The prevalence of diabetes and related complications are disproportionally higher in Native Americans. Diabetes self-management (DSM) is instrumental in preventing complications. The results presented here are a part of a larger hermeneutic phenomenology study to explore living with diabetes for one Pacific Northwest tribe. This study identified barriers to DSM within the worldview of the tribal people. Using purposive sampling, 10 Coeur d'Alene tribal members, ages 26 to 86 years, participated in in-depth interviews. Data interpretation used a three-step method leading to integrated themes across the transcripts. Perceived unsatisfactory care emerged as the major barrier to self-management, including communication barriers (distrust, misunderstanding, and educational methods) and organizational barriers (quality of care and access issues). Findings highlight the need to improve cross-cultural communication and calls for different approaches to diabetes education. Our profession is challenged to create new DSM and diabetes educational approaches for acceptable and compassionate cross-cultural nursing care.

Background: Achieving work-life balance can be a challenge for academic faculty members. The multifaceted demands and expectations of the role can affect faculty satisfaction and the ability to attain work-life balance. The ever-changing trends in higher education, including technology and online education modalities provide additional factors that can inhibit faculty satisfaction and work-life balance.Aims: This paper explores barriers to achieving work-life balance such as cognitive dissonance, emotional dissonance and burnout. Understanding barriers is essential to developing strategies to promote work-life balance.Methods: An integrated review of the literature on life balance of academic faculty in all disciplines using multiple online databases.Conclusion: Strategies, organized around mentoring and self-care, include promoting physical health, connecting socially, and practicing mindfulness as a cognitive approach can help counteract work-place stressors and help in achieving work-life balance.

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Despite national initiatives, diabetes disproportionately affects Native Americans. Although many studies have focused on the needs of Native Americans for culturally relevant diabetes programs, few have focused on Northwest tribes. This article presents the results of a phenomenological study exploring the experience of Coeur d'Alene tribal members living with type 2 diabetes. The main theme to emerge was perseverance while balancing tensions between burdens and strengths in 4 areas: valuing tribal traditions, being inattentively caring, struggling with disease burdens, and experiencing patient-provider tensions. This article provides new understanding about barriers and supports for diabetes self-management in one Native American tribe.

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