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Evans E, Jacobs M. Diabetes and Financial Well-Being: Differential Hardship Among Vulnerable Populations. Sci Diabetes Self Manag Care 2024:26350106241256324. [PMID: 38853573 DOI: 10.1177/26350106241256324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
PURPOSE The purpose of the study was to examine financial well-being among a diverse population of individuals with and without diabetes. METHODS Data from the Understanding America Survey, a nationally representative, longitudinal panel, were utilized to identify adults with self-reported diabetes diagnoses between 2014 and 2020. We used longitudinal mixed effects regression models to assess the association between diabetes and financial well-being score (FWBS) among racial and ethnic population subgroups. Models included sex, age, marital status, household size, income, education, race/ethnicity, insurance, body mass index, employment, and health insurance, incorporating individual- and household-level fixed effects. Racial and ethnic differentials were captured using group-condition interactions. RESULTS Black participants (17.06%) had the highest prevalence of diabetes, followed by White participants (12.2%), "other" racial groups (10.7%), and Hispanic participants (10.0%). In contrast, White participants (M = 67.66, SD = 22.63) and other racial groups (M = 67.99, SD = 18.45) had the highest FWBSs, followed by Hispanic participants (M = 59.31, SD = 22.78) and Black participants (M = 55.86, SD = 25.67). Compared to White participants, Black participants (β = -5.49, SE = 0.71) and Hispanic participants (β = -2.06, SE = 0.63) have significantly lower FWBSs. Compared to males, females (β = -3.25, SE = 0.41) had lower FWBSs among individuals with diabetes. FWBSs of individuals with diabetes was 2.71 points lower (SE = 0.52), on average, than those without diabetes. Education, household size, age, marital status, and income were also significantly associated with FWBSs. CONCLUSIONS Findings suggest potential disparities in the financial ramifications of diabetes among socially marginalized populations.
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Affiliation(s)
- Elizabeth Evans
- Communication Equity and Outcomes Laboratory, Department of Speech, Language and Hearing Sciences, College of Public Health and Health Professions, University of Florida, Gainesville, Florida
| | - Molly Jacobs
- Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, Florida
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Rutledge S, Hulbert L, Charter-Harris J, Smith A, Owens-Gary M. A qualitative exploration of facilitators and barriers to adopting a healthy lifestyle among Black, Hispanic, and American Indian males with diabetes or at risk for type 2 diabetes. ETHNICITY & HEALTH 2024:1-18. [PMID: 38842432 DOI: 10.1080/13557858.2024.2359377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 05/20/2024] [Indexed: 06/07/2024]
Abstract
OBJECTIVES Higher prevalence of several chronic diseases occurs in men in the United States, including diabetes and prediabetes. Of the 34 million adults with diabetes and 88 million with prediabetes there is a higher prevalence of both conditions in men compared to women. Black, Hispanic, and American Indian men have some of the highest rates of diabetes and diabetes complications. Adopting a healthy lifestyle including healthy eating and physical activity, is important in preventing type 2 diabetes and diabetes complications. DESIGN This study included six focus groups that explored facilitators and barriers to adopting a healthy lifestyle in Black, Hispanic, and American Indian men with diabetes or at risk for type 2 diabetes. Thematic analysis was used to identify facilitators and barriers to adopting a healthy lifestyle. RESULTS Participants included males 18 years of age and older identifying as Black, Hispanic, or American Indian and diagnosed with prediabetes, diabetes, hypertension, or otherwise at risk for type 2 diabetes. Thirty-seven men participated, 19 diagnosed with diabetes and 18 at risk for type 2 diabetes. Fourteen Black, 14 Hispanic, and 9 American Indian men participated. The themes of facilitators to a healthy lifestyle included: family and the social network; psychosocial factors; health status, health priorities and beliefs about aging; knowledge about health and healthy behavior; and healthy community resources. Themes of barriers to a healthy lifestyle also included: mistrust of the health care system, cost, and low socioeconomic status. CONCLUSIONS This study underscores the complexity of factors involved in adopting a healthy lifestyle for some racial and ethnic minority men with diabetes or at risk for type 2 diabetes.
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Affiliation(s)
- Stephanie Rutledge
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - LaShonda Hulbert
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jasmine Charter-Harris
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Akimi Smith
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Michelle Owens-Gary
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA
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3
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Britton LE, Kaur G, Zork N, Marshall CJ, George M. 'We tend to prioritise others and forget ourselves': How women's caregiving responsibilities can facilitate or impede diabetes self-management. Diabet Med 2023; 40:e15030. [PMID: 36537593 DOI: 10.1111/dme.15030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 11/23/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022]
Abstract
AIM The objective of the parent study was to examine attitudes and experiences regarding counselling about preconception care among Black and/or Latina women in the United States with type 2 diabetes (T2DM). Here, we present emergent findings from a secondary analysis of caregiving. METHODS In this qualitative descriptive study, we used conventional content analysis to identify themes from semi-structured interviews with 32 Black and/or Latina women ages 18-40 who have T2DM in the United States recruited from online platforms and snowball sampling. RESULTS Caregiving responsibilities both motivate and disrupt diabetes self-management behaviours. Caregiving largely meant taking care of children, but women also had responsibilities to adult family members and romantic partners. Women were motivated to manage their diabetes in order to prevent negative health effects on their children and to stay healthy so they could fulfil caregiving responsibilities. However, caregiving competed for time, energy and money with self-management. Struggling to balance caregiving and self-management caused stress that women felt was intrinsically unhealthy and undermined self-management. CONCLUSIONS Young adult women with T2DM identified different ways that the roles and responsibilities in the family could affect their diabetes self-management. Providers and policymakers should develop health-promoting interventions that accommodate caregiving responsibilities.
