, that’s what I’ve, more or less, for me, like.

I How do you feel about that?

P Sometimes I, like, well I used to go out for a drink Friday nights,

but I don’t go out now, no, no, it’s, if I do, I’m like one and a half
pints, me done, that’s it. I’m not a, I used to be a big boozer but I’m
not now, gone right down, right down and I’ve got to have tablets
every day and that’s more or less for it, like.

I Have you been taking tablets?

P Yes, I take Metformin, two in the morning and two at night and
then I take these other, like an orange one, and that brings my
cholesterol down, like and what the doctors told me to take, I take
them.

I Is that difficult? Taking all these tablets?

P Well, it’s very hard really because in the morning you think tablets
straight away and you’ve got to take your tablets, you’ve got to
take them and, to bring cholesterol down, like, but that’s all I can
really do now. That’s the trouble with diabetics, like, you’ve got to
get your sugar and everything down. I don’t know much about it,
what I’ve got. My family, they haven’t got any, only me. Unless
my grandparents had it and they didn’t find out, all this like
diabetics but like it started playing up in last ten, fifteen year.

I So you were not aware of anyone in your family?

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P No, not up to now, my aunties, I’ve asked all of them, relations, my

cousins, my parents, never had it. I know they didn’t, my mum
didn’t have it, my dad, and none of them. My grandparents might
have had it, but they never found out these things.

I I see. So you said you have tried to control your diet and you’ve
been taking tablets and still your blood sugar, according to the
doctor, is still not very well controlled?

P No, no it isn’t, it’s not very well controlled, you’re right there.

I So, what did the doctor advise you?

P Well, she knew this was coming, I think. I asked her the other week
when I went, because I had a bit of cold, I’ve had that for two and
half weeks. I were getting my sugar level down and then I were
taking these penicillin tablets. It flared back up. And doctor said to
me, ‘right, what do you think about insulin, what do you think of
that?’ So I said ‘well, what do you think’ and she said ‘well, it’s
your decision.’

I had a word with my wife and my daughter. My daughter said,

‘right, dad, this is it. See what the injections can do for you, see if
that can bring your sugar level right down, like’ to what it should
be. I’ve been getting it down to eight, ten but that’s high. I’ve been
told it’s high and I’ve had it down, other week, to two five and
that’s too low. I’ve had it at six five, but, like I say, it’s different
days what you’ve eaten, it goes up and I eat a lot of fruit. I’ve been
told I can still eat fruits. But I’m eating fruits, I think, at the wrong
time, at night instead of morning and then it goes right through me.
My daughter said, she had a lot of info on that and she knew it
were more or less try needle and that’s all I knew all about that. So
I went about it and I asked doctor and she says ‘fine, see what you
think’ and I said ‘well I’ll have it, definitely have it’.

I So your daughter actually has read up quite a bit about diabetes?

P Oh she’s read right up to it. For me, I read little bits and then it
disappears like, but I can read it, I get books out and I’ve got uncle
and he’s a bit, any diseases going, he reads up on them because
he’s very clever that way, he’s a bit slow but he’s very clever with
this.

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I How about yourself, how do you feel about going on insulin?

Insulin?

I Yes.

P I feel a bit down really, because it’s a new, like an adventure to me.
It’s like that really, a new adventure, but if it’s better now, it’ll be
more control and when I get older, it might be, what you call it,
more control of it and better for me, that’s what I’ve been, like, in
my own head, think that myself. And, does diabetic people ever go
down? Does it ever disappear? No, it’s with me for life, isn’t it?
So I’ve got to start doing the records and doing it right, I think.

I Is there any worry, even fear, thinking about starting insulin?

P Well, I’ve got a brother-in-law and he’s a diabetic. I go and see him
now and again and he’s got bad sugar. He’s shown me his leg and
he’s got it so bad that he might have to have his leg amputated or
his foot, and he showed me. He said that’s my diabetic, you’ve got
to get it more or less under control, P, and if you don’t you’ll be
like me. He’s like seventy eight and he’s had it like, twenty year
and he was explaining what you can do. Nurse comes every day to
see him, to see how his foot is. Yes, he has shown me that and I
was a bit fear of it, and he says ‘get it controlled and you’ll be
alright once you have got it more controlled, they’ll help you and if
you don’t you’ll end up like this coming every day’ because, like,
his skin comes off with it and he has bandaged up and every other
day they’ll come and do it. That’s what he showed me.

