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Ling I, Zambrana RE, Echeverria S, López L. Peer Support to Enhance Type 2 Diabetes Prevention Among African American and Latino Adults. Endocrinol Metab Clin North Am 2023; 52:573-583. [PMID: 37865474 DOI: 10.1016/j.ecl.2023.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2023]
Abstract
Social support occurs within complex social networks that are diffusely embedded within the social determinants of health. Social networks operate through five primary interconnected pathways: (1) provision of social support; (2) social influence; (3) social engagement; (4) social capital; and (5) social cohesion. Research has demonstrated that increased social support can have a beneficial impact on Type 2 Diabetes (T2DM) prevention and outcomes through culturally tailored Diabetes Prevention Programs in minority communities. Further research is needed to fully measure the impact of social network peer support on T2DM outcomes to better operationalize and scale up community specific interventions.
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Affiliation(s)
- Irving Ling
- Kaiser Permanente Northern California, 2425 Geary Boulevard, San Francisco, CA 94115, USA
| | - Ruth Enid Zambrana
- Harriet Tubman Department of Women, Gender and Sexuality Studies, University of Maryland, Consortium on Race, Gender and Ethnicity, Susquehanna Hall, 4200 Lehigh Road Room 4117, College Park, MD 20742, USA
| | - Sandra Echeverria
- Department of Public Health Education, 437 Coleman Building, 1408 Walker Avenue, Greensboro, NC 27412, USA
| | - Lenny López
- University of California San Francisco, San Francisco VA Medical Center, 4150 Clement Street, San Francisco, CA 94121, USA.
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2
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Amaslidou A, Ierodiakonou-Benou I, Bakirtzis C, Nikolaidis I, Tatsi T, Grigoriadis N, Nimatoudis I. Multiple sclerosis and mental health related quality of life: The role of defense mechanisms, defense styles and family environment. AIMS Neurosci 2023; 10:354-375. [PMID: 38188008 PMCID: PMC10767059 DOI: 10.3934/neuroscience.2023027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 11/13/2023] [Accepted: 11/21/2023] [Indexed: 01/09/2024] Open
Abstract
Background Multiple sclerosis is a demyelinating chronic neurologic disease that can lead to disability and thus to deterioration of quality of life. Psychological parameters such as ego defense mechanisms, defense styles and family environment are important factors in the adaptation process, and as such they can play important roles in QoL. This study aims to assess the psychological factors as well as the clinical and demographic characteristics related to mental health quality of life (MHQoL). Methods This was an observational, cross-sectional study conducted in a sample of 90 people with MS in the years 2018-2020. All participants completed the following questionnaires: MSQoL-54, DSQ-88, LSI, FES-R, SOC, BDI-II, STAI. Disability was assessed using EDSS. Results In multiple linear regression, significant roles were played by depression (R2: 41.1%, p: 0.001) and, to a lesser extent, the event of a relapse (R2: 3.5%, p: 0.005), expressiveness (R2: 3.6%, p < 0.05) and image distortion style (R2: 4.5%, p: 0.032). After performing a hierarchical-stepwise analysis (excluding depression), the important factors were maladaptive defense style (R2: 23.7%, p: 0.002), the event of relapse (R2: 8.1%, p < 0.001), expressiveness (R2: 5.5%, p: 0.004) and self-sacrificing defense style (R2: 2.4%, p: 0.071). Conclusion Psychological factors play important roles in MHQoL of people with multiple sclerosis. Thus, neurologists should integrate in their practice an assessment by mental health specialists. Moreover, targeted psychotherapeutic interventions could be planned i to improve QoL.
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Affiliation(s)
- Anthi Amaslidou
- 3 Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Ioanna Ierodiakonou-Benou
- 3 Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Christos Bakirtzis
- 2 Department of Neurology, MS Center, School of Medicine, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Ioannis Nikolaidis
- 2 Department of Neurology, MS Center, School of Medicine, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Theano Tatsi
- 2 Department of Neurology, MS Center, School of Medicine, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Nikolaos Grigoriadis
- 2 Department of Neurology, MS Center, School of Medicine, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Ioannis Nimatoudis
- 3 Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
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Zwane J, Modjadji P, Madiba S, Moropeng L, Mokgalaboni K, Mphekgwana PM, Kengne AP, Mchiza ZJR. Self-Management of Diabetes and Associated Factors among Patients Seeking Chronic Care in Tshwane, South Africa: A Facility-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105887. [PMID: 37239611 DOI: 10.3390/ijerph20105887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/13/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023]
Abstract
The burden of diabetes continues to increase in South Africa and a significant number of diabetes patients present at public primary healthcare facilities with uncontrolled glucose. We conducted a facility-based cross-sectional study to determine the diabetes self-management practices and associated factors among out-patients in Tshwane, South Africa. An adapted validated questionnaire was used to collect data on sociodemography, diabetes knowledge, and summaries of diabetes self-management activities measured in the previous seven days, and over the last eight weeks. Data were analysed using STATA 17. A final sample of 402 diabetes out-patients was obtained (mean age: 43 ± 12 years) and over half of them were living in poor households. The mean total diabetes self-management of score was 41.5 ± 8.2, with a range of 21 to 71. Almost two thirds of patients had average self-management of diabetes, and 55% had average diabetes knowledge. Twenty-two percent of patients had uncontrolled glucose, hypertension (24%) was the common comorbidity, and diabetic neuropathy (22%) was the most common complication. Sex [male: AOR = 0.55, 95% CI: 0.34-0.90], race [Coloured: AOR = 2.84, 95% CI: 1.69-4.77 and White: AOR = 3.84, 95% CI: 1.46-10.1], marital status [divorced: AOR = 3.41, 95% CI: 1.13-10.29], social support [average: AOR = 2.51, 95% CI: 1.05-6.00 and good: AOR = 4.49, 95% CI: 1.61-7.57], body mass index [obesity: AOR = 0.31, 95% CI: 0.10-0.95], diabetes knowledge [average: AOR = 0.58, 95% CI: 0.33-0.10 and good: AOR = 1.86, 95% CI: 0.71-4.91], and uncontrolled glucose [AOR = 2.97, 95% CI: 1.47-5.98] were factors independently predictive of diabetes self-management. This study emphasizes that the self-management of diabetes was mostly on average among patients and was associated with the aforementioned factors. Innovative approaches are perhaps needed to make diabetes education more effective. Face-to-face sessions delivered generally during clinic visits should be better tailored to the individual circumstances of diabetes patients. Considerations should be given to the options of leveraging information technology to ensure the continuity of diabetes education beyond clinic visits. Additional effort is also needed to meet the self-care needs of all patients.
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Affiliation(s)
- Janke Zwane
- Department of Public Health, School of Health Care Sciences, Sefako Makgatho Health Sciences University, 1 Molotlegi Street, Ga-Rankuwa 0208, South Africa
| | - Perpetua Modjadji
- Department of Public Health, School of Health Care Sciences, Sefako Makgatho Health Sciences University, 1 Molotlegi Street, Ga-Rankuwa 0208, South Africa
- Non-Communicable Disease Research Unit, South African Medical Research Council, Tygerberg 7505, South Africa
| | - Sphiwe Madiba
- Faculty of Health Sciences, University of Limpopo, Polokwane 0700, South Africa
| | - Lucky Moropeng
- Faculty of Health Sciences, School of Health Systems and Public Health Care Sciences, University of Pretoria, 31 Bophelo Road, Gezina 0031, South Africa
| | - Kabelo Mokgalaboni
- Department of Life and Consumer Sciences, College of Agriculture and Environmental Sciences, University of South Africa, Florida 1710, South Africa
| | - Peter Modupi Mphekgwana
- Research Administration and Development, University of Limpopo, Polokwane 0700, South Africa
| | - Andre Pascal Kengne
- Non-Communicable Disease Research Unit, South African Medical Research Council, Tygerberg 7505, South Africa
| | - Zandile June-Rose Mchiza
- Non-Communicable Disease Research Unit, South African Medical Research Council, Tygerberg 7505, South Africa
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4
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Setyoadi S, Yusuf A, Kristianingrum ND, Hayati YS, Noviyanti LW, Syafiky NF. The correlation between family support and health status in patients with diabetes mellitus. HEALTHCARE IN LOW-RESOURCE SETTINGS 2023. [DOI: 10.4081/hls.2023.11212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
Introduction: The health status of a patient is strongly influenced by the family members because they play an important role during the health care process, and in healthy living. This implies that they must be involved in decision-making and therapeutic actions at every stage of the treatment. Therefore, this study aims to determine the relationship between family support and the health status of diabetes mellitus patients in Malang.
Design and Methods: This study used a descriptive correlational design with a cross-sectional approach, which was carried out by filling questionnaires to determine the relationship between family support and the health status of diabetes mellitus patients. The sample population consists of 327 diabetes mellitus patients and 327 family caregivers of patients with the disease. Meanwhile, the respondents were selected through a cluster random sampling technique.
Results: The results showed that 62.7% of the caregivers provided a good family support, while 90.8% of the patients have a good health status. This indicates that there is a positive correlation between family support and the health status of people with the disease (p-value= 0,000, α<0.05, r= 0,400).