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Affiliation(s)
- Laura E Britton
- Columbia University School of Nursing, New York, New York, USA
| | - Guneet Kaur
- University of California Los Angeles David Geffen School of Medicine, California, Los Angeles, USA
| | - Noelia Zork
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, Columbia University, New York, New York, USA
| | - Cassondra J Marshall
- School of Public Health, University of California Berkeley, Berkeley, California, USA
| | - Maureen George
- Columbia University School of Nursing, New York, New York, USA
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Jalilian H, Javanshir E, Torkzadeh L, Fehresti S, Mir N, Heidari‐Jamebozorgi M, Heydari S. Prevalence of type 2 diabetes complications and its association with diet knowledge and skills and self-care barriers in Tabriz, Iran: A cross-sectional study. Health Sci Rep 2023; 6:e1096. [PMID: 36761031 PMCID: PMC9895320 DOI: 10.1002/hsr2.1096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 01/22/2023] [Accepted: 01/23/2023] [Indexed: 02/05/2023] Open
Abstract
Background and Aims Diabetes can lead to multiple complications that can reduce the quality of life, impose additional costs on the healthcare systems and ultimately lead to premature death. Proper self-care in diabetic patients can impede or delay the onset of diabetes complications. This study aimed to investigate diabetes complications and their association with diet knowledge, skills, and self-care barriers. Methods This was a cross-sectional study. A total of 1139 patients with Type 2 Diabetes Mellitus (T2DM) referring to health centers in Tabriz, Iran, were included from January to July 2019. Data were collected using two questionnaires: (1) a sociodemographic questionnaire and (2) a Personal Diabetes Questionnaire (PDQ). Data were analyzed using SPSS software version 22. χ 2 test was used to examine the association between the socioeconomic and disease-related variables and the prevalence of diabetes complications. T-test was used to examine the association between diet knowledge and skills, self-care barriers, and the incidence of diabetes complications. Results In this study, 76.1% of patients had at least one complication, and 30.2% had a history of hospitalization due to diabetes complications during the past year. Approximately 49% and 43% were diagnosed with high blood pressure and hyperlipidemia, respectively. Cardiovascular disease was the most common diabetes complication (15.9%) and the cause of hospitalization (11.01%) in patients with diabetes. Barriers to diet adherence, blood glucose monitoring, and exercise were significantly associated with self-reported diabetes complications (p < 0.001). Our results showed no significant association between the number of complications and diet knowledge and skills (p = 0.44). Conclusion This study indicated that the prevalence of diabetes complications was higher among patients with more barriers to self-care. In light of these findings, taking appropriate measures to reduce barriers to self-care can prevent or delay the onset of diabetes complications.
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Affiliation(s)
- Habib Jalilian
- Department of Health Services Management, School of HealthAhvaz Jundishapur University of Medical SciencesAhvazIran,Social Determinants of Health Research CenterAhvaz Jundishapur University of Medical SciencesAhvazIran
| | - Elnaz Javanshir
- Cardiovascular Research CentreTabriz University of Medical SciencesTabrizIran
| | - Leila Torkzadeh
- Department of Health Policy and Management, School of Management and Medical InformaticsTabriz University of Medical SciencesTabrizIran
| | - Saeedeh Fehresti
- Department of Health Economics and Management, School of Public HealthTehran University of Medical SciencesTehranIran
| | - Nazanin Mir
- Health Management and Economics Research CenterIran University of Medical SciencesTehranIran
| | | | - Somayeh Heydari
- Social Determinants of Health Research CenterAhvaz Jundishapur University of Medical SciencesAhvazIran
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5
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Tseng HHK, Nkimbeng M, Han HR. Gender differences in psychosocial characteristics and diabetes self-management among inner-city African Americans. Nurs Open 2022; 9:2425-2433. [PMID: 35616066 PMCID: PMC9374402 DOI: 10.1002/nop2.1259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 03/17/2022] [Accepted: 05/10/2022] [Indexed: 11/09/2022] Open
Abstract
Aims To characterize differences in psychosocial variables between inner‐city African American men and women with type 2 diabetes, and to test if the relationships between psychosocial variables and diabetes self‐management behaviours differ by gender. Design Secondary analysis. Methods We used baseline data from participants enrolled in the Prevention through Lifestyle Intervention and Numeracy 4 Success‐Diabetes study (N = 37). Differences in psychosocial variables between genders were compared using chi‐square tests. A two‐way analysis of variance was then used to compare self‐management scores by different psychosocial characteristics and gender. Results There was no statistically significant difference in psychosocial characteristics between genders. High diabetes knowledge and self‐efficacy were associated with better self‐management behaviours in African American women but not in men. In contrast, high numeracy was associated with better diabetes self‐management only in men. Low depression, high health literacy, and high social support were associated with better self‐management practices in both genders.
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Affiliation(s)
| | - Manka Nkimbeng
- School of Nursing, The Johns Hopkins University, Baltimore, Maryland, USA.,School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Hae-Ra Han
- School of Nursing, The Johns Hopkins University, Baltimore, Maryland, USA.,Center for Cardiovascular and Chronic Care, The Johns Hopkins University, Baltimore, Maryland, USA.,Center for Community Programs, Innovation and Scholarship, The Johns Hopkins University, Baltimore, Maryland, USA
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6
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Salazar-Collier CL, Reininger BM, Wilkinson AV, Kelder SH. Exploration of Fatalism and Religiosity by Gender and Varying Levels of Engagement Among Mexican-American Adults of a Type 2 Diabetes Management Program. Front Public Health 2021; 9:652202. [PMID: 34646799 PMCID: PMC8502957 DOI: 10.3389/fpubh.2021.652202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 08/30/2021] [Indexed: 11/18/2022] Open
Abstract
Objectives: Purpose of study is to explore the roles religiosity and fatalistic beliefs play in diabetes management among newly, currently, and long-term enrolled Mexican-American participants in a Type 2 diabetes mellitus (T2DM) chronic care management program. Methods: In 2017, study participants (n = 15) completed a semi-structured interview in their preferred language (English or Spanish). Sample was stratified by amount of time individual had been enrolled as a participant of the Salud y Vida program: newly, currently, or long-term. Interviews assessed religious beliefs, beliefs concerning the cause(s) of diabetes, perceived relationship between religiosity and fatalistic beliefs with T2DM management, and the appropriateness of discussing such topics with a health professional. Interview responses were analyzed using ATLAS.ti 8. Results: Themes identified included: perceived autonomy over diabetes prognosis, motivators for self-care, discussions of personal beliefs in the healthcare setting, and the church's role in diabetes management. Conclusions: Among this sample, religiosity and religious fatalism played a complex role in coping with and managing diabetes. Long-term enrolled and male participants expressed beliefs of divine control over health, and a connection between religiosity and health behavior. Long-term enrolled participants felt religious and fatalistic beliefs may be suitable and beneficial to discuss in the healthcare setting.