I Does that affect your decision whether to start insulin?

P No, it doesn’t, I’ll take it, if I’ve got to take it, I’ll take it, insulin,
this insulin, what’s it, what’s in it? Is it like a, does it bring your
temperature thingy down?

I Temperature?

P No not temperature –

I Sugar?

P Sugar down quicker than what you more or less your tablets?

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I It, yes, we’ll probably explain to you in a while but basically it just
brings it down because the tablets no longer control the sugar, so
insulin is that hormone to bring down the sugar.

P Yes, yes.

I But we will explain to you a little bit more after this. There are just
a few questions that I want to ask you. Do you find making the
decision about starting insulin difficult? I mean, now you seem to
be wanting to start, but before that, was it difficult, I mean,
thinking back - ?

P Oh yes, definitely. I agree with it more or less. I thought, on tablets

were going to do it, but they didn’t and I thought no way I’m going
to have that needle put it in your arm every day. It was frightening
me off, doing it and puncturing yourself every day with it and
thinking that oh no it’s going to be scarred, it’s going to a cylinder
covered with huge needle. Then a friend, whom I know, he says,
this friend, well a friend who came and did me a little job at home,
and he said ‘no I have it in stomach’, he puts it in his stomach, says
‘I am done then, for the day’ and you’re finished with it, while next
day, then you’ve got to have it again. So I say ‘oh that’s not too bad
then’ and he says ‘don’t be frightened of it’ and I thought ‘right, I’ll
get it down with tablets but then I really had a good think about it
and I’ve got to go on insulin, I’ve got to go on insulin.’

I So besides the needles and initially you were thinking that you
maybe scarred or –

Yes.

I Are there any other things that you’re worried about with the
insulin?

P No, not really.

I It’s mainly the thoughts of having to inject and scarring and things
like that?

P Well, it could come one day where you find out, I think, that it’s
going to be something, instead of needle, there’s going to be
something else what we’re going to find out in future where you

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don’t have to inject yourself, that’s going to come. I think, that’s

what I think on it more than anything.

I I see.

P That insulin thingy. But now I’ve talked to you a little bit, I’m not
as frightened of having it like I was at first.

I Right, because you’ve talked to many people and they have shared
their experience with you?

P Yes, yes, yes and that’s what I’ve done. I’ve talked to people
who’ve got it, there’s another friend whom I know, he did it with
tablets and lost weight with it. He’s alright now and then he told
me, like, he did it with tablets and I say ‘Well I’ve done it with
tablets but I don’t think it’s working for me but injection might do.’

I Do you think you have any other choices besides insulin?

P There’s no any other choices, I don’t think, I’ve got to get it right
or when I get older, I could go and that’s it and I don’t want that
yet.

I You don’t what that yet.

P So I’ve got to do what I was being told to do.

I Is there anything that you think will help you to make this decision
easier? Is there anything you need, at this moment, to help you to
make it easier for you to make a decision?

P I’ve got to have it, more or less, easier and I’ve got to do it and
that’s all I can say.

I Do you need more information do you think?

P Not really, no, because I can read up on information what I should

know and what I’m into. The nurse’ll help me, the nurses, they’re
good here and doctor too, she’s alright as well. Doctor B, me
doctor.

I If you were to ask you one thing that really make you decide to
start insulin, what would that be?

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P When can I start it?!

[laughing]

I Okay, okay. I just want to know when you make this decision, was
this decision mainly yours or is it the doctor who made the decision
for you or did you discuss –

P It’s my decision.

I It’s your decision?

P Yes, my decision, not the doctor’s, no, it’s mine.

I It’s yours. Has it always been like this or –

P Yes, yes, it’s my decision, I’ve got to really do it, that’s it, more or
less.

I Are you comfortable with that?

P Yes, yes, yes.

I Okay, that’s very good, yes. Okay, do you think there’s going to be
any problems for you to start insulin?

P No, I don’t think so. I think, the first couple of days it might be
different, like, for me. It might be a bit upsetting, it might not. I’ve
got to try this thing to do it.

I Right, okay, that’s very good. Okay, is there anything else you
would like to share with me?

P No.

I Okay, thank you, Mr P.

[END OF INTERVIEW]