Conclusions: Further studies are advised to explore the use of nursing interventions as an effort to maintain and improve the ability of families in providing long-term care for members with diabetes mellitus.
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Shiyanbola OO, Rao D, Kuehl S, Bolt D, Ward E, Brown C. Psychometric evaluation of a culturally adapted illness perception questionnaire for African Americans with type 2 diabetes. BMC Public Health 2022; 22:741. [PMID: 35418064 PMCID: PMC9007270 DOI: 10.1186/s12889-022-13172-2] [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: 08/14/2021] [Accepted: 03/31/2022] [Indexed: 11/29/2022] Open
Abstract
Background Diabetes is burdensome to African Americans, who are twice as likely to be diagnosed, more likely to develop complications and are at a greater risk for death and disability than non-Hispanic whites. Medication adherence interventions are sometimes ineffective for African Americans because their unique illness perceptions are not adequately addressed. The Illness Perception Questionnaire-Revised (IPQ-R) that assesses illness perceptions has shown reliability and validity problems when used with African Americans. Thus, the study objective was to adapt the IPQ-R for African Americans and assess the validity and reliability of the culturally adapted questionnaire. Methods The parent study used an exploratory sequential mixed methods design, to explore African Americans’ illness perceptions qualitatively, used the results to adapt the IPQ-R, and tested the culturally adapted IPQ-R items quantitatively. In this paper, a preliminary culturally adapted IPQ-R refined based on the qualitative study, was administered to 170 middle-aged United States-based African Americans with type 2 diabetes in a face-to-face survey. Content, construct, convergent, and predictive validity, including reliability was examined. Pearson and item-total correlations, item analysis, exploratory factor analysis, multiple linear regression analysis, and test-retest were conducted. Results A revised culturally adapted IPQ-R was identified with a 9-factor structure and was distinct from the old factor structure of the original IPQ-R. The ‘consequences’ domain from the IPQ-R occurred as two factors (external and internal consequences) while the ‘emotional representations’ domain in the IPQ-R emerged as separate ‘present’ and ‘future’ emotional representation factors. Illness coherence’ was differently conceptualized as ‘illness interpretations’ to capture additional culturally adapted items within this domain. Most items had factor loadings greater than 0.4, with moderate factor score correlations. Necessity and concern beliefs in medicines significantly correlated with domains of the culturally adapted IPQ-R. Pearson’s correlation values were not greater than 0.7, indicating good convergent validity. The culturally adapted IPQ-R significantly predicted medication adherence. None of the correlation values were higher than 0.7 for the test-retest, indicating moderate reliability. Most domains of the culturally adapted IPQ-R had Cronbach’s alpha values higher than 0.7, indicating good internal consistency. Conclusions The results provide preliminary support for the validity of the culturally adapted IPQ-R in African Americans with diabetes, showing good construct, convergent and predictive validity, as well as reliability. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13172-2.
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Affiliation(s)
- Olayinka O Shiyanbola
- Division of Social and Administrative Sciences, School of Pharmacy, University of Wisconsin-Madison, 777 Highland Avenue, Madison, WI, 53705, USA.
| | - Deepika Rao
- Division of Social and Administrative Sciences, School of Pharmacy, University of Wisconsin-Madison, 777 Highland Avenue, Madison, WI, 53705, USA
| | - Sierra Kuehl
- Division of Social and Administrative Sciences, School of Pharmacy, University of Wisconsin-Madison, 777 Highland Avenue, Madison, WI, 53705, USA
| | - Daniel Bolt
- Department of Educational Psychology, University of Wisconsin-Madison, Madison, WI, USA
| | - Earlise Ward
- Department of Nursing, University of Wisconsin-Madison, Madison, WI, USA
| | - Carolyn Brown
- Division of Health Outcomes and Pharmacy Practice, University of Texas- Austin, Austin, TX, USA
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Basinger ED, Hartsell H. Communal Coping and Self-Care in Black and White Individuals Living with Type 2 Diabetes. HEALTH COMMUNICATION 2021; 36:1961-1969. [PMID: 32844697 DOI: 10.1080/10410236.2020.1808408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Type 2 diabetes mellitus is both prevalent and profoundly impactful, and how people cope with the illness is related to a variety of individual and relational outcomes. The goal of this investigation was to test the logic of the recently extended Theoretical Model of Communal Coping (TMCC), a communication theory that argues that race (in this study, Black and White) moderates the relationship between communal coping and disease-related outcomes (i.e., glucose, diet, and exercise self-care). In general, survey data from 348 participants (n = 224 Black participants, n = 124 White participants) revealed that although communal coping was directly and positively related to self-care, the relationship between communal coping and self-care was stronger for Black participants than White participants. The results of the study have implications for the TMCC and for researchers, families managing type 2 diabetes, and healthcare practitioners.
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Affiliation(s)
- Erin D Basinger
- Department of Communication Studies, University of North Carolina at Charlotte
| | - Haley Hartsell
- Department of Communication Studies, University of North Carolina at Charlotte
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7
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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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8
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Wang X, Parameswaran S, Bagul DM, Kishore R. Can online social support be detrimental in stigmatized chronic diseases? A quadratic model of the effects of informational and emotional support on self-care behavior of HIV patients. J Am Med Inform Assoc 2019; 25:931-944. [PMID: 29684190 DOI: 10.1093/jamia/ocy012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 02/01/2018] [Indexed: 11/14/2022] Open
Abstract
Objective We studied the impact of online social support on patient self-care behavior in an online health community for human immunodeficiency virus (HIV) patients. We conceptualized emotional and informational support provided by community members into nuanced sub-dimensions. We explored how the direct and interaction effects of these sub-dimensions impact the self-care behavior of a support seeker. Methods We used data from 330 255 posts in 30 050 threads from POZ, an online health community for HIV patients. Our key variables-self-care behaviori, objective informationj, experiential supportj, and emotional tonej-were operationalized using linguistic analysis with self-generated dictionaries and Python libraries. We tested our hypotheses using Tobit regression. Results Out of 6 null hypotheses, 5 were rejected. Objective information and emotional tone had an inverted-U relationship with self-care behavior. Experiential information and community involvement were positively related to self-care behavior. Community involvement amplified the inverted-U relationship between emotional tone and self-care behavior. No significant interaction effect was found between experiential support and objective information. Conclusions Beyond a threshold, both informational and emotional online social support had a deleterious impact on self-care behavior of HIV patients. Our results suggested that caution should be exercised in the use of online health community interventions for HIV patients, and perhaps patients with other stigmatized chronic diseases.
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Affiliation(s)
- Xunyi Wang
- Department of Management Science and Systems, State University of New York at Buffalo, Buffalo, NY 14260-4000, USA
| | - Srikanth Parameswaran
- Department of Management Science and Systems, State University of New York at Buffalo, Buffalo, NY 14260-4000, USA
| | - Darshan Mahendra Bagul
- Department of Computer Science and Engineering, State University of New York at Buffalo, Buffalo, NY 14260-4000, USA
| | - Rajiv Kishore
- Department of Management Science and Systems, State University of New York at Buffalo, Buffalo, NY 14260-4000, USA
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Badriah S, Sahar J, Gunawijaya J, Prasetyo S. Pampering older people with diabetes in Sundanese culture: A qualitative study. ENFERMERIA CLINICA 2019. [DOI: 10.1016/j.enfcli.2019.04.111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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10
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Abstract
PURPOSE OF REVIEW This article discusses the state of type 2 diabetes (T2D) self-management research on non-Hispanic Black men with a focus on their knowledge of diabetes, factors that impact T2D self-management and intervention research that specifically targets non-Hispanic Black men with T2D. RECENT FINDINGS Studies on T2D knowledge and barriers and facilitators to T2D self-management in non-Hispanic Black men are limited to small qualitative focus group and in-depth interviews. To date, few T2D interventions for non-Hispanic Black men have been developed and tested. Research shows that non-Hispanic Black men's knowledge of T2D may be less than optimal compared to non-Hispanic white men. Factors that influence T2D self-management in non-Hispanic Black men include gender-related values and beliefs, and a range of other psychosocial (e.g., social support) and structural (e.g., access to health care) factors. Interventions with gender-specific programming may show promise. More studies with larger sample sizes and longitudinal designs are needed to develop programming to effectively target this at-risk population.
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Affiliation(s)
- Jaclynn M Hawkins
- School of Social Work, University of Michigan, 1080 S. University Ave, Ann Arbor, MI, 48109, USA.
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11
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Pereira MG, Pedras S, Ferreira G, Machado JC. Family and Couple Variables Regarding Adherence in Type 2 Diabetes Patients in the Initial Stages of the Disease. JOURNAL OF MARITAL AND FAMILY THERAPY 2019; 45:134-148. [PMID: 28944969 DOI: 10.1111/jmft.12281] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This study analyzed which family and couple variables predicted adherence to standard care treatment, in patients recently diagnosed with type 2 diabetes. The sample comprised 224 dyads assessed during the first year of diagnosis (T1) and 4 months later (T2). The results showed that family stress, dyadic adjustment, family coping, and positive support assessed by patients at T1 predicted medication adherence and glucose monitoring at T2. Positive support and dyadic adjustment, assessed by partners at T1, predicted patients' adherence to glucose monitoring and diet at T2. This study highlights the important role of the partner in patient`s adherence. Therefore, standard care in type 2 diabetes should be offered in the context of the dyad.
