Maintaining an Outward Image

Abstract

Type 2 diabetes mellitus (DM) and hypertension (HTN) disproportionately affect minority populations in the United States, including Korean American immigrants (KAI). We conducted qualitative interviews with middle-aged KAI in Maryland living with DM and HTN to examine the illness experience to inform future intervention strategies. Study results show that participants utilized strategies to maintain respect and Korean identity, including an image of being healthy and in control of their behavior in the public arena. These strategies included the lack of disclosure of their illness, even to family members, and avoiding outside assistance when engaging in problem solving. Maintaining an outward image of health was a common goal that affected the self-care of KAI in this study, a finding that might prove significant in the management of other chronic illnesses affecting this population. The study findings demonstrate the importance of in-depth understanding of specific populations when treating chronic illness, and caretakers' sensitivity to each population's unique cultural issues regarding identity, image, and disclosure.

Family Harmony: Reconciling Individual and Collective Responsibility in the Care of Type 2 Diabetes Mellitus in Korean Middle-Aged Americans

“…These findings are consistent with other studies of diabetes management in Korean Americans [29,30]. Although these informants' experiences challenged the legitimacy of the familial intimacy and harmony that they desired, they pursued an appearance of harmony within their family [9].…”

“…The first-author and the bilingual interviewer compared the English-translated transcripts against the Korean transcripts to ensure accuracy of the translations. A full description of methods and analysis was described elsewhere [9].…”

“…According to illness management frameworks, self-care and treatment choices are heavily reliant on an individual's decision-making that involves personal self-efficacy, the resources to manage diabetes, balancing social responsibilities, and desiring normalcy [3][4][5]. While the nature of DM and management generally require personal motivation, self-knowledge, goals and decision-making, which are strong, individualistic or independent ideals originated from a biomedical perspective [6,7], the personal management models may not fully explain the experience of immigrants to the United States [8] or take into consideration of the traditional KAI culture and efforts to maintain family and community cohesion [9].…”

The influence of social networks on self-management support: a metasynthesis

“…Sharing knowledge and experiences within a personal community can provide people with a sense of not being alone and offers a valued opportunity to exchange gain and reinforce existing knowledge relevant to a condition [21,22,42,43,45]. The process of sharing also feeds into people’s internal capacity to cope with stress and, though not always explicitly acknowledged, can act to motivate lifestyle changes or involvement by adding new activities with which to self-manage [21-23].…”

The experience of the illness and of the treatment for the person with systemic arterial hypertension: an ethnographic study

“…We recognize that living with SAH is a complex experience, given the need for medicalization of life, given the abdications from the everyday, and the need for interactions with the health-care subsystems throughout life, to treat the condition or for the care which is intrinsic to their living conditions. In spite of the growing interest from research for understanding the cultural construction of the health-illness process, there are few current works related to SAH in this perspective (13)(14)(15)(16) . The scarcity of works anchored in this frame of reference and the search for answers to our concerns, which involve how people with SAH think, …”