Evolving self-care in individuals with schizophrenia and diabetes mellitus.

Individuals with schizophrenia have higher rates of diabetes mellitus as compared with the general population, but little is known about their diabetic self-care. This grounded theory study was conducted to develop a theory of self-care for individuals with comorbid schizophrenia/schizoaffective disorder and diabetes. Twenty-six interviews were conducted among 11 respondents with varying degrees of ability to care for these coexisting illnesses. Respondents identified psychiatric symptoms as a major barrier to diabetic self-care. The resulting theory of Evolving Self-Care describes the process by which respondents developed self-care health beliefs over time to help them successfully manage their psychiatric disorder and diabetes. Categories include mastering mental illness, accommodating diabetes, and striving for health. When providing care to patients with schizophrenia/schizoaffective disorder and diabetes, advanced registered nurse practitioners are encouraged to provide education about the negative consequences of psychosis on diabetes self-care.