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Affiliation(s)
- Cindy Lynn Salazar-Collier
- Department of Public Health, College of Nursing and Health Sciences, Texas A&M International University, Laredo, TX, United States
| | - Belinda M. Reininger
- Department of Health Promotion & Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Brownsville, TX, United States
| | - Anna V. Wilkinson
- Deaprtment of Epidemiology, Human Genetics & Environmental Sciences, School of Public Health, The University of Texas Health Science at Houston, Austin, TX, United States
| | - Steven H. Kelder
- Deaprtment of Epidemiology, Human Genetics & Environmental Sciences, School of Public Health, The University of Texas Health Science at Houston, Austin, TX, United States
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Haase KR, Sattar S, Hall S, McLean B, Wills A, Gray M, Kenis C, Donison V, Howell D, Puts M. Systematic review of self-management interventions for older adults with cancer. Psychooncology 2021; 30:989-1008. [PMID: 33724608 DOI: 10.1002/pon.5649] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 01/20/2021] [Accepted: 02/01/2021] [Indexed: 12/26/2022]
Abstract
AIM The purpose of this systematic review was to determine the effectiveness of self-management interventions for older adults with cancer and to determine the effective components of said interventions. METHODS We conducted a systematic review of self-management interventions for older adults (65+) with cancer guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement. We conducted an exhaustive search of the following databases: Ageline, AMED, ASSIA, CINAHL, Cochrane, Embase, Medline, PsychINFO, and Sociological Abstracts. We assessed for quality using the Cochrane Risk of Bias tool and Down & Black for quasi-experimental studies, with data synthesized in a narrative and tabular format. RESULTS Sixteen thousand nine hundred and eight-five titles and abstracts were screened, subsequently 452 full-text papers were reviewed by two independent reviewers, of which 13 full-text papers were included in the final review. All self-management interventions included in this review measured Quality of Life; other outcomes included mood, self-care activity, supportive care needs, self-advocacy, pain intensity, and analgesic intake; only one intervention measured frailty. Effective interventions were delivered by a multidisciplinary teams (n = 4), nurses (n = 3), and mental health professionals (n = 1). Self-management core skills most commonly targeted included: problem solving; behavioural self-monitoring and tailoring; and settings goals and action planning. CONCLUSIONS Global calls to action argue for increased emphasize on self-management but presently, few interventions exist that explicitly target the self-management needs of older adults with cancer. Future work should focus on explicit pathways to support older adults and their caregivers to prepare for and engage in cancer self-management processes and behaviours.
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Affiliation(s)
- Kristen R Haase
- Faculty of Applied Science, School of Nursing, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Schroder Sattar
- College of Nursing, University of Saskatchewan, Regina, Saskatchewan, Canada
| | - Steven Hall
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Bianca McLean
- De Groote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Aria Wills
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Mikaela Gray
- Gerstein Science Information Centre, University of Toronto, Toronto, Ontario, Canada
| | - Cindy Kenis
- Department of General Medical Oncology and Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium.,Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven - University of Leuven, Leuven, Belgium
| | - Valentina Donison
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Doris Howell
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.,Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada
| | - Martine Puts
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
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8
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Anderson D, Sturt J, McDonald N, White C, Porter-Steele J, Rogers R, Temple A, Seib C, McGuire A, Tjondronegoro D, Walker R, Sapkota D. International feasibility study for the Women's Wellness with Type 2 Diabetes Programme (WWDP): An eHealth enabled 12-week intervention programme for midlife women with type 2 diabetes. Diabetes Res Clin Pract 2021; 171:108541. [PMID: 33227358 DOI: 10.1016/j.diabres.2020.108541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 10/01/2020] [Accepted: 11/06/2020] [Indexed: 10/22/2022]
Abstract
AIMS The current study aimed to examine feasibility of participant recruitment and retention rates for the Women's Wellness with Type 2 Diabetes program (WWDP), and to assess initial efficacy of the program in improving wellbeing outcomes. METHODS 70 midlife women with type 2 diabetes mellitus (T2DM) participated in a 12-week wellness-focused intervention, the WWDP. The WWDP involved a structured book (with participatory activities), an interactive website and nurse consultations. This study had an Australian and a UK arm. Analyses were conducted using chi-square, McNemar, paired t-test, and Wilcoxon signed-ranks tests. RESULTS The attrition rate for the sample was 22.2%. Overall, significant improvement was observed in diabetes distress (DD), diabetes self-efficacy, weight, BMI, menopausal symptoms and sleep symptoms from baseline to program completion at 12 weeks. Australian participants were also more likely to meet fruit recommendation guidelines and had significant waist- and hip-circumference reductions. CONCLUSIONS Good retention rates and initial efficacy findings indicated feasibility of the WWDP as a promising 12-week health and wellness program for women with T2DM. They also suggest incorporating a focus on self-efficacy and gendered information may be important in improving wellness and health outcomes related to distress and menopause.