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Peyrot M, Egede L, Funnell M, Hsu W, Ruggiero L, Stuckey H. US Ethnic Group Differences in Family Member Support for People With Diabetes in the 2nd Diabetes Attitudes, Wishes and Needs (DAWN2) Study. DIABETES EDUCATOR 2018; 44:249-259. [PMID: 29787698 PMCID: PMC5967008 DOI: 10.1177/0145721718770767] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Purpose The purpose of the study was to describe the perceptions of family members (FM) and people with diabetes (PWD) regarding the frequency and helpfulness of FM support for PWD, including differences among US ethnic groups. Methods The US 2nd Diabetes Attitudes, Wishes and Needs (DAWN2) substudy was a survey of independent samples of 238 adult FM and 540 adult PWD. Outcome measures included ratings by FM and PWD of the frequency and perceived helpfulness of 7 FM support behaviors and composite scores for frequency and helpfulness. Results Ratings of individual FM support behaviors were strongly correlated between FM and PWD but significantly different among behaviors. FM and PWD reported most frequent support for listening, assisting, and doing activities with PWD and reporting PWD was doing poorly least frequently. Both groups reported listening, assisting, and reporting PWD was doing well as most helpful; reporting PWD was doing poorly was least helpful. PWD rated support and helpfulness of most behaviors lower than FM. Composite measures of support frequency and helpfulness were strongly correlated for both FM and PWD. Ethnic minority PWD and FM reported most support behaviors as more frequent and more helpful than non-Hispanic white Americans. Conclusions FM more frequently engage in the support behaviors they view as most helpful, but PWD perceive support to be less frequent and less helpful than FM. FM support differs across ethnic groups, with ethnic minorities reporting higher support frequency and helpfulness. Diabetes care providers should consider ethnic group differences in FM support for PWD.
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Affiliation(s)
- Mark Peyrot
- Loyola University Maryland, Baltimore, Maryland
| | - Leonard Egede
- Medical College of Wisconsin, Division of General Internal Medicine, Milwaukee, Wisconsin
| | - Martha Funnell
- University of Michigan Medical School, Ann Arbor, Michigan
| | - William Hsu
- Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts
| | - Laurie Ruggiero
- School of Public Health, University of Illinois at Chicago, Chicago, Illinois.,University of Delaware, School of Nursing, Newark, Delaware
| | - Heather Stuckey
- Penn State University, Department of Medicine, Hershey, Pennsylvania
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13
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Shiyanbola OO, Ward EC, Brown CM. Utilizing the common sense model to explore African Americans' perception of type 2 diabetes: A qualitative study. PLoS One 2018; 13:e0207692. [PMID: 30462704 PMCID: PMC6248983 DOI: 10.1371/journal.pone.0207692] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 11/04/2018] [Indexed: 12/26/2022] Open
Abstract
Illness perceptions, which are likely influenced by patients' cultural contexts, are associated with disease self-management and adherence. African American patients perceptions of type 2 diabetes is not well understood and no known studies has used a comprehensive evidence-based theoretical framework to explore what AAs with type 2 diabetes know, believe, and think about type 2 diabetes. Understanding perceptions of an illness shared by a group of people will be useful in developing culturally-appropriate interventions targeted to the needs of the community. The purpose of this study is to explore African Americans' perceptions of type 2 diabetes based on the common sense model of illness and self-regulation. Using a phenomenology qualitative approach and purposive sampling, 40 African American men and women, age 45-60 years old with diagnosed type 2 diabetes at least one year prior, and who took at least one prescription diabetes medication, participated in six semi-structured 90-minute focus groups conducted in a private space. Qualitative content analysis was conducted to explore African Americans beliefs about type 2 diabetes. Participants expressed that historical issues, e.g., slavery, healthcare providers, the government, and God influenced how they developed diabetes. Participants reported a loss of autonomy, a change of their identity as an employee, a social individual and sexual person, as well as anger and frustration due to having diabetes. Diabetes made the African American family bonding experience of eating difficult, and the disease diminished their cultural experiences. Concerns about diabetes ranged from fear of death and amputations to the inability to prevent the disease among their children/grandchildren. Participants perceived that medications, faith in God, and positive thinking about survival helped control diabetes. Conclusions: Improved diabetes self-management and medication adherence may depend on the meaning African Americans attach to diabetes, available psychosocial support for managing diabetes, and African Americans experience with diabetes.
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Affiliation(s)
- Olayinka O. Shiyanbola
- Division of Social and Administrative Sciences, University of Wisconsin-Madison, Madison, WI, United States of America
| | - Earlise C. Ward
- Department of Nursing, University of Wisconsin-Madison, Madison, WI, United States of America
| | - Carolyn M. Brown
- Division of Health Outcomes and Pharmacy Practice, University of Texas-Austin, Austin, TX, United States of America
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McCaskill GM, Bowen PG, Lee LT, Burgio KL, Leeper J, Clay OJ. Influence of Diabetes-Related Support on Aerobic Activity Among Older African Americans With Type 2 Diabetes. Int J Aging Hum Dev 2018; 89:279-293. [PMID: 30180766 DOI: 10.1177/0091415018796602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The objective of this study was to examine the influence of diabetes-related support in promoting aerobic activity in a sample of older African Americans. A secondary data analysis was conducted based on a diabetes self-management study of community-dwelling older African Americans. Logistic regression was conducted to examine the influence of diabetes-related support on aerobic activity. The final model demonstrated that there was a strong relationship between having diabetes-related support and aerobic activity, odds ratio =6.56, 95% confidence interval [2.14, 20.11]. The final model also demonstrated a significant influence based on the total number of chronic health conditions on aerobic activity, odds ratio = 0.63, 95% confidence interval [0.498, 0.802]. Findings suggest that older African Americans with Type 2 diabetes and other chronic health conditions may engage in physical activity if they have diabetes-related support from their family and friends.
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Affiliation(s)
- Gina M McCaskill
- 1 Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs, Birmingham VA Medical Center, AL, USA.,2 Comprehensive Center for Healthy Aging, University of Alabama at Birmingham, AL, USA
| | - Pamela G Bowen
- 3 School of Nursing, University of Alabama at Birmingham, AL, USA
| | - Loretta T Lee
- 3 School of Nursing, University of Alabama at Birmingham, AL, USA
| | - Kathryn L Burgio
- 1 Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs, Birmingham VA Medical Center, AL, USA.,2 Comprehensive Center for Healthy Aging, University of Alabama at Birmingham, AL, USA
| | - James Leeper
- 4 Department of Community and Rural Medicine, The University of Alabama, Tuscaloosa, AL, USA
| | - Olivio J Clay
- 5 Department of Psychology, University of Alabama at Birmingham, AL, USA
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Caballero AE. The "A to Z" of Managing Type 2 Diabetes in Culturally Diverse Populations. Front Endocrinol (Lausanne) 2018; 9:479. [PMID: 30233490 PMCID: PMC6127640 DOI: 10.3389/fendo.2018.00479] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 08/02/2018] [Indexed: 12/15/2022] Open
Abstract
Type 2 diabetes affects racial/ethnic minorities at an alarming rate in the US and in many countries around the world. The quality of health care provided to these groups is often suboptimal, resulting in worse patient-related outcomes when compared to those in mainstream populations. Understanding the complex biological elements that influence the development and course of the disease in high-risk populations is extremely important but often insufficient to implement effective prevention and treatment plans. Multiple factors must be addressed in routine diabetes clinical care. This paper discusses various key factors, organized in alphabetical order. These are acculturation, biology, clinician's cultural awareness, depression and diabetes-specific emotional distress, educational level, fears, group integration, health literacy, intimacy and sexual dysfunction, judging, knowledge of the disease, language, medication adherence, nutritional preferences, other forms of medicine (alternative), perception of body image, quality of life, religion and faith, socio-economic status, technology, unconscious bias, vulnerable groups, asking why?, exercise, "you are in charge" and zip it! Considering these factors in the development of type 2 diabetes prevention and treatment programs will help improve diabetes-related outcomes in culturally diverse populations and reduce health care disparities.
