Influences on day-to-day self-management of type 2 diabetes among African-American women: spirituality, the multi-caregiver role, and other social context factors.

Abstract

OBJECTIVE -Many African-American women are affected by diabetes and its complications, and culturally appropriate lifestyle interventions that lead to improvements in glycemic control are urgently needed. The aim of this qualitative study was to identify culturally relevant psychosocial issues and social context variables influencing lifestyle behaviors-specifically diet and physical activity-of southern African-American women with diabetes.RESEARCH DESIGN AND METHODS -We conducted 10 focus group interviews with 70 southern African-American women with type 2 diabetes. Group interviews were audiotaped and transcripts were coded using qualitative data analysis software. A panel of reviewers analyzed the coded responses for emerging themes and trends.RESULTS -The dominant and most consistent themes that emerged from these focus groups were 1) spirituality as an important factor in general health, disease adjustment, and coping; 2) general life stress and multi-caregiving responsibilities interfering with daily disease management; and 3) the impact of diabetes manifested in feelings of dietary deprivation, physical and emotional "tiredness," "worry," and fear of diabetes complications.CONCLUSIONS -Our findings suggest that influences on diabetes self-management behaviors of African-American women may be best understood from a sociocultural and family context. Interventions to improve self-management for this population should recognize the influences of spirituality, general life stress, multi-caregiving responsibilities, and the psychological impact of diabetes. These findings suggest that family-centered and church-based approaches to diabetes care interventions are appropriate.

The Role of Culture in Health Literacy and Chronic Disease Screening and Management

“…Samuel-Hodge and colleagues [83] conducted focus group interviews with African-American women with type 2 diabetes, and learned that their multiple caregiving responsibilities often interfered with managing their own illnesses. Participants in this qualitative study reported that faith and spirituality were important and under-recognized coping mechanisms for people living with chronic disease.…”

How Religosity and/or Spirituality Might Influence Self-Care in Diabetes Management : A Structured Review

“…In an Iranian study, the patients regarded the physician as 'holy men' 5 . The influence of relatives has been shown to play a major role in supporting patients with chronic illness and specifically diabetes 6,7 . Evidence showed that partners had shared the same burden with diabetes patients, especially if the partners were women 8 .…”

Evidence produced by qualitative investigations on type 2 diabetes: a review of the literature

“…Em 17 pesquisas foram utilizados softwares para análise de dados qualitativos, com destaque para o Ethnograph (Arcury et al, 2004;Broom, Whittaker, 2004;Savoca, Miller, Quandt, 2004;MercadoMartinez, Ramos-Herrera, 2002;Liburd et al, 1999) e o NUD.IST (Lawton et al, 2005;Sarkadi, Rosenqvist, 2003;Daaleman, Cobb, Frey, 2001;Samuel-Hodge et al, 2000;Loewe et al, 1998), seguidos pelo Atlas.ti (Cabassa et al, 2008;Lutfey, Freese, 2007) e pelo NVivo (Polzer, Miles, 2007;Lawton, Peel, Parry, 2008).…”