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Affiliation(s)
- Debra Anderson
- Menzies Health Institute Queensland, Griffith University, Queensland, Australia; Faculty of Health, University of Technology Sydney, New South Wales, Australia.
| | - Jackie Sturt
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, Kings College London, United Kingdom
| | - Nicole McDonald
- Menzies Health Institute Queensland, Griffith University, Queensland, Australia
| | - Codi White
- Menzies Health Institute Queensland, Griffith University, Queensland, Australia
| | | | - Rebecca Rogers
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, Kings College London, United Kingdom
| | - Ayako Temple
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, Kings College London, United Kingdom
| | - Charrlotte Seib
- Menzies Health Institute Queensland, Griffith University, Queensland, Australia
| | - Amanda McGuire
- Menzies Health Institute Queensland, Griffith University, Queensland, Australia
| | - Dian Tjondronegoro
- Menzies Health Institute Queensland, Griffith University, Queensland, Australia
| | - Rosie Walker
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, Kings College London, United Kingdom; Successful Diabetes, Ipswich, United Kingdom
| | - Diksha Sapkota
- Menzies Health Institute Queensland, Griffith University, Queensland, Australia
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9
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Hurt TR, Francis SL, Seawell AH, Krisco MP, Flynn MH, O'Connor MC, Rudolph CS, Hill A. Revising Diabetes Programming for Black Men and Their Families. Glob Qual Nurs Res 2020; 7:2333393620960183. [PMID: 33088849 PMCID: PMC7545759 DOI: 10.1177/2333393620960183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 08/25/2020] [Accepted: 08/31/2020] [Indexed: 12/20/2022] Open
Abstract
Type-2 diabetes has increased 160% for African American males in the United States. This two-part study's purpose was to apply social marketing theory to understand the Type-2 diabetes education needs of men in Iowa. Study One was a preference assessment of Type-2 diabetes education strategies. Four African American men participated in a series of four focus groups and indicated that they were interested in diabetes prevention programming with their families but not in having it labeled as diabetes education. Participating men would rather increase their physical activity as opposed to tracking their food intake. As a follow-up to this study, nine other African American males took part in Study Two, which used cooking demonstrations and recipe taste-testing with the men to examine their relationship to food in the context of managing their Type-2 diabetes. The findings of both studies, which provided insight into these African American men's lifestyle as related to their Type-2 diabetes, could be useful for nursing professionals who have a critical role in navigating cultural, gender, and family norms while developing care plans, offering patient education, and promoting quality of life.
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Umeda E, Shimizu Y, Kawai N. Difficulties in daily life and the association with self-care ability in adults with type 1 diabetes mellitus in Japan: A cross-sectional study. Nurs Open 2020; 7:943-950. [PMID: 32587712 PMCID: PMC7308687 DOI: 10.1002/nop2.466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 01/24/2020] [Accepted: 02/16/2020] [Indexed: 11/17/2022] Open
Abstract
Aim To identify the unique contents of difficulties experienced in daily life among adult type 1 diabetes mellitus patients and to determine how basic characteristics and diabetic-related self-care agency are associated with difficulties in daily life. Methods This study used two surveys: "Difficulties in Daily Life," which was a questionnaire developed for this survey and "Instrument of Diabetes Self-Care Agency." These two measures were then used with demographic information for cross-sectional analysis. Result The final sample included 321 type 1 diabetes mellitus patients. Difficulties in daily life were composed of four factors: "Difficulties in diseases disclosure," "Difficulties accommodating diabetes into daily life," "Difficulties in employment or continuing education" and "Lack of knowledge of diabetes." The instrument of Diabetes Self-Care Agency was found to be associated with all four factors of difficulties in daily life. In addition, sex and diabetes duration were shown to be important predictors.
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Affiliation(s)
- Eiko Umeda
- Division of Health ScienceOsaka University Graduate School of MedicineSuitaJapan
| | - Yasuko Shimizu
- Division of Health ScienceOsaka University Graduate School of MedicineSuitaJapan
| | - Nobuko Kawai
- Division of Health ScienceOsaka University Graduate School of MedicineSuitaJapan
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11
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Routh B, Hurt T, Winham D, Lanningham-Foster L. Family Legacy of Diabetes-Related Behaviors: An Exploration of the Experiences of African American Parents and Adult Children. Glob Qual Nurs Res 2019; 6:2333393619852343. [PMID: 31192273 PMCID: PMC6542120 DOI: 10.1177/2333393619852343] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 04/18/2019] [Accepted: 04/29/2019] [Indexed: 12/16/2022] Open
Abstract
African Americans are at higher risk of developing type 2 diabetes mellitus (T2DM), and this risk may be influenced by familial experiences and cultural norms throughout the life course. This led us to conduct this study of 20 African American families with strong histories of T2DM to explore familial complexities that prevent or help manage diabetic symptoms. Experiences were analyzed inductively through individual family profiles created using content-analytic summaries. When profiles were further analyzed for emerging and theoretically informed data patterns, two themes emerged: (a) family interactions characterized by T2DM-related actions and communication patterns, and (b) intergenerational patterns of openness characterized by variations in approach within generational cohort and parental gender. Through inquiries related to intergenerational experiences with T2DM, nursing and health care professionals may be better able to tailor and promote success for prevention and management of behaviors among high-risk African Americans.
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Affiliation(s)
| | - Tera Hurt
- Iowa State University, Ames, Iowa, USA
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12
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Adu MD, Malabu UH, Malau-Aduli AEO, Malau-Aduli BS. Enablers and barriers to effective diabetes self-management: A multi-national investigation. PLoS One 2019; 14:e0217771. [PMID: 31166971 PMCID: PMC6550406 DOI: 10.1371/journal.pone.0217771] [Citation(s) in RCA: 141] [Impact Index Per Article: 28.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 05/19/2019] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE The study aimed to identify the common gaps in skills and self-efficacy for diabetes self-management and explore other factors which serve as enablers of, and barriers to, achieving optimal diabetes self-management. The information gathered could provide health professionals with valuable insights to achieving better health outcomes with self-management education and support for diabetes patients. METHODS International online survey and telephone interviews were conducted on adults who have type 1 or type 2 diabetes. The survey inquired about their skills and self-efficacy in diabetes self-management, while the interviews assessed other enablers of, and barriers to, diabetes self-management. Surveys were analysed using descriptive and inferential statistics. Interviews were analysed using inductive thematic analysis. RESULTS Survey participants (N = 217) had type 1 diabetes (38.2%) or type 2 diabetes (61.8%), with a mean age of 44.56 SD 11.51 and were from 4 continents (Europe, Australia, Asia, America). Identified gaps in diabetes self-management skills included the ability to: recognize and manage the impact of stress on diabetes, exercise planning to avoid hypoglycemia and interpreting blood glucose pattern levels. Self-efficacy for healthy coping with stress and adjusting medications or food intake to reach ideal blood glucose levels were minimal. Sixteen participants were interviewed. Common enablers of diabetes self-management included: (i) the will to prevent the development of diabetes complications and (ii) the use of technological devices. Issues regarding: (i) frustration due to dynamic and chronic nature of diabetes (ii) financial constraints (iii) unrealistic expectations and (iv) work and environment-related factors limited patients' effective self-management of diabetes. CONCLUSIONS Educational reinforcement using technological devices such as mobile application has been highlighted as an enabler of diabetes self-management and it could be employed as an intervention to alleviate identified gaps in diabetes self-management. Furthermore, improved approaches that address financial burden, work and environment-related factors as well as diabetes distress are essential for enhancing diabetes self-management.
