A Thematic Analysis and a Systematic Review Examining Psychological and Health Care Professionals’ Language on Shame in Those Living with Diabetes

Abstract

Introduction: Diabetes mellitus is a prevalent condition affecting 10.5% of the global population. Diabetes significantly impacts physical and psychological health and is associated with shame and stigma. Shame is a core human emotion; however, for individuals living with diabetes (LWD), the experience of shame can be influenced via the language of healthcare and psychological professionals.
Objectives: To explore the impact of psychological professionals’ language on the experience of shame among individuals LWD, and to review and synthesise current literature exploring the impact of healthcare professionals' (HCPs) language on the experience of shame amongst individuals LWD.

Methodology: Reflexive thematic analysis of semi-structured interviews from 17 individuals LWD, and a systematic review with a thematic synthesis of qualitative studies of adults LWD, where HCPs’ language has contributed to the experience of shame.

Results: from the thematic analysis, three themes were identified: (A) (P5) “Language matters” (B) Connection and Community, and (C) Diabetes knowledge. From the systematic review and thematic synthesis, three Analytical themes were identified: (1) The Emotional Toll of Interactions with HCPS when Living with Diabetes; (2) The Power of Shame within HCP Interactions; (3) HCP Interactions are Not Always Doom and Gloom.

Conclusion: Psychological professionals and HCPs’ language impacts the experience of shame among individuals living with diabetes. Both psychological professionals’ and HCPs’ language contributes to feelings of shame. Psychological professionals' language can rupture therapeutic rapport and create a sense of disconnection, while diabetes knowledge and positive experience during therapy foster connection. Furthermore, individuals LWD can fear being shamed by HCPs, and shame can lead to non-disclosure of symptoms, help-seeking behaviour, and making behavioural changes to manage the condition.

Keywords: Diabetes, psychological professionals, Healthcare Professionals, shame, language, Thematic analysis, systematic review, thematic synthesis.

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ORCID for Catherine Brignell: orcid.org/0000-0001-7768-6272

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