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Affiliation(s)
- A. Enrique Caballero
- Office for External Education, Harvard Medical School, Boston, MA, United States
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16
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Li ECY, Yu CKC. Filial piety as a protective factor against burden experienced by family caregivers of diabetic patients in Hong Kong. ASIA PACIFIC JOURNAL OF COUNSELLING AND PSYCHOTHERAPY 2018. [DOI: 10.1080/21507686.2018.1493517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Eva Chi-Yin Li
- Counselling and Research Centre, Department of Counselling and Psychology, Hong Kong Shue Yan University, Hong Kong SAR
| | - Calvin Kai-Ching Yu
- Counselling and Research Centre, Department of Counselling and Psychology, Hong Kong Shue Yan University, Hong Kong SAR
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Brier MJ, Williams RM, Turner AP, Henderson AW, Roepke AM, Norvell DC, Henson H, Czerniecki JM. Quality of Relationships With Caregivers, Depression, and Life Satisfaction After Dysvascular Lower Extremity Amputation. Arch Phys Med Rehabil 2017; 99:452-458. [PMID: 28987901 DOI: 10.1016/j.apmr.2017.09.110] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 07/26/2017] [Accepted: 09/08/2017] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To describe the relationship between caregiver-specific support and conflict, and psychosocial outcomes among individuals experiencing their first dysvascular lower extremity amputation (LEA). DESIGN Cross-sectional cohort study using self-report surveys. SETTING Department of Veterans Affairs, academic medical center, and level I trauma center. PARTICIPANTS Individuals undergoing their first major LEA because of complications of peripheral arterial disease (PAD) or diabetes who have a caregiver and completed measures of caregiver support and conflict (N=137; 94.9% men). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES The Patient Health Questionnaire-9 to assess depression and the Satisfaction With Life Scale to assess life satisfaction. RESULTS In multiple regression analyses, controlling for global levels of perceived support, self-rated health, age, and mobility, caregiver-specific support was found to be associated with higher levels of life satisfaction and caregiver-specific conflict was found to be associated with lower levels of life satisfaction and higher levels of depressive symptoms. CONCLUSIONS The specific relationship between individuals with limb loss and their caregivers may be an important determinant of well-being. Conflict with caregivers, which has received little attention thus far in the limb loss literature, appears to play a particularly important role. Individuals with limb loss may benefit from interventions with their caregivers that both enhance support and reduce conflict.
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Affiliation(s)
- Moriah J Brier
- Rehabilitation Care Service, VA Puget Sound Health Care System, Seattle, WA.
| | - Rhonda M Williams
- Rehabilitation Care Service, VA Puget Sound Health Care System, Seattle, WA; Department of Rehabilitation Medicine, University of Washington, Seattle, WA
| | - Aaron P Turner
- Rehabilitation Care Service, VA Puget Sound Health Care System, Seattle, WA; Department of Rehabilitation Medicine, University of Washington, Seattle, WA
| | - Alison W Henderson
- Rehabilitation Care Service, VA Puget Sound Health Care System, Seattle, WA
| | - Ann Marie Roepke
- Rehabilitation Care Service, VA Puget Sound Health Care System, Seattle, WA
| | | | - Helene Henson
- Physical Medicine and Rehabilitation, Houston VA Medical Center, Houston, TX
| | - Joseph M Czerniecki
- Rehabilitation Care Service, VA Puget Sound Health Care System, Seattle, WA; Department of Rehabilitation Medicine, University of Washington, Seattle, WA
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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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Samuel-Hodge CD, Holder-Cooper JC, Gizlice Z, Davis G, Steele SP, Keyserling TC, Kumanyika SK, Brantley PJ, Svetkey LP. Family PArtners in Lifestyle Support (PALS): Family-based weight loss for African American adults with type 2 diabetes. Obesity (Silver Spring) 2017; 25:45-55. [PMID: 27911049 PMCID: PMC5182111 DOI: 10.1002/oby.21700] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 08/30/2016] [Accepted: 09/19/2016] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To develop and test a family-centered behavioral weight loss intervention for African American adults with type 2 diabetes. METHODS In this randomized trial, dyads consisting of an African American adult with overweight or obesity and type 2 diabetes (index participant) paired with a family partner with overweight or obesity but not diagnosed with diabetes were assigned in a 2:1 ratio to a 20-week special intervention (SI) or delayed intervention (DI) control group. The primary outcome was weight loss among index participants at the 20-week follow-up. RESULTS One hundred eight participants (54 dyads-36 (SI) and 18 (DI) dyads) were enrolled: 81% females; mean age, 51 years; mean weight,103 kg; and mean BMI, 37 kg/m2 . At post-intervention, 96 participants (89%) returned for follow-up measures. Among index participants, mean difference in weight loss between groups was -5.0 kg, P <0.0001 (-3.6 kg loss among SI; 1.4 kg gain in DI). SI index participants showed significantly greater improvements in hemoglobin A1c, depressive symptoms, family interactions, and dietary, physical activity, and diabetes self-care behaviors. SI family partners also had significant weight loss (-3.9 kg (SI) vs. -1.0 kg (DI), P = 0.02). CONCLUSIONS A family-centered, behavioral weight loss intervention led to clinically significant short-term weight loss among family dyads.
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Affiliation(s)
- Carmen D Samuel-Hodge
- Department of Nutrition, Gillings School of Global Public Health, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Judith C Holder-Cooper
- Department of Psychiatry and Behavioral Science, Duke University, Durham, North Carolina, USA
- Department of Community and Family Medicine, Duke University, Durham, North Carolina, USA
| | - Ziya Gizlice
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Gwendolyn Davis
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Sonia P Steele
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Thomas C Keyserling
- Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of General Internal Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Shiriki K Kumanyika
- Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Phillip J Brantley
- Behavioral Medicine Laboratory, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Laura P Svetkey
- Department of Medicine, Division of Nephrology, Sarah W. Stedman Nutrition and Metabolism Center, Duke University Medical Center, Durham, North Carolina, USA
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Skelly AH, Dougherty M, Gesler WM, Soward ACM, Burns D, Arcury TA. African American Beliefs About Diabetes. West J Nurs Res 2016; 28:9-29; discussion 30-41. [PMID: 16676724 DOI: 10.1177/0193945905280298] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In this presentation, a diabetes explanatory model of rural, African American adults at high risk for diabetes is described. Kleinman’s explanatory model of illness was used as the organizing framework. African American men and women ( N = 42), between the ages of 18 and 51, participated. Participants described their knowledge and beliefs about diabetes, preventing diabetes, and whether diabetes could be cured or controlled. A common explanatory model of diabetes was not shared among the participants, and gender and age differences were apparent. Common themes included diabetes “running in families,” “eating too much sugar,” and “not taking care of yourself” as causes of diabetes. Weight and physical activity or exercise were not seen as contributing to the development of diabetes. Participants were not sure if diabetes could be prevented. These results provide information to address primary prevention of diabetes in this at-risk group.
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Affiliation(s)
- Anne H Skelly
- University of North Carolina at Chapel Hill, School of Nursing, USA
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21
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Pereira MG, Costa V, Oliveira D, Ferreira G, Pedras S, Sousa MR, Machado JC. Patients' and Spouses' Contribution Toward Adherence to Self-Care Behaviors in Type 2 Diabetes. Res Theory Nurs Pract 2016; 29:276-96. [PMID: 26714355 DOI: 10.1891/1541-6577.29.4.276] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This article focuses on patients' and partners' variables regarding adherence to self-care, in recently diagnosed patients with Type 2 diabetes. One hundred four patients and partners were included. Instruments answered were Family Inventory of Life Events and Changes (family stress), Family Crisis Oriented Personal Evaluation Scales (family coping), Revised Dyadic Adjustment Scale (dyadic adjustment), Multidimensional Diabetes Questionnaire (partner support) and Hospital Anxiety and Depression Scale (psychological morbidity). Results showed adherence to diet to be positively predicted by patient dyadic adjustment and patient positive support and negatively by partner depression and partner negative support. Adherence to exercise was predicted by patient's family stress and negatively by partner anxiety. Adherence to glucose monitoring was predicted by partner positive support. Psychological variables were not associated with adherence to foot care. Finally, positive partner support moderated the relationship between family stress and dyadic adjustment in patients. The results emphasize the need to treat the patient in the context of the dyad. Future research should focus on partners' specific instrumental behaviors that promote patients' self-care behaviors.
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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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24
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Abstract
Despite many novel treatments available for managing type 2 diabetes mellitus, Black patients continue to disproportionately suffer complications associated with poor glycemic control. This article describes a comprehensive approach to managing diabetes mellitus in these patients while addressing cultural nuances that may be barriers to positive outcomes.
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Affiliation(s)
- Adeola Akindana
- Adeola Akindana is a diabetes education program coordinator/diabetes educator: Joslin Diabetes Center Affiliate at Doctors Community Hospital, Lanham, Md. Chioma Ogunedo is a clinical director at Peace and Harmony Homecare, LLC, Foxboro, Mass
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25
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Bi X, Moos RH, Timko C, Cronkite RC. Family conflict and somatic symptoms over 10 years: a growth mixture model analysis. J Psychosom Res 2015; 78:459-465. [PMID: 25684248 DOI: 10.1016/j.jpsychores.2015.01.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Revised: 01/24/2015] [Accepted: 01/27/2015] [Indexed: 10/24/2022]
Abstract
OBJECTIVE While family conflict and somatic symptoms are mutually associated, few longitudinal studies have examined multiple (heterogeneous) trajectory subgroups for family conflict and somatic symptoms and their covariation over time. The aim of this study was to identify heterogeneous trajectory subgroups for family conflict and somatic symptoms and their joint trajectories. METHODS A representative sample of 424 community participants completed surveys at baseline and 1-, 4-, and 10-year follow-ups. Family conflict and somatic symptoms were assessed at each wave. Covariates (age, gender, marital status, education, and medical conditions) were assessed at baseline. Growth mixture modeling (GMM) was used to identify heterogeneous trajectory subgroups for family conflict and somatic symptoms. A parallel process GMM was used to examine joint trajectory subgroup membership between family conflict and somatic symptoms. RESULTS There were three trajectory subgroups for family conflict: stable low; worsening; and improving, and three somewhat similar trajectory subgroups for somatic symptoms: stable low; stable moderate; and improving. Family conflict and somatic symptom trajectory subgroup memberships were jointly associated. Individuals who had stable low family conflict were most likely to follow a stable low somatic symptom trajectory. Individuals who improved in family conflict were most likely to continue to have stable low somatic symptoms or improve in somatic symptoms. Moreover, individuals who had stable moderate somatic symptoms were most likely to show worsening family conflict. CONCLUSION This study demonstrates heterogeneous family conflict and somatic symptom trajectories and indicates that these trajectories covary over time.