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Affiliation(s)
- Mary D. Adu
- College of Medicine and Dentistry, James Cook University, Townsville, Australia
- * E-mail: ,
| | - Usman H. Malabu
- College of Medicine and Dentistry, James Cook University, Townsville, Australia
| | - Aduli E. O. Malau-Aduli
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
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13
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Milo RB, Connelly CD. Predictors of glycemic management among patients with type 2 diabetes. J Clin Nurs 2019; 28:1737-1744. [DOI: 10.1111/jocn.14779] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 10/25/2018] [Accepted: 12/05/2018] [Indexed: 02/03/2023]
Affiliation(s)
- Razel B. Milo
- Hahn School of Nursing and Health Science, Beyster Institute for Nursing Research University of San Diego San Diego California
| | - Cynthia D. Connelly
- Hahn School of Nursing and Health Science, Beyster Institute for Nursing Research University of San Diego San Diego California
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Tokunaga-Nakawatase Y, Taru C, Tsutou A, Nishigaki M, Miyawaki I. Self-management behavior concerning physical activity of Japanese type 2 diabetes patients, characterized by sex, daily energy intake and body mass index. Diabetol Int 2018; 10:206-212. [PMID: 31275787 DOI: 10.1007/s13340-018-0381-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 11/01/2018] [Indexed: 11/24/2022]
Abstract
Objectives We assess differences in physical activity self-management behavior in association with dietary intake and BMI between the sexes in patients with type 2 diabetes. Methods Patients with type 2 diabetes (n = 145) completed a self-administrated questionnaire. Patients were classified into four groups by BMI and dietary intake: non-obesity and non-overeating (NO/NOE); non-obesity and overeating (NO/OE); obesity and non-overeating (O/NOE); obesity and overeating (O/OE). Differences in physical activity self-management behavior between the four groups were determined by the analysis of variance using a Tukey-Kramer post hoc test. Results Male O/OE group showed higher HbA1c (p = 0.001) than the other groups. Male NO/OE group had higher steps/day than O/NOE (p = 0.036) and score of "Exercising to stimulate the enjoyment of eating" was higher than O/OE (p = 0.031). Female NO/OE group showed higher HbA1c (p = 0.001) than NO/NOE and O/NOE. Conclusions BMI and dietary intake were associated with frequencies of physical activity self-management strategies in men. Self-management behavior peculiar to male NO/OE group is "Exercising to stimulate the enjoyment of eating". Health professionals should assess sex, BMI, and dietary intake of patients and endeavor to improve individuals' ability to regulate their caloric balance based on physical activity level.
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Affiliation(s)
- Yuri Tokunaga-Nakawatase
- 1Department of Adult Nursing, Nursing Course, School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-Ku, Yokohama, 236-0004 Japan.,2Division of Development Sciences for Practical Nursing, Department of Nursing, Faculty of Health Sciences, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, 654-0142 Japan
| | - Chiemi Taru
- 2Division of Development Sciences for Practical Nursing, Department of Nursing, Faculty of Health Sciences, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, 654-0142 Japan
| | - Akimitsu Tsutou
- 3Division of Preventive Health Science, Department of Community Health Sciences, Faculty of Health Sciences, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, 654-0142 Japan
| | - Masakazu Nishigaki
- 4Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8397 Japan
| | - Ikuko Miyawaki
- 2Division of Development Sciences for Practical Nursing, Department of Nursing, Faculty of Health Sciences, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, 654-0142 Japan
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Choi SA, Hastings JF. Religion, spirituality, coping, and resilience among African Americans with diabetes. JOURNAL OF RELIGION & SPIRITUALITY IN SOCIAL WORK 2018; 38:93-114. [PMID: 31607831 PMCID: PMC6788765 DOI: 10.1080/15426432.2018.1524735] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 09/13/2018] [Indexed: 05/28/2023]
Abstract
Study aims were to explore how religion and spirituality impacted attitudes about self-management practices among African Americans with homelessness histories and to understand resilience in diabetes care practices. Qualitative semi-structured face-to-face interviews were conducted with 42 African Americans older than 18 years. All audio-taped interviews lasted between 1-1.5 hr, transcribed verbatim, and analyzed using ATLAS.ti (version 7.0). Five resilience themes emerged. While participants recognized diabetes as an illness requiring professional treatment, the context of balancing treatment with religion and spiritual practices mattered. The study findings highlight the importance of spirituality, religious beliefs, and coping strategies in diabetes self-care activities.
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Affiliation(s)
- Sung Ah Choi
- School of Social Welfare, University at Albany, SUNY, Albany, New York, USA
| | - Julia F. Hastings
- School of Social Welfare, University at Albany, SUNY, Albany, New York, USA
- School of Public Health, Health Policy, Management, & Behavior University at Albany, SUNY, Rensselaer, New York, USA
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Schmidt-Busby J, Wiles J, Exeter D, Kenealy T. Understanding 'context' in the self-management of type 2 diabetes with comorbidities: A systematic review and realist evaluation. Diabetes Res Clin Pract 2018; 142:321-334. [PMID: 29902543 DOI: 10.1016/j.diabres.2018.06.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 05/14/2018] [Accepted: 06/06/2018] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To identify contextual factors that affect self-management of diabetes with comorbidities, and to evaluate in what way these factors affect self-management effectiveness. METHODS A systematic review of literature considered English language articles published within Medline, PsycINFO, Pubmed, CINAHL Plus, and Scopus databases that focussed on individuals' experiences of type 2 diabetes from primary intervention or observational studies. A realist evaluation approach was used to analyse themes identified within the literature. Context-mechanism-outcome theories were constructed to identify underlying contextual factors and to construct a model illustrating diabetes self-management effectiveness. RESULTS Of 1519 articles identified, 30 met inclusion criteria. Adherence was found to be the common mechanism that (within given contexts) determined self-management effectiveness. Limited financial resources were identified as the key context. Our model makes explicit a structural weaknesses of diabetes self-management. CONCLUSIONS Coping with diabetes in the context of people's lives requires attention to issues that are often outside the remit of the person with diabetes, the health care team, and the health system within which self-management is located. Realist evaluations illuminate programme mechanisms and fine-tune context. They aid initial understandings of how an intervention or programme is thought to work, in order to influence and (re)design (new) programmes.
