Occupational Stressors, Well-being, and Treatment Adherence Among Employees with Type 2 Diabetes in Nigeria: Investigating the Roles of Perceived Control and Self-Compassion

In Nigeria and the entire sub-Saharan Africa, the incidence of type 2 diabetes and occupational stress is a significant health concern, impacting on employees’ well-being and treatment adherence. Support for people facing these challenges is scarce. In contrast, other long-term illnesses, including cancer, HIV and malaria, continue to receive financial, psychological and medical support. Studies indicated that self-compassion and perceived control play an important role in helping people cope with such challenges. However, there is a lack of evidence on the role of these constructs in Nigerian employees with type 2 diabetes who experience stress at work. This thesis, therefore, investigates the relationship between occupational stressors, overall well-being and treatment adherence among Nigerian employees with type 2 diabetes and the role that perceived control and self-compassion play in this process. Three studies are reported in this thesis, namely a qualitative study, a survey and a brief intervention. Study 1 explored the lived experiences of 15 employees with type 2 diabetes in Nigeria, using semi-structured interviews to understand the relationship between occupational stressors, general well-being and adherence to treatment regimens. Five themes emerged: (1) effects of workplace stressors on well-being; (2) effects of work stressors on diabetic conditions; (3) current type 2 diabetes treatment; (4) support employees receive in managing their type 2 diabetes and coping with occupational stressors; and (5) influence of beliefs and the ability to self-manage type 2 diabetes and cope with work-related stress. The results highlighted the unpleasant experiences brought on by rising workloads and a dearth of support at work to help management of diabetes by employees. Many employees turned to other sources of support, particularly religious practices, family and friends, to enhance their well-being. Study 2 was a cross-sectional survey of 180 employees in Nigeria that examined whether self-compassion and perceived control moderate the relationship between occupational stressors and treatment adherence and well-being of employees with type 2 diabetes. Higher levels of occupational stress were associated with lower treatment adherence and well-being. The relationship between occupational stress and well-being was significantly moderated and weakened by self-compassion, but not by perceived control. The relationships between occupational stress and treatment adherence were not significantly moderated by either self-compassion or perceived control. In Study 3, the effect of self-compassion manipulation on treatment adherence intentions was examined. Ninety Nigerian employees with type 2 diabetes who were experiencing occupational stress were randomly allocated to either the control condition or the self-compassion manipulation condition. The participants then completed an assessment on their intentions to adhere to their treatment plan. The participants in the self-compassion condition were found to have significantly stronger intentions to adhere to their treatment regimen than did those in the control condition. The impact of condition on treatment adherence intentions was not moderated by level of occupational stress. Taken together, the results from the three studies presented in the thesis enhance understanding of the ways in which self-compassion can be employed to handle type 2 diabetes and act as a coping mechanism for occupational stressors among Nigerian employees with type 2 diabetes. The findings indicated that employees with type 2 diabetes who are self-compassionate are better able to manage their health challenges when under occupational stress. Therefore, encouraging self-compassion among employees with type 2 diabetes may be beneficial in reducing the complications associated with type 2 diabetes and occupational stress.