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Affiliation(s)
- Xiaoyu Bi
- Center for Innovation to Implementation, Health Services Research and Development (HSR&D), VA Palo Alto Health Care System, Menlo Park, CA, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
| | - Rudolf H Moos
- Center for Innovation to Implementation, Health Services Research and Development (HSR&D), VA Palo Alto Health Care System, Menlo Park, CA, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
| | - Christine Timko
- Center for Innovation to Implementation, Health Services Research and Development (HSR&D), VA Palo Alto Health Care System, Menlo Park, CA, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
| | - Ruth C Cronkite
- Center for Innovation to Implementation, Health Services Research and Development (HSR&D), VA Palo Alto Health Care System, Menlo Park, CA, USA; Department of Sociology, Stanford University, Stanford, CA, USA; Center for Primary Care and Outcomes Research, Stanford University, Stanford, CA, USA.
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Seawell AH, Hurt TR, Shirley MC. The Influence of Stress, Gender, and Culture on Type 2 Diabetes Prevention and Management Among Black Men: A Qualitative Analysis. Am J Mens Health 2015; 10:149-56. [PMID: 25862692 DOI: 10.1177/1557988315580132] [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: 11/16/2022] Open
Abstract
This study used focus-group methodology to seek understanding about the unique influence of stress, gender, and culture on type 2 diabetes mellitus (t2dm) prevention and management among Black men. Twenty men from Iowa were recruited from a larger longitudinal study on Black families; each of these men participated in one of three focus groups. Ninety-five percent of the men in the sample were Black and all were either diagnosed with t2dm (n = 10), were prediabetic (n = 1), or had experience with t2dm through family and friends (n = 9). Our results revealed the existence of significant stress and some pessimism with respect to perceived ability to prevent and manage t2dm. The participants made it clear that, while their families are primary sources of support for managing stress, including t2dm, they can also be a source of stress, particularly with respect to parenting. Black men had mixed opinions on their relationships with respect to their health care providers; some had positive, long-standing relationships while others reported little or no relationship with their providers. In response to life stress, Black men reported experiencing inadequate and disrupted sleep as well as consuming too much alcohol at times. Some of the participants reported engaging in physical activity to manage their stress. The study concluded that, as researchers develop t2dm prevention and management programs, they should continue to consider the unique role that stress in its various forms, plays in the lives of Black men.
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Rintala TM, Paavilainen E, Åstedt-Kurki P. Everyday life of a family with diabetes as described by adults with type 1 diabetes. ACTA ACUST UNITED AC 2015. [DOI: 10.1002/edn.234] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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28
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Paddison CAM. Family support and conflict among adults with type 2 diabetes. ACTA ACUST UNITED AC 2015. [DOI: 10.1002/edn.152] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Qualitative Trends in Biopsychosocial-Spiritual Treatment for Underserved Patients with Type 2 Diabetes. CONTEMPORARY FAMILY THERAPY 2015. [DOI: 10.1007/s10591-015-9326-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Peyrot M, Egede LE, Funnell MM, Hsu WC, Ruggiero L, Siminerio LM, Stuckey HL. Ethnic differences in family member diabetes involvement and psychological outcomes: results from the second Diabetes Attitudes, Wishes and Needs (DAWN2) study in the USA. Curr Med Res Opin 2015; 31:1297-307. [PMID: 25907127 DOI: 10.1185/03007995.2015.1043251] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To assess differences among USA ethnic groups in psychological status of adult family members (FMs) and their involvement with the diabetes of another adult. RESEARCH METHODS Data are from the FM survey of the USA DAWN2 study, including 105 White non-Hispanics, 47 African Americans, 46 Hispanic Americans and 40 Chinese Americans. All FMs lived with and cared for an adult with diabetes. Analysis of covariance controlled for respondent and patient characteristics to assess ethnic group differences (P < 0.05). Multiple regression analyses identified significant (P < 0.05) independent correlates of psychological outcomes. MAIN OUTCOME MEASURES FM psychological outcomes measured include well-being, quality of life (QoL), impact of diabetes on life domains, diabetes distress, and burden. CLINICAL TRIAL REGISTRATION NCT01507116. RESULTS White non-Hispanics reported less diabetes burden and distress, more negative life impact, and lower well-being than FMs from ethnic minority groups. African Americans reported the highest well-being and lowest negative life impact, Chinese Americans reported the most diabetes burden, Hispanic Americans reported the highest distress. There were no ethnic group differences in QoL. Ethnic minority FMs reported having more involvement with diabetes, greater support success, and more access to a diabetes support network than White non-Hispanics. Higher FM diabetes involvement was associated with negative psychological outcomes, while diabetes education, support success and diabetes support network size were associated with better psychological outcomes. Potential limitations are the sample sizes and representativeness. CONCLUSIONS Minority ethnic FMs experienced both advantages and disadvantages in psychological outcomes relative to each other and to White non-Hispanics. Ethnic minority FMs had more involvement in diabetes care, support success and support from others, with the first associated with worse and the latter two with better psychological outcomes. Additional studies are needed with larger samples and broader representation of ethnic groups to better understand these associations and identify areas for intervention.
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Affiliation(s)
- Mark Peyrot
- Loyola University Maryland , Baltimore, MD , USA
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Gefter L, Rosas LG, Rodriguez E, Morioka-Douglas N. Training At-Risk Youth to Become Diabetes Self-management Coaches for Family Members. DIABETES EDUCATOR 2014; 40:786-96. [DOI: 10.1177/0145721714549676] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose The purpose of this study is to evaluate the impact of a school-based health program in which family medicine residents trained healthy at-risk adolescents to become diabetes self-management coaches for family members with diabetes. Methods A mixed methods study included 97 adolescents from 3 San Francisco Bay Area high schools serving primarily ethnic minority youth of low socioeconomic status. Physicians came to schools once a week for 8 weeks and trained 49 adolescents to become coaches. Student coaches and 48 nonparticipant students completed pre- and posttest intervention questionnaires, and 15 student coaches and 9 family members with diabetes gave in-depth interviews after participation. Linear regression was used to determine differences in knowledge and psychosocial assets on pre- and posttests between student coaches and nonparticipant students, and NVIVO was used to analyze interview transcripts. Results After controlling for initial score, sex, grade, and ethnicity, student coaches improved from pre- to posttest significantly compared to nonparticipants on knowledge, belonging, and worth scales. Student coaches reported high satisfaction with the program. Articulated program benefits included improvement in diet, increased physical activity, and improved relationship between student coach and family member. Conclusions Overall, this program can increase diabetes knowledge and psychosocial assets of at-risk youth, and it holds promise to promote positive health behaviors among at-risk youth and their families.
