{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:24:46Z","timestamp":1791390286449,"version":"4.3.3"},"reference-count":55,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T00:00:00Z","timestamp":1763078400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T00:00:00Z","timestamp":1763078400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Scandinavian Caring Sciences"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Individuals with type 2 diabetes who consume alcohol require lifestyle changes, including altering food and alcohol consumption. Alcohol and food consumption for individuals with type 2 diabetes create an accumulative impact that adversely affects their potential to alter their lifestyle.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>This study explores how individuals with type 2 diabetes who consume alcohol at varying levels interpret and manage lifestyle changes related to drinking and diet.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study uses hermeneutic phenomenology. Semi\u2010structured face\u2010to\u2010face interviews were conducted with 12 participants living with type 2 diabetes who consumed alcohol. Data were collected from September 2017 to February 2018. The University's ethics committee approved the study, and the data were analysed using thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics<\/jats:title>\n                    <jats:p>Ethics committee approval was obtained from the University of Leeds Committee on Research Ethics, and written informed consent was obtained from participants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Lifestyle modifications for individuals with type 2 diabetes who consume alcohol are more complex than for individuals with type 2 diabetes who do not. Also, the impersonal nature of organisational and professional culture impedes lifestyle changes. Furthermore, insufficient, unfriendly and incomprehensible labelling of food and alcohol impedes healthier food and alcohol selection choices. Finally, family, friends, and other social networks unintentionally encourage alcohol drinking and food consumption.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The increased number of group memberships or the potential to develop new group memberships increases the likelihood of commencing and sustaining lifestyle changes. Also, healthcare professionals need to educate individuals with type 2 diabetes who consume alcohol to read, evaluate and interpret food and alcohol labels, and act upon policies regulating the food and alcohol industry. Health professionals need to empower individuals living with type 2 diabetes to develop new social group memberships. Furthermore, an integral component of the caring process is the co\u2010construction of explanatory, sense\u2010making and transformative narratives that justify and warrant lifestyle changes. Finally, health professionals need to re\u2010envisage their healthcare roles and reshape how they employ information technology and integrate family in the lifestyle changes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/scs.70149","type":"journal-article","created":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T12:09:25Z","timestamp":1763122165000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Exploring the Experiences of Individuals With Type 2 Diabetes in the Context of Alcohol Use and Lifestyle Change: A Phenomenological Study"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1834-1669","authenticated-orcid":false,"given":"Christine","family":"Mantzouka","sequence":"first","affiliation":[{"name":"School of Health and Community Studies Leeds Beckett University  Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,14]]},"reference":[{"key":"e_1_2_13_2_1","unstructured":"IDF Diabetes Atlas 2021."},{"issue":"4","key":"e_1_2_13_3_1","first-page":"665","article-title":"Facilitating Positive Health Behaviors and Well\u2010Being to Improve Health Outcomes: Standards of Care in Diabetes","volume":"48","author":"American Diabetes Association Professional Practice Committee","year":"2025","journal-title":"Diabetes Care"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13796"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(23)00347-9"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.4324\/9780203082898"},{"key":"e_1_2_13_7_1","unstructured":"National Health System Alcohol Misuse(2018) https:\/\/www.nhs.uk\/conditions\/alcohol\u2010misuse\/."},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732309334517"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/1012690213493105"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2015.09.001"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13679-014-0129-4"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare11121681"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjso.12081"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.3109\/02813432.2011.654193"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.37464\/2010.273.1708"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13801"},{"key":"e_1_2_13_17_1","unstructured":"D.Karin M.Nystr\u00f6m andH.Dahlberg \u201cReflective Lifeworld Research \u201d(2007)."},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.4324\/9781003228073"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph16020281"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.4103\/jehp.jehp_216_20"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.29173\/pandp14931"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/1077800419836696"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11019-008-9174-7"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/1468794112468475"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1177\/1074840707312237"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/146879410200200205"},{"key":"e_1_2_13_27_1","unstructured":"NHS England \u201cThe NHS Diabetes Prevention Programme: Helping You Take Control of Your Health \u201d(2018) https:\/\/www.england.nhs.uk\/diabetes\/diabetes\u2010prevention\/."},{"key":"e_1_2_13_28_1","unstructured":"NICE \u201cType 2 Diabetes in Adults: Management (NICE Guideline [NG28]). 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