The role of acculturation in diabetes self-management among Chinese Americans with type 2 diabetes

According to the Centers for Disease Control and Prevention, diabetes affects 29.1 million people in the United States. Marriage has been suggested to have a protective effect on overall health outcomes, but few studies have evaluated the role of partnership status on patients with type 2 diabetes. This study aimed to assess this role of partnership status on diabetes control and self-management behaviors. Patients with type 2 diabetes taking at least one oral hypoglycemic agent were assessed over a 3-month period to measure hemoglobin A1c (HbA1c) changes and adherence to medication, exercise, diet, and glucose monitoring. Partnered participants were more likely to adhere to their medications, but there was no significant difference in HbA1c changes over 3 months or exercise, diet, or glucose monitoring adherence. This study suggests that being partnered improves medication adherence; further analysis with a larger population is required to fully assess the role of partner support for patients with type 2 diabetes.

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Diabetes Self-Management in African Americans: An Exploration of the Role of Fatalism

The Diabetes Educator ◽

10.1177/014572170302900115 ◽

2003 ◽

Vol 29 (1) ◽

pp. 105-115 ◽

Cited By ~ 76

Author(s):

Leonard E. Egede ◽

Ramita J. Bonadonna

Keyword(s):

Type 2 Diabetes ◽

African Americans ◽

Self Management ◽

Spiritual Beliefs ◽

Management Behavior ◽

Four Dimensions ◽

Psychology Theory ◽

The Individual

PURPOSE This study was conducted to explore the concept of fatalism in relation to diabetes self-management behavior in African Americans with type 2 diabetes. METHODS Participants (n=39) were recruited from a clinic sample of African Americans with type 2 diabetes. Seven focus groups were conducted; the sessions were recorded, transcribed, and analyzed to identify themes related to fatalism and diabetes self-management. The ISAS paradigm (individual, symbols, audience, situation), a social psychology theory, provided the theoretical framework for the study. RESULTS Four dimensions of fatalism were identified: the meaning of diabetes, the illness experience, the individual's coping response, and the individual's religious and spiritual beliefs. For the participants in this study, fatalism seemed to characterize the nature of the interaction between the individual with diabetes and others, the meanings they attached to such interactions, and the decision to adopt an effective or ineffective diabetes self-management behavior. CONCLUSIONS Fatalism was associated with diabetes self-management in African Americans with diabetes and was multidimensional in this population; the construct appeared to differ conceptually from the perspective of current measures.

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Cross-Validating a Structural Model of Factors Influencing Diabetes Self-Management in Chinese Americans with Type 2 Diabetes

Journal of Transcultural Nursing ◽

10.1177/1043659618790085 ◽

2018 ◽

Vol 30 (2) ◽

pp. 163-172 ◽

Cited By ~ 1

Author(s):

Wei Pan ◽

Shaoqing Ge ◽

Yin Xu ◽

Deborah Toobert

Keyword(s):

United States ◽

Type 2 Diabetes ◽

Structural Model ◽

Chinese Americans ◽

The United States ◽

Self Management ◽

Equation Modeling ◽

Convenience Sample ◽

Management Interventions

Introduction: The purpose of this study was to cross-validate a structural model depicting the effects of individual and environmental factors on diabetes self-management in Chinese Americans with type 2 diabetes. Methodology: A cross-sectional survey was administered to a convenience sample of 209 Chinese Americans with type 2 diabetes in the Midwest of the United States. Structural equation modeling was used to cross-validate the model fit. Results: Provider–patient communication indirectly influenced self-management via belief in treatment. Knowledge indirectly influenced self-management via belief in treatment and self-efficacy. Social support indirectly influenced self-management via belief in treatment and knowledge. Discussion: This study demonstrated that the structural model, previously tested with Chinese diabetes patients in China, also fits Chinese Americans in the United States with few modifications. The cross-validated model provides a theoretical basis for developing culturally relevant diabetes self-management interventions for Chinese Americans, which may lead to health improvements in this ethnic population.

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Understanding Challenges, Strategies, and the Role of Support Networks in Medication Self-management Among Patients With Type 2 Diabetes

The Diabetes Educator ◽

10.1177/0145721717697243 ◽

2017 ◽

Vol 43 (2) ◽

pp. 190-205 ◽

Cited By ~ 8

Author(s):

Gerda Bernhard ◽

Dominik Ose ◽

Ines Baudendistel ◽

Hanna M. Seidling ◽

Marion Stützle ◽

...

Keyword(s):

Type 2 Diabetes ◽

Health Care ◽

Support Networks ◽

The Self ◽

Self Management ◽

Medication Regimen ◽

Self Help ◽

Self Help Groups

Purpose The purpose of this qualitative study was to investigate the challenges and strategies of patients with type 2 diabetes mellitus (T2DM) regarding daily management of their medication regimen focusing on the role of their support networks. Methods A purposeful sample of 25 patients with T2DM was recruited from local self-help groups, general practitioner practices, and a university hospital in southwestern Germany. Four semi-structured focus groups were conducted to identify the challenges patients experienced, the strategies they used, and their collaboration with support networks to assist them in self-managing their medication regimen. Sessions were audio- and video-recorded, fully transcribed, and subjected to computer-aided qualitative content analysis, guided by the Self- and Family Management Framework (SFMF). Results Patients with T2DM experienced numerous challenges affecting medication self-management arising from their personal situation, health status and resources, characteristics of their regimen, and how health care is currently organized. Patients’ self-initiated strategies included activating health care, community, social, and online resources; taking ownership of medication-related needs; and integrating medication-taking into daily life. Patients drew on self-help groups, family, and friends to discuss concerns regarding medication safety and receive experience-based information and advice for navigating within the health care system as well as practical hands-on support with daily medication self-management. Conclusions Understanding the challenges and building on strategies patients with T2DM devised help diabetes educators to better address patients’ needs and priorities and guide patient-centered interventions to support patients’ self-management activities. Community and social support networks operating in patients’ lives need to be engaged in the self-management support.

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