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Affiliation(s)
- Liana Gefter
- Center for Education and Research in Family and Community Medicine, Stanford University School of Medicine, Stanford, CA (Dr Gefter, Dr Morioka-Douglas)
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA (Dr Rosas)
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA (Dr Rodriguez)
| | - Lisa G. Rosas
- Center for Education and Research in Family and Community Medicine, Stanford University School of Medicine, Stanford, CA (Dr Gefter, Dr Morioka-Douglas)
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA (Dr Rosas)
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA (Dr Rodriguez)
| | - Eunice Rodriguez
- Center for Education and Research in Family and Community Medicine, Stanford University School of Medicine, Stanford, CA (Dr Gefter, Dr Morioka-Douglas)
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA (Dr Rosas)
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA (Dr Rodriguez)
| | - Nancy Morioka-Douglas
- Center for Education and Research in Family and Community Medicine, Stanford University School of Medicine, Stanford, CA (Dr Gefter, Dr Morioka-Douglas)
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA (Dr Rosas)
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA (Dr Rodriguez)
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Pakpour AH, Saffari M, Burri A. Translation and validation of an Iranian version of the Diabetes Quality of Life measure. J Diabetes Investig 2014; 3:471-8. [PMID: 24843609 PMCID: PMC4019249 DOI: 10.1111/j.2040-1124.2012.00217.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Aims/Introduction: The objective of this study was to translate and validate an Iranian version of the Diabetes Quality of Life (DQOL) questionnaire in an Iranian population of males and females with a diagnosis of type 2 diabetes. Materials and Methods: A total of 503 patients with type 2 diabetes were recruited from nine diabetes clinics across several Iranian cities. A standard backward and forward translation procedure was used to convert the English version of the DQOL into the Iranian language (Persian). Internal consistency, convergent validity, known group comparison, confirmatory factor analysis (CFA) and factorial invariance were applied for the assessment of psychometric properties of the translated version. Results: The translated version of the DQOL showed adequate internal consistency reliabilities for all subscales (Cronbach’s α >0.70). CFA confirmed the underlying domain structure to be the same as for the original English version, therefore supporting the factorial validity of the translated questionnaire. In addition, questionnaire responsiveness showed good sensitivity to interventions. Conclusions: In conclusion, the translated Iranian version of DQOL has shown high internal reliability and good construct validity, and can potentially be applied as an assessment tool for health‐related quality of life in patients with diabetes. (J Diabetes Invest, doi: 10.1111/j.2040‐1124.2012.00217.x, 2012)
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Affiliation(s)
- Amir H Pakpour
- Qazvin Research Center for Social Determinants of Health ; Department of Public Health, Qazvin University of Medical Sciences, Qazvin
| | - Mohsen Saffari
- Department of Health Education, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Andrea Burri
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
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Li J, Drury V, Taylor B. 'Diabetes is nothing': the experience of older Singaporean women living and coping with type 2 diabetes. Contemp Nurse 2014; 45:188-96. [PMID: 24299247 DOI: 10.5172/conu.2013.45.2.188] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
PURPOSE The purpose of this study was to describe, through qualitative methods, the experiences and ways of coping of older Singaporean Chinese women with type 2 diabetes. METHODS Using a qualitative approach, 10 Singaporean Chinese women between the ages of 60-69 described their experiences of living and coping with type 2 diabetes. Data were collected via semi-structured interviews and analysed using thematic analysis. RESULTS Three themes were identified in the analysis: (i) Living with diabetes; (ii) Coping with diabetes; and (iii) Caring for the self in diabetes. CONCLUSIONS Findings indicate that women living and coping with diabetes confront numerous issues. In order to help these patients initiate and sustain lifestyle modifications, healthcare providers are encouraged to be empathetic and supportive and an understanding of the coping strategies used will ensure that effective coping strategies are utilised. Furthermore, diabetes education for family members will assist them to provide essential, ongoing support for the patient.
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Affiliation(s)
- Jiemin Li
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore
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Mitchell JA, Hawkins J. Current approaches to support the psychosocial care of African American adults with diabetes: a brief review. SOCIAL WORK IN PUBLIC HEALTH 2014; 29:518-527. [PMID: 25144694 PMCID: PMC4145410 DOI: 10.1080/19371918.2014.888533] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Accepted: 01/24/2014] [Indexed: 06/03/2023]
Abstract
African Americans are disproportionately affected by Type 2 diabetes and experience significantly higher age-adjusted prevalence of the disease. Psychosocial support, material resources, and education can have a significant impact on successful diabetes management, particularly among populations with diabetes-related psychological distress such as African Americans. This brief review of the literature identifies and synthesizes current evidence on faith-based, community-based, empowerment-based, strength-based, and culturally competent strategies that may be particularly relevant for social work practitioners supporting African American adults at risk for or diagnosed with Type 2 diabetes. Discussion focuses on multiple influences on the self-determination of clients working to manage their condition.
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Affiliation(s)
- Jamie Ann Mitchell
- School of Social Work, Wayne State University, 337 Thompson Home, 4756 Cass Avenue, Detroit, MI 48202
| | - Jaclynn Hawkins
- School of Social Work, University of Michigan, 1080 S. University Avenue, Ann Arbor, MI 48109-1106
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Ziegahn L, Styne D, Askia J, Roberts T, Lewis ET, Edwards W. Strategies to prevent and reduce diabetes and obesity in Sacramento, California: the African American Leadership Coalition and University of California, Davis. Prev Chronic Dis 2013; 10:E187. [PMID: 24229570 PMCID: PMC3830925 DOI: 10.5888/pcd10.130074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Diabetes is one of the leading causes of illness and death for African Americans and people of African descent throughout the United States and in the city and county of Sacramento, California. The involvement of families and communities in developing prevention strategies can increase the likelihood that behavioral changes will be sustained. CONTEXT Three member organizations of the African American Leadership Coalition (AALC) entered into a partnership with the University of California, Davis (UC Davis) to engage families in developing a process to identify barriers to diabetes and obesity prevention and reduction, exchange strategies, and create action plans for prevention. METHODS The intervention comprised 3 phases: 1) coalition formation and training; 2) data collection, analysis, and dissemination of results; and 3) development of family and community action plans. Academic and community partners planned and implemented all project phases together. OUTCOMES Sources of information about diabetes and obesity were primarily doctors and the Internet; barriers were related to lack of time needed to prepare healthy meals, high food costs, transportation to fresh markets, motivation around healthy habits, and unsafe environments. Action plans addressed behavioral change and family cohesion. The group discussion format encouraged mutual support and suggestions for better eating and physical exercise habits. INTERPRETATION This collaborative partnership model can strengthen existing group relationships or promote new affiliations that form the basis for future action coalitions. Participants worked both within and across groups to exchange information, stories of success and challenges, and specific health improvement strategies.
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Affiliation(s)
- Linda Ziegahn
- Clinical and Translational Science Center, 2921 Stockton Blvd, Sacramento, CA 95817. E-mail:
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Cosansu G, Erdogan S. Influence of psychosocial factors on self-care behaviors and glycemic control in Turkish patients with type 2 diabetes mellitus. J Transcult Nurs 2013; 25:51-9. [PMID: 24084701 DOI: 10.1177/1043659613504112] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE The main purpose of this study was to investigate the direct and indirect effects of psychosocial factors on self-care behavior and glycemic control in Turkish patients with type 2 diabetes mellitus. METHOD The study used a cross-sectional questionnaire survey design (N = 350). Data were collected using the Summary of Diabetes Self-Care Activities Scale and the Multidimensional Diabetes Questionnaire. The relationship between the study variables was analyzed using Pearson's correlation coefficient and structural equation modeling. RESULTS Self-efficacy was associated with social support, outcome expectancies, perceived interference, educational level, and self-care and A1C. According to the structural equation model, self-efficacy was the predictor variable that influenced both self-care and glycemic control. CONCLUSIONS Self-efficacy in achieving desired health outcomes was found to play a central role in Turkish patients. Although interventions are planned and implemented to achieve and maintain self-management in individuals with diabetes, strengthening psychosocial factors, particularly self-efficacy, may contribute to adjustment to disease and good glycemic control in the long term.
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Affiliation(s)
- Gulhan Cosansu
- Istanbul University, Florence Nightingale Nursing Faculty, Public Health Nursing Department Istanbul, Turkey
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Li J, Drury V, Taylor B. ‘Diabetes is nothing’ :The experience of older Singaporean women living and coping with type 2 diabetes. Contemp Nurse 2013. [DOI: 10.5172/conu.2013.3430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Kalra S, Sridhar GR, Balhara YPS, Sahay RK, Bantwal G, Baruah MP, John M, Unnikrishnan AG, Madhu K, Verma K, Sreedevi A, Shukla R, Prasanna Kumar KM. National recommendations: Psychosocial management of diabetes in India. Indian J Endocrinol Metab 2013; 17:376-95. [PMID: 23869293 PMCID: PMC3712367 DOI: 10.4103/2230-8210.111608] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Although several evidence-based guidelines for managing diabetes are available, few, if any, focus on the psychosocial aspects of this challenging condition. It is increasingly evident that psychosocial treatment is integral to a holistic approach of managing diabetes; it forms the key to realizing appropriate biomedical outcomes. Dearth of attention is as much due to lack of awareness as due to lack of guidelines. This lacuna results in diversity among the standards of clinical practice, which, in India, is also due to the size and complexity of psychosocial care itself. This article aims to highlight evidence- and experience-based Indian guidelines for the psychosocial management of diabetes. A systemic literature was conducted for peer-reviewed studies and publications covering psychosocial aspects in diabetes. Recommendations are classified into three domains: General, psychological and social, and graded by the weight they should have in clinical practice and by the degree of support from the literature. Ninety-four recommendations of varying strength are made to help professionals identify the psychosocial interventions needed to support patients and their families and explore their role in devising support strategies. They also aid in developing core skills needed for effective diabetes management. These recommendations provide practical guidelines to fulfill unmet needs in diabetes management, and help achieve a qualitative improvement in the way physicians manage patients. The guidelines, while maintaining an India-specific character, have global relevance, which is bound to grow as the diabetes pandemic throws up new challenges.