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Affiliation(s)
- Jacqueline Schmidt-Busby
- Counties Manukau Health, Middlemore Hospital, Auckland, New Zealand; School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, New Zealand.
| | - Janine Wiles
- School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, New Zealand.
| | - Daniel Exeter
- School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, New Zealand.
| | - Timothy Kenealy
- School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, New Zealand.
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Hurt TR, Seawell AH, Cutrona C, O'Connor MC, Camp RD, Duran R, Elderts R, Green C, Hara V, Pattee J. Black Women's Recommendations for Developing Effective Type 2 Diabetes Programming. Glob Qual Nurs Res 2017; 4:2333393617715335. [PMID: 28804746 PMCID: PMC5484429 DOI: 10.1177/2333393617715335] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 05/13/2017] [Accepted: 05/22/2017] [Indexed: 01/28/2023] Open
Abstract
The purpose of this study was to learn from 29 Black women how to develop effective Type 2 diabetes programming. Three focus groups were held in Des Moines, Iowa, during fall 2012. Results highlighted themes related to diabetes knowledge, diabetes management and prevention, physical activity, diet, and diabetes management programming. Opinions were shared as to whether family members should be included in programs for supporting those diagnosed with diabetes. These results provided guidance and ideas to scholars and health care professionals aiming to improve effectiveness of diabetes programs for Black women and families.
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18
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Miller ST, Akohoue SA. Two-year follow-up study of a group-based diabetes medical nutrition therapy and motivational interviewing intervention among African American women. PATIENT-RELATED OUTCOME MEASURES 2017; 8:57-61. [PMID: 28450793 PMCID: PMC5399984 DOI: 10.2147/prom.s125884] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To assess the 2-year efficacy of a combined medical nutrition therapy and motivational interviewing (MI) pilot study intervention and factors that influenced long-term dietary self-care. RESEARCH DESIGN AND METHODS Pilot study participants, African American women with type 2 diabetes, completed a 2-year follow-up study visit, including clinical assessments and completion of a dietary self-care questionnaire and a semi-structured interview. Wilcoxon signed-rank tests were used to evaluate differences between baseline and 2-year follow-up clinical and dietary self-care outcomes. Hierarchical coding was used to analyze semi-structured interviews and categorize facilitator and barrier themes into subthemes. Subthemes were quantified based on the number of subtheme-related comments. RESULTS Among the 12 participants (mean age 57.1±5.7 years), improvements were observed for HbA1c (baseline: 10.25%; interquartile range [IQR]: 8.10, 11.72 and follow-up: 8.8%; IQR: 7.48,10.22), systolic blood pressure (baseline: 142 mm Hg; IQR: 134.25, 157.25 and follow-up: 127 mm Hg; IQR: 113.5, 143.25), frequency of eating high-fat foods (baseline: 3.5 days; IQR: 2.75, 4.25 and follow-up: 3 days; IQR: 2.5, 4.5), and of spacing carbohydrates throughout the day (baseline: 3 days; IQR: 3.0, 4.0 and follow-up: 4 days; IQR: 1.5, 4.5). There was a statistically significant decrease (p=0.04) in the frequency of fruit and vegetable intake (baseline: 4 days; IQR: 3.75, 7.0 and follow-up: 3.5 days; IQR: 2.75, 4.0). Dietary self-care barriers and facilitators included internal (eg, motivation) and external factors (eg, social support). Motivation (70 comments) and lack of motivation (67 comments) were the most pervasive facilitator and barrier subthemes, respectively. CONCLUSION Overall, diabetes-related clinical and dietary self-care outcomes were improved following a combined medical nutritional therapy/MI intervention, and motivation played an important role in dietary self-care engagement. Future research is needed to assess the added benefit of MI in improving clinical and dietary self-care outcomes and to identify best strategies to support post-intervention dietary self-care engagement.
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Affiliation(s)
| | - Sylvie A Akohoue
- Department of Family and Community Medicine, Meharry Medical College, Nashville, TN, USA
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Lee LT, Bowen PG, Mosley MK, Turner CC. Theory of Planned Behavior: Social Support and Diabetes Self-Management. J Nurse Pract 2017. [DOI: 10.1016/j.nurpra.2016.07.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Chlebowy DO, Coty MB, Fu L, Hines-Martin V. Comorbid Diabetes and Depression in African Americans: Implications for the Health Care Provider. J Racial Ethn Health Disparities 2017; 5:111-116. [PMID: 28281178 DOI: 10.1007/s40615-017-0349-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 01/30/2017] [Accepted: 02/06/2017] [Indexed: 10/20/2022]
Abstract
Health care providers (HCPs) face many obstacles as they undertake efforts to meet the challenges of caring for African American patients with comorbid diabetes and depression. This review article discusses the incidence of comorbid diabetes and depression in African Americans, cultural factors affecting diabetes self-management, and clinical practice implications for the HCP. The role of patient-centered care, engagement, and best-practice strategies are discussed to provide the HCP with guidelines regarding the minimal standards that support improved health care outcomes for African Americans with comorbid diabetes and depression.
