Abstract

In resource-limited settings like Ethiopia, managing type 2 diabetes mellitus (T2DM) depends heavily on patients' self-care. Yet, this process is often disrupted by a complex interplay of emotional, cultural, and systemic factors. Existing research has insufficiently captured how these forces shape the lived experiences of patients managing diabetes in such settings. Therefore, this study explored the lived experiences and perceived barriers of self-care practices among individuals with T2DM attending hospitals in the Wolaita Zone of South Ethiopia.A descriptive phenomenological approach grounded in Husserlian philosophy was employed. Data were collected through 12 in-depth interviews with T2DM patients and supplemented by two focus group discussions with additional 13 patients conducted between August and September 2024. Data were analysed manually using a five-step phenomenological approach, emphasizing meaning extraction and textual synthesis. Five interconnected themes emerged:1) Emotional disruptions following diagnosis, 2) Perceived disease severity and fear of complications, 3) Economic and infrastructural constraints, 4) Cultural and religious beliefs, and 5) systemic and interpersonal gaps in support. Patients described experiences of fear, hopelessness, and shock at diagnosis, compounded by medication inaccessibility, unaffordable diets, and traditional beliefs conflicting with biomedical guidance. Patients reported limited diabetes-specific knowledge and insufficient emotional and educational support from their families and the health system. Self-care practices among patients with T2DM in Ethiopia are shaped by deeply embedded emotional, socio-cultural, and systemic realities. Effective diabetes management requires interventions that extend beyond clinical knowledge provision, incorporating emotional support, culturally tailored education, and improved health system responsiveness. Multi-level collaboration between healthcare providers, policymakers, religious institutions, and community structure is critical for building sustainable, patient-centred self-care support systems.