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Affiliation(s)
- Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, India
| | - G. R. Sridhar
- Department of Endocrine and Diabetes Centre, Visakhapatnam, India
| | - Yatan Pal Singh Balhara
- Department of Psychiatry, National Drug Dependence Treatment Centre (NDDTC), AIIMS, New Delhi, India
| | | | - Ganapathy Bantwal
- Department of Endocrinology, St. John's Medical College, Bengaluru, India
| | - Manash P. Baruah
- Department of Endocrinology, Excel Centre Hospitals, Guwahati, India
| | - Mathew John
- Department of Endocrinology, Providence Endocrine and Diabetes Specialty Centre, Trivandrum, India
| | | | - K. Madhu
- Department of Psychology, Andhra University, Vishakhapatnam, India
| | - Komal Verma
- Department of Psychology, Consultant Psychologist, Noida, India
| | - Aswathy Sreedevi
- Department of Community Medicine, Amrita Institute of Medical Sciences, Kochi, India
| | - Rishi Shukla
- Department of Endocrinology, Center For Diabetes, Kanpur, Uttar Pradesh, India
| | - K. M. Prasanna Kumar
- Department of Endocrinology, CDEC and Bangalore Diabetes Hospital, Bengaluru, Karnataka, India
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Chesla CA, Chun KM, Kwan CML, Mullan JT, Kwong Y, Hsu L, Huang P, Strycker LA, Shum T, To D, Kao R, Waters CM. Testing the efficacy of culturally adapted coping skills training for Chinese American immigrants with type 2 diabetes using community-based participatory research. Res Nurs Health 2013; 36:359-72. [PMID: 23606271 DOI: 10.1002/nur.21543] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2013] [Indexed: 11/08/2022]
Abstract
Chinese Americans demonstrate greater prevalence of diabetes than non-Hispanic whites and find standard diabetes care disregards their cultural health beliefs. Academic researchers and Chinatown agencies collaborated to culturally adapt and test an efficacious cognitive-behavioral intervention using community-based participatory research. Using a delayed-treatment repeated-measures design, 145 adult Chinese immigrants with Type 2 diabetes completed treatment. Immediate benefits of treatment were evident in the improvement (p < .05) in diabetes self-efficacy, diabetes knowledge, bicultural efficacy, family emotional and instrumental support, diabetes quality of life, and diabetes distress. Prolonged benefits were evident in all changed variables 2 months post-intervention. The CBPR approach enabled the development of a culturally acceptable, efficacious behavioral intervention, and provides a model for working with communities that demonstrate health disparities.
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Affiliation(s)
- Catherine A Chesla
- Department of Family Health Care Nursing, University of California San Francisco, 2 Koret Way, Box 0606, San Francisco, CA 94143-0606, USA
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Family diabetes matters: a view from the other side. J Gen Intern Med 2013; 28:428-35. [PMID: 23054922 PMCID: PMC3579978 DOI: 10.1007/s11606-012-2230-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2011] [Revised: 07/30/2012] [Accepted: 09/13/2012] [Indexed: 11/26/2022]
Abstract
BACKGROUND Typically, chronic disease self-management happens in a family context, and for African American adults living with diabetes, family seems to matter in self-management processes. Many qualitative studies describe family diabetes interactions from the perspective of adults living with diabetes, but we have not heard from family members. OBJECTIVE To explore patient and family perspectives on family interactions around diabetes. DESIGN Qualitative study using focus group methodology. PARTICIPANTS & APPROACH: We conducted eight audiotaped focus groups among African Americans (four with patients with diabetes and four with family members not diagnosed with diabetes), with a focus on topics of family communication, conflict, and support. The digital files were transcribed verbatim, coded, and analyzed using qualitative data analysis software. Directed content analysis and grounded theory approaches guided the interpretation of code summaries. RESULTS Focus groups included 67 participants (81 % female, mean age 64 years). Family members primarily included spouses, siblings, and adult children/grandchildren. For patients with diabetes, central issues included shifting family roles to accommodate diabetes and conflicts stemming from family advice-giving. Family members described discomfort with the perceived need to police or "stand over" the diabetic family member, not wanting to "throw diabetes in their [relative's] face," perceiving their communications as unhelpful, and confusion about their role in diabetes care. These concepts generated an emergent theme of "family diabetes silence." CONCLUSION Diabetes silence, role adjustments, and conflict appear to be important aspects to address in family-centered diabetes self-management interventions. Contextual data gathered through formative research can inform such family-centered intervention development.
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Rintala TM, Jaatinen P, Paavilainen E, Astedt-Kurki P. Interrelation between adult persons with diabetes and their family: a systematic review of the literature. JOURNAL OF FAMILY NURSING 2013; 19:3-28. [PMID: 23288886 DOI: 10.1177/1074840712471899] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Diabetes mellitus is a common chronic disease all over the world. Self-management plays a crucial role in diabetes management. The purpose of this systematic review was to summarize what is known about the interactions between adult persons with diabetes, their family, and diabetes self-management. MEDLINE, CINAHL, PSYCHINFO, LINDA, and MEDIC databases were searched for the years 2000 to 2011 and for English language articles, and the reference lists of the studies included were reviewed to capture additional studies. The findings indicate that family members have influence on the self-management of adult persons with diabetes. The support from family members plays a crucial role in maintaining lifestyle changes and optimizing diabetes management. Diabetes and its treatment also affect the life of family members in several ways, causing, for example, different types of psychological distress. More attention should be paid to family factors in diabetes management among adult persons.
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Affiliation(s)
- Tuula-Maria Rintala
- University of Tampere, Tampere University of Applied Sciences, Tampere, Finland.
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Naranjo D, Hessler DM, Deol R, Chesla CA. Health and psychosocial outcomes in U.S. adult patients with diabetes from diverse ethnicities. Curr Diab Rep 2012; 12:729-38. [PMID: 22961116 DOI: 10.1007/s11892-012-0319-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Within the United States, diabetes is a serious public health concern and patients with diabetes are more likely to experience clinical depression, psychological distress, and depressive symptoms than those without. Negative psychosocial factors are associated with poorer diabetes management and glycemic control. Overall, both the rates of diabetes and related psychological distress are greater for persons of diverse ethnicities than for non-Latino whites, and have reached epidemic proportions in certain groups. The following article will provide an overview across ethnicities of the rates of diabetes, health outcomes, psychosocial outcomes, and unique cultural and linguistic challenges that contribute to disparities within US diabetes patients of diverse ethnicities. Using this information, our hope is that health care practitioners and researchers alike can better respond to the psychosocial needs of ethnically diverse patients.
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Affiliation(s)
- Diana Naranjo
- Department of Pediatrics, University of California San Francisco, 400 Parnassus Avenue, 4th Floor, UCSF, MailBox 0318, San Francisco, CA 94143-0318, USA.
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Hessler DM, Fisher L, Naranjo D, Masharani U. Young adult African American patients with type 2 diabetes: a high risk patient sub-group with few supports for good diabetes management. J Health Psychol 2011; 17:535-44. [PMID: 21963680 DOI: 10.1177/1359105311422120] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study examined age differences in support, BMI, and HbA1c among African American patients with type 2 diabetes. Participants were 158 African American adults with type 2 diabetes. Average HbA1c was 1% higher among patients aged 20-49 than patients 60-77, and double the number of younger patients had a BMI ≥35 than older patients. Younger patients reported less trust in their physician and greater disagreement with recommendations. They reported relying less on partners, greater unresolved conflict with partners around diabetes, and less church involvement. The association between age and HbA1c was partially mediated by patients' trust of their physician.
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Bao Y, Alexopoulos GS, Casalino LP, Ten Have TR, Donohue JM, Post EP, Schackman BR, Bruce ML. Collaborative depression care management and disparities in depression treatment and outcomes. ACTA ACUST UNITED AC 2011; 68:627-36. [PMID: 21646579 DOI: 10.1001/archgenpsychiatry.2011.55] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
CONTEXT Collaborative depression care management (DCM), by addressing barriers disproportionately affecting patients of racial/ethnic minority and low education, may reduce disparities in depression treatment and outcomes. OBJECTIVE To examine the effects of DCM on treatment disparities by education and race/ethnicity in older depressed primary care patients. DESIGN Analysis of data from the randomized controlled trial Prevention of Suicide in Primary Care Elderly: Collaborative Trial (PROSPECT). SETTING Twenty primary care practices. PARTICIPANTS A total of 396 individuals 60 years or older with major depression. We conducted model-based analysis to estimate potentially differential intervention effects by education, independent of those by race/ethnicity (and vice versa). INTERVENTION Algorithm-based recommendations to physicians and care management by care managers. MAIN OUTCOME MEASURES Antidepressant use, depressive symptoms, and intensity of DCM over 2 years. RESULTS The PROSPECT intervention had a larger and more lasting effect in less-educated patients. At month 12, the intervention increased the rate of adequate antidepressant use by 14.2 percentage points (pps) (95% confidence interval [CI], 1.7 to 26.4 pps) in the no-college group compared with a null effect in the college-educated group (-9.2 pps [95% CI, -25.0 to 2.7 pps]); at month 24, the intervention reduced depressive symptoms by 2.6 pps on the Hamilton Depression Rating Scale (95% CI, -4.6 to -0.4 pps) in no-college patients, 3.8 pps (95% CI, -6.8 to -0.4) more than in the college group. The intervention benefitted non-Hispanic white patients more than minority patients. Intensity of DCM received by minorities was 60% to 70% of that received by white patients after the initial phase but did not differ by education. CONCLUSIONS The PROSPECT intervention substantially reduced disparities by patient education but did not mitigate racial/ethnic disparities in depression treatment and outcomes. Incorporation of culturally tailored strategies in DCM models may be needed to extend their benefits to minorities. TRIAL REGISTRATION clinicaltrials.gov Identifier for PROSPECT NCT00279682.