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Affiliation(s)
| | - Mary-Beth Coty
- University of Louisville School of Nursing, Louisville, KY, USA
| | - Liyan Fu
- Wenzhou Medical University School of Nursing, Wenzhou, Zhejiang, China
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21
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Campesi I, Franconi F, Seghieri G, Meloni M. Sex-gender-related therapeutic approaches for cardiovascular complications associated with diabetes. Pharmacol Res 2017; 119:195-207. [PMID: 28189784 DOI: 10.1016/j.phrs.2017.01.023] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 12/14/2016] [Accepted: 01/23/2017] [Indexed: 12/14/2022]
Abstract
Diabetes is a chronic disease associated with micro- and macrovascular complications and is a well-established risk factor for cardiovascular disease. Cardiovascular complications associated with diabetes are among the most important causes of death in diabetic patients. Interestingly, several sex-gender differences have been reported to significantly impact in the pathophysiology of diabetes. In particular, sex-gender differences have been reported to affect diabetes epidemiology, risk factors, as well as cardiovascular complications associated with diabetes. This suggests that different therapeutic approaches are needed for managing diabetes-associated cardiovascular complications in men and women. In this review, we will discuss about the sex-gender differences that are known to impact on diabetes, mainly focusing on the cardiovascular complications associated with the disease. We will then discuss the therapeutic approaches for managing diabetes-associated cardiovascular complications and how differences in sex-gender can influence the existing therapeutic approaches.
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Affiliation(s)
- Ilaria Campesi
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy.
| | - Flavia Franconi
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy; Dipartimento Politiche della Persona, Regione Basilicata, Italy.
| | | | - Marco Meloni
- BHF Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, UK.
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22
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Lee LT, Willig AL, Agne AA, Locher JL, Cherrington AL. Challenges to Healthy Eating Practices: A Qualitative Study of Non-Hispanic Black Men Living With Diabetes. DIABETES EDUCATOR 2016; 42:325-35. [PMID: 27036128 DOI: 10.1177/0145721716640904] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE The purpose of this study was to explore current dietary practices and perceived barriers to healthy eating in non-Hispanic black men with type 2 diabetes. METHODS Four 90-minute focus groups held in September and October 2011 were led by a trained moderator with a written guide to facilitate discussion on dietary practices and barriers to healthy eating. Participants were recruited from the diabetes database at a public safety-net health system in Jefferson County, Alabama. Two-independent reviewers performed content analysis to identify major themes using a combined deductive and inductive approach. RESULTS There were 34 male participants aged 18 years and older. Mean years living with diabetes was 9.6 ± 5.9. Sixty-two percent of participants perceived themselves to be in fair or poor health. Participants' self-reported eating practices did not always relate to hunger. Internal cues to eat included habit and response to emotions, and external cues to eat included media messaging, medication regimens, and work schedules. Men identified multiple barriers to healthy eating including hard-to-break habits, limited resources and availability of food at home and in neighborhood grocery stores, and perceived poor communication with health care professionals. CONCLUSION Non-Hispanic black men acknowledged the importance of healthy eating as part of diabetes self-management but reported various internal and external challenges that present barriers to healthy eating. Tailored strategies to overcome barriers to healthy eating among non-Hispanic black men should be developed and tested for their impact on diabetes self-management.
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Affiliation(s)
- Loretta T Lee
- School of Nursing, Acute, Chronic, and Continuing Care, University of Alabama at Birmingham (Dr Lee)
| | - Amanda L Willig
- Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham (Dr Willig)
| | - April A Agne
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham (Ms Agne, Dr Cherrington)
| | - Julie L Locher
- School of Public Health, Department of Health Care Organization and Policy, University of Alabama at Birmingham (Dr Locher)
| | - Andrea L Cherrington
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham (Ms Agne, Dr Cherrington)
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Snyder H, Engström J. The antecedents, forms and consequences of patient involvement: A narrative review of the literature. Int J Nurs Stud 2016; 53:351-78. [DOI: 10.1016/j.ijnurstu.2015.09.008] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 09/01/2015] [Accepted: 09/09/2015] [Indexed: 12/19/2022]
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Hurt TR, Seawell AH, O'Connor MC. Developing Effective Diabetes Programming for Black Men. Glob Qual Nurs Res 2015; 2:2333393615610576. [PMID: 28462319 PMCID: PMC5342290 DOI: 10.1177/2333393615610576] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Revised: 08/29/2015] [Accepted: 09/04/2015] [Indexed: 12/18/2022] Open
Abstract
The purpose of this study is to obtain feedback from 20 men on developing effective programming to reduce the impact of diabetes (t2dm) among Black men. Three focus groups were convened in Des Moines, Iowa. Men were recruited, all either diagnosed with t2dm (n = 10), pre-diabetic (n = 1), or experienced t2dm through family and friends (n = 9). The results highlighted themes related to t2dm knowledge, masculinity, and behavioral health; gender-centered diabetes management education; and family support and functioning. Men provided recommendations for program format and content, desirable facilitator characteristics, and whether to include spouses/partners, relatives, and friends. These results provide guidance and ideas to nurses wishing to enhance t2dm education and patient outcomes for Black men.
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25
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Mondesir FL, White K, Liese AD, McLain AC. Gender, Illness-Related Diabetes Social Support, and Glycemic Control Among Middle-Aged and Older Adults. J Gerontol B Psychol Sci Soc Sci 2015; 71:1081-1088. [PMID: 26307487 DOI: 10.1093/geronb/gbv061] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 06/13/2015] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES This study examined whether the association between illness-related diabetes social support (IRDSS) and glycemic control among middle-aged and older adults is different for men and women. METHOD This cross-sectional analysis included 914 adults with diabetes who completed the Health and Retirement Study's 2003 Mail Survey on Diabetes. IRDSS is a composite score of 8 diabetes self-care measures. Hemoglobin A1c levels were obtained to measure good glycemic control (<8.0%). Gender-stratified multivariate log-binomial regression models were used to estimate prevalence ratios and examine the association between IRDSS and glycemic control after controlling for sociodemographic, lifestyle, and clinical characteristics. RESULTS The prevalence of good glycemic control was 48.9% among women and 51.1% among men. Mean composite IRDSS scores did not differ by gender. Among women, composite IRDSS was associated with adequate glycemic control (prevalence ratio: 1.06; 95% confidence interval: 1.02, 1.08), and all individual components of IRDSS, with the exception of keeping appointments, were positively associated with adequate glycemic control. No significant associations were observed in men for composite or individual components of IRDSS. DISCUSSION Determining the gender-specific impact derived from IRDSS is a worthwhile approach to highlighting factors that differentially predict optimal glycemic control among middle-aged and older adults.
