Table 3.

Examples of case summaries of navigation, negotiation and collective efficacy

ID and demographics	Summary of navigation, negotiation and collective efficacy
BG1, Female age 58, working part‐time	This is a woman, who had been living and caring for her mother, and for her brother's children, because he had been a widower for long time. To do SM activities, she relies on a girlfriend who also has diabetes type 2 and who is stimulating and encourages her to solve everyday problems. They visit GPs and medical specialists together and take part in the activities organized by ‘The club… [for disabled]’, because ‘one has the need to do culture’
GR8, Female age 75 Lives with her ill husband Former farmer	The participant was diagnosed with diabetes 2 years ago. She got examined whilst on a trip abroad when she felt ill. Her relatives acted immediately and transferred her to Athens for further examination. When her husband had a respiratory attack, her neighbours who are employed at the hospital ran to help and prompted him to go straight to hospital. It was there that they discovered that he too suffered from diabetes. Her daughter made an appointment at a specialized hospital for him to receive heart surgery which had already been damaged by the diabetes. They have developed common dietary habits and do agricultural chores so that they get exercise
NL26, Male, age 73, lives with partner and two children	This 73‐year‐old male has roots in Suriname but has lived for a long time in the Netherlands. He is well‐educated and lives with his partner and two children. He does a lot of volunteering, for example coaching his son's football team, driving a taxi bus for elderly and is part of several commissions. Typical for his relationship with others is his open attitude about his disease. He involves everyone by explaining to them that he has diabetes and what they should do if something happens to him. This way of negotiating differs from many others who are not very open about their disease. When it comes to the management of his disease, he has full confidence in professionals, but negotiates between his GP and internist at the hospital in the way that he chooses treatment at the hospital. Collective efficacy can be found in his volunteering where he helps others, but also receive support and information. Also being part of a family (especially his spouse) provides him with support to manage his disease
N207, Female 45 years, married, on sick leave	N 207 had diabetes in a pregnancy in 1996. Her disease was not properly treated until 2000. Much diabetes in her family, her sister, mother and grandmother. She has navigated to try and manage her illness, but has had great challenges regulating her diabetes, and medication has little effect. She has changed her diet and lost weight, but still struggles with high blood glucose. She feels she has had bad follow‐up in health care. She also has trouble with her back and with fibromyalgia. She has much pain and concerns about her condition. She claims she has injuries on her inner organs because of much use of pain killers. She is isolated and avoids social arrangements because of her diabetes and because she is tired and her condition varies from day‐to‐day. Before she got ill she used to be active. She has a dog she goes for walks with, and she tries to use a treadmill, but she is challenged by pain. She draws a picture of a challenging and hopeless situation. She has college education on ICT, but has been on sick leave for 4 years
SP4, Male age 64, lives with mother who is dependent	This newly kidney‐transplanted patient reflects on the involvement of several members of his network achieving as a result collective efficacy, to the point that his diabetes has little impact on his life. He has performed some navigation work in terms of making judgements of who he might contact in case of emergency, but does not need to do much negotiation as the support that his family provides him with in terms of diet and help in contexts where he does not feel as autonomous, supplements these needs. For example, his brother is a blood donor, so he helps him with the needles. He also accompanies him to the consultation every time. And his sister cooks for him
UK12, Female age 75, lives alone, voluntary work	This very actively networked woman is an example of the work needed to plan and obtain collective efficacy from a network. She has worked hard during her life to navigate, negotiate and maintain a supportive network which allows her to be a ‘good patient’ and keep her diabetes under control. She lives in a retirement complex. The support is very reciprocal as she gives a great deal of support to others, for example neighbours and young people in a skills swap group. Her network provides activities which promote well‐being, exercise and lifelong learning. She navigates this through a series of hubs which all give connections to other resources/activities: sports centre, library, the retirement complex (warden and place for groups to meet). She needs to negotiate her network, for example daughter‐in‐law who can give her ‘slots’ when she can provide help; being aware of the sensitivities of her sons (she tries to protect them from her serious health episodes); and neighbour who gives her cakes – has to teach her why she is starting to refuse these. She has negotiated support from her HCP by being a ‘good patient’ and her pharmacist is used to provide information on medicines