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Affiliation(s)
- Yuhua Bao
- Department of Public Health, Weill Cornell Medical College, New York, NY 10065, USA.
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Rosland AM, Heisler M, Piette JD. The impact of family behaviors and communication patterns on chronic illness outcomes: a systematic review. J Behav Med 2011; 35:221-39. [PMID: 21691845 DOI: 10.1007/s10865-011-9354-4] [Citation(s) in RCA: 171] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2010] [Accepted: 05/16/2011] [Indexed: 01/12/2023]
Abstract
In general, social support from family members affects chronic illness outcomes, but evidence on which specific family behaviors are most important to adult patient outcomes has not been summarized. We systematically reviewed studies examining the effect of specific family member behaviors and communication patterns on adult chronic illness self-management and clinical outcomes. Thirty studies meeting inclusion criteria were identified, representing 22 participant cohorts, and including adults with arthritis, chronic cardiovascular disease, diabetes, and/or end stage renal disease. Family emphasis on self-reliance and personal achievement, family cohesion, and attentive responses to symptoms were associated with better patient outcomes. Critical, overprotective, controlling, and distracting family responses to illness management were associated with negative patient outcomes. Study limitations included cross-sectional designs (11 cohorts); however results from longitudinal studies were similar. Findings suggest that future interventions aiming to improve chronic illness outcomes should emphasize increased family use of attentive coping techniques and family support for the patient's autonomous motivation.
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Affiliation(s)
- Ann-Marie Rosland
- Department of Veterans Affairs, Ann Arbor VA Center for Clinical Management Research, 2215 Fuller Road, Mailstop 152, Ann Arbor, MI 48105, USA.
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Raue PJ, Schulberg HC, Lewis-Fernandez R, Boutin-Foster C, Hoffman AS, Bruce ML. Shared decision-making in the primary care treatment of late-life major depression: a needed new intervention? Int J Geriatr Psychiatry 2010; 25:1101-11. [PMID: 19946872 PMCID: PMC2889183 DOI: 10.1002/gps.2444] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE We suggest that clinicians consider models of shared decision-making (SDM) for their potential ability to improve the treatment of major depression in the primary care setting and overcome limitations of collaborative care and other interventions. METHODS We explore the characteristics and techniques of patient-clinician SDM, with particular emphasis on this model's relevance to the unique treatment concerns of depressed older adults. RESULTS We describe a SDM intervention to engage older adults in depression treatment in the primary care sector. CONCLUSIONS It is timely to examine SDM models for elderly depressed primary care patients given their potential ability to improve treatment adherence and clinical outcomes.
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Affiliation(s)
- Patrick J Raue
- Department of Psychiatry, Weill Cornell Medical College, USA.
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Jack L, Toston T, Jack NH, Sims M. A gender-centered ecological framework targeting Black men living with diabetes: integrating a "masculinity" perspective in diabetes management and education research. Am J Mens Health 2010; 4:7-15. [PMID: 19477741 PMCID: PMC3012620 DOI: 10.1177/1557988308321956] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Blacks have traditionally experienced a disproportionate burden of diabetes in the United States. Research published from 1980 to 2008 revealed a paucity of diabetes education and management research targeting Black men. There is a paucity of published research that takes into consideration attributes of "being male," such as masculinity, and how its attributes influence diabetes self-management behaviors. This article discusses three important factors that may help explain diabetes-related disparities among Black men.These factors include absence of consistent sources of health care, lack of health insurance, and the absence of a masculinity perspective in diabetes education and management research. This article offers a gender-centered ecological framework that examines pathways between demographic factors, family functioning, knowledge and psychological health, biological health, behavioral health and medical compliance, masculinity, and diabetes-related outcomes. Recommendations for future research that consider how aspects of masculinity might lead to the identification of gender-based risk factors are presented.
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Affiliation(s)
- Leonard Jack
- Behavioral and Community Health Sciences Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana 70112, USA.
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Piette JD, Rosland AM, Silveira M, Kabeto M, Langa KM. The case for involving adult children outside of the household in the self-management support of older adults with chronic illnesses. Chronic Illn 2010; 6:34-45. [PMID: 20308349 PMCID: PMC2864454 DOI: 10.1177/1742395309347804] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES This study sought to (1) identify barriers to spousal support for chronic illness self-care among community-dwelling older adults; and (2) describe the potential availability of self-care support from adult children living outside of the household. METHODS Nationally representative US sample of chronically ill adults aged 51+ were interviewed as part of the Health and Retirement Study (N = 14,862). Both participants and their spouses (when available) reported information about their health and functioning. Participants also reported information about their contact with adult children and the quality of those relationships. RESULTS More than one-third (38%) of chronically ill older adults in the US are unmarried; and when spouses are available, the majority of them have multiple chronic diseases and functional limitations. However, the vast majority of chronically ill older adults (93%, representing roughly 60 million Americans) have adult children, with half having children living over 10 miles away. Most respondents with children (78%) reported at least weekly telephone contact and that these relationships were positive. Roughly 19 million older chronically ill Americans have adult children living at a distance but none nearby; these children are in frequent telephone contact and respondents (including those with multiple chronic diseases) report that the relationships are positive. DISCUSSION As the gap between available health services for disease management and the need among community-dwelling patients continues to grow, adult children-including those living at a distance-represent an important resource for improving self-care support for people with chronic diseases.
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Affiliation(s)
- John D Piette
- VA Center for Clinical Management Research, 300 North Ingalls, Ann Arbor, MI, USA.
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Children's roles in parents' diabetes self-management. Am J Prev Med 2009; 37:S251-61. [PMID: 19896027 PMCID: PMC2811065 DOI: 10.1016/j.amepre.2009.08.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2009] [Revised: 07/24/2009] [Accepted: 08/05/2009] [Indexed: 11/23/2022]
Abstract
BACKGROUND Family support is important in diabetes self-management. However, children as providers of support have received little attention. This study examines the role of children in their parents' diabetes self-management, diet, and exercise. METHODS This research used community-based participatory research principles. Researchers conducted semi-structured parallel interviews of 24 Latino and African-American adults with diabetes and with a child (aged 10-17 years) in their home (2004-2006). Interviews were transcribed, coded, and analyzed for themes (2004-2007). RESULTS Adults and children perceived that children play many roles related to adults' diabetes self-management. Parents described children as monitoring parents' dietary intake and reminding them what they should not be eating. Some children helped with shopping and meal preparation. Families described children reminding parents to exercise and exercising with their parents. Children reminded parents about medications and assisted with tasks such as checking blood sugar. Parents and children perceived that children played a role in tempting parents to stray from their diabetes diet, because children's diets included food that parents desired but tried to avoid. CONCLUSIONS Children and parents perceived that children have many roles in both supporting and undermining adults' diabetes self-management. There is more to learn about the bi-directional relationships between adults and children in this setting, and the most beneficial roles children can play. Healthcare providers should encourage family lifestyle changes, strengthen social support for families, and direct children toward roles that are beneficial for both parent and child without placing an unreasonable level of responsibility on the child.
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Chesla CA, Chun KM, Kwan CML. Cultural and family challenges to managing type 2 diabetes in immigrant Chinese Americans. Diabetes Care 2009; 32:1812-6. [PMID: 19628812 PMCID: PMC2752925 DOI: 10.2337/dc09-0278] [Citation(s) in RCA: 94] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Although Asians demonstrate elevated levels of type 2 diabetes, little attention has been directed to their unique cultural beliefs and practices regarding diabetes. We describe cultural and family challenges to illness management in foreign-born Chinese American patients with type 2 diabetes and their spouses. RESEARCH DESIGN AND METHODS This was an interpretive comparative interview study with 20 foreign-born Chinese American couples (n = 40) living with type 2 diabetes. Multiple (six to seven) semistructured interviews with each couple in individual, group, and couple settings elicited beliefs about diabetes and narratives of care within the family and community. Interpretive narrative and thematic analysis were completed. A separate respondent group of 19 patients and spouses who met the inclusion criteria reviewed and confirmed the themes developed from the initial couples. RESULTS Cultural and family challenges to diabetes management within foreign-born Chinese American families included how 1) diabetes symptoms challenged family harmony, 2) dietary prescriptions challenged food beliefs and practices, and 3) disease management requirements challenged established family role responsibilities. CONCLUSIONS Culturally nuanced care with immigrant Chinese Americans requires attentiveness to the social context of disease management. Patients' and families' disease management decisions are seldom made independent of their concerns for family well-being, family face, and the reciprocal responsibilities required by varied family roles. Framing disease recommendations to include cultural concerns for balance and significant food rituals are warranted.
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Affiliation(s)
- Catherine A Chesla
- Department of FamilyHealth Care Nursing, University of California San Francisco, San Francisco, California, USA.
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