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Affiliation(s)
- Favel L Mondesir
- Department of Epidemiology, The University of Alabama at Birmingham
| | - Kellee White
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia.
| | - Angela D Liese
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia
| | - Alexander C McLain
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia
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Carthron DL, Bailey DE, Anderson RA. The "invisible caregiver": multicaregiving among diabetic African-American grandmothers. Geriatr Nurs 2015; 35:S32-6. [PMID: 24702718 DOI: 10.1016/j.gerinurse.2014.02.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE To explore the multicaregiving roles African-American grandmothers assume while self-managing their diabetes. DESIGN & METHODS This longitudinal, qualitative pilot study explored the challenges of self-managing diabetes among six African-American caregiving grandmothers. Data were collected at 5 times points across 18 months. Content analysis, guided by the Adaptive Leadership framework, was conducted using data matrices to facilitate within-case and cross-case analyses. RESULTS Although participants initially stated they cared only for grandchildren, all had additional caregiving responsibilities. Four themes emerged which illustrated how African-American caregiving grandmothers put the care of dependent children, extended family and community before themselves. Using the Adaptive Leadership framework, technical and adaptive challenges arising from multicaregiving were described as barriers to diabetes self-management. IMPLICATIONS When assisting these women to self-manage their diabetes, clinicians must assess challenges arising from multicaregiving. This might require developing collaborative work relationships with the client to develop meaningful and attainable goals.
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Affiliation(s)
- Dana L Carthron
- Department of Social Medicine University of North Carolina, Chapel Hill, NC, USA.
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Choi JS, Kim BH, Chang SJ. Gender-Specific Factors Influencing Diabetes Self-Care Behaviors and Health-Related Quality of Life Among Older Adults With Type 2 Diabetes in South Korea. Res Gerontol Nurs 2015; 8:231-9. [PMID: 25893724 DOI: 10.3928/19404921-20150331-01] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 01/15/2015] [Indexed: 11/20/2022]
Abstract
The purpose of the current study was to identify gender-specific factors influencing diabetes self-care behaviors and health-related quality of life among older adults with type 2 diabetes in South Korea. This is a secondary analysis using data from 278 older adults (77 women, 201 men) with type 2 diabetes. An independent t test and hierarchical multiple regression analyses were used to analyze the data. No significant mean differences in diabetes self-care behaviors and health-related quality of life were observed according to gender. Regarding predictors by gender, the number of diabetes-related complications was a unique predictor of diabetes self-care behaviors in older men, whereas duration of diabetes and barriers were unique predictors in older women. Depression was a significant common predictor of health-related quality of life in older men and women. Nurses should be aware of and consider gender specificity when developing intervention programs for promoting self-care behaviors and health-related quality of life.
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Crabtree K, Sherrer N, Rushton T, Willig A, Agne A, Shelton T, Cherrington A. Diabetes connect: African American men's preferences for a community-based diabetes management program. DIABETES EDUCATOR 2014; 41:118-26. [PMID: 25367259 DOI: 10.1177/0145721714557043] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of the study is to explore African American men's perceptions of how community-based, community-health worker (CHW)-delivered diabetes interventions might best be implemented. METHODS Four 90-minute focus groups were guided by a trained moderator with a written guide to facilitate discussion on the topic of diabetes management and preferences for community-based programs. Participants were recruited from the diabetes education database at a safety-net health system in Jefferson County, AL. Two independent reviewers performed content analysis to identify major themes using an iterative, combined deductive and inductive approach. RESULTS There were 25 male participants. Mean years living with diabetes was 9.6 (range, 1-20). Participants demonstrated knowledge of self-management strategies and identified various hardships including emotional and physical manifestations of diabetes, dietary restrictions, and institutional frustrations with the health system that contributed to self-management barriers. Their preferred CHW responsibilities were to educate, hold support groups, help track daily activities, and help find resources. Potential concerns included the need for confidentiality and fears of being stereotyped. CONCLUSIONS Participants identified critical self-management strategies but endure hardships that present barriers to daily diabetes management. Preferences for community-based programs and suggested CHW responsibilities could help to overcome many of those barriers by increasing access and providing support.
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Affiliation(s)
- Krysia Crabtree
- Eastern Virginia Medical School, Norfolk, Virginia (Ms Crabtree)
| | - Nathan Sherrer
- School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama (Mr Sherrer)
| | | | - Amanda Willig
- Division of Infectious Diseases, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama (Dr Willig)
| | - April Agne
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama (Ms Agne, Dr Cherrington)
| | - Tanya Shelton
- Cooper Green Mercy Health System, Birmingham, Alabama (Mrs Shelton)
| | - Andrea Cherrington
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama (Ms Agne, Dr Cherrington)
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Chesla CA, Kwan CML, Chun KM, Stryker L. Gender differences in factors related to diabetes management in Chinese American immigrants. West J Nurs Res 2014; 36:1074-90. [PMID: 24558055 DOI: 10.1177/0193945914522718] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Chinese American women with type 2 diabetes (T2DM) are more vulnerable to poor diabetes outcomes than men because immigrant status, ethnicity, and economics intersect with gender to diminish disease management opportunities. We explored gender differences in factors associated with diabetes management at intake and after treatment with a behavioral intervention in first-generation Chinese American immigrants. A sample of 178 Chinese Americans with T2DM was enrolled in a single-cohort, repeated-measures delayed-treatment trial. Data were collected at baseline, 8, 16, 24, and 32 weeks with 6-week treatment provided after 16 weeks. Gender differences at baseline and gender by treatment interactions were noted. Women at baseline reported significantly worse depressive symptoms and general health. Significant gender by treatment interactions were observed for diabetes self-efficacy, bicultural efficacy, family instrumental support, and diabetes quality of life-satisfaction. Only women showed improvement, suggesting women benefited more from the intervention in psychosocial factors related to diabetes management.
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