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Rascón AM, McEwen MM, Slebodnik M. Self-management of chronic disease in Latina Kinship caregivers: an integrative review. J Women Aging 2023; 35:65-80. [PMID: 34821538 DOI: 10.1080/08952841.2021.2007827] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
In the United States, Latinos experience a higher prevalence of chronic diseases with concomitant complications when compared to Non-Latino Whites. Older Latina women often manage a chronic illness while also providing kinship care. This article presents an integrative review of Latina kinship caregivers' self-management of chronic disease. An extensive review of the literature was conducted in seven databases. Four resulting studies included qualitative, quantitative, and mixed methods research and suggested health outcomes for Latina kinship caregivers were often worse when compared to other groups. A major gap in the literature identified an absence of disease-specific self-management behaviors for this population.
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Affiliation(s)
- Aliria Muñoz Rascón
- Edson College of Nursing and Health Innovation, Arizona State University, Tempe, Arizona, USA
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Randolph SD, Johnson R, McGee K, A Adimora A, Ramirez C, Bailey DE, Holt L, Koch A, McMillian-Bohler JM, Ritchwood T, Relf MV. Adaptive leadership in clinical encounters with women living with HIV. BMC Womens Health 2022; 22:217. [PMID: 35681158 PMCID: PMC9185975 DOI: 10.1186/s12905-022-01810-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 06/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Women living with HIV (WLWH) report low engagement in health care, missed office visits, and less engagement in the clinical encounter. Strengthening the clinical encounter for WLWH may improve health outcomes and quality of life. The Adaptive Leadership Framework for Chronic Illness offers specific adaptive leadership strategies for providers to improve patient-provider interactions. The purpose of this study was to examine adaptive leadership behaviors that contribute to the development of effective patient-provider communication from the perspectives of WLWH. METHODS The descriptive, cross-sectional and qualitative study conducted interviews with 22 WLWH to assess perceptions of the clinical encounter related to HIV-related stigma, engagement in care, medical distrust, and experiences with discrimination and quality of life. Members of the study team using a set of a priori codes analyzed data using NVivo 12.0. RESULTS Participants described two primary themes and subthemes of each for adaptive leadership behaviors. The primary theme for adaptive leadership of providers was "my provider cares about me"; subthemes were communication, trust building takes time, and supportive providers are trusted. The primary theme for adaptive leadership of WLWH themselves was "I care about me; subthemes were self-advocacy and self-empowerment. CONCLUSIONS Providers can use adaptive leadership behaviors during clinical encounters to support WLWH, improve patient-provider communication, enhance trust, and improve patient outcomes.
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Affiliation(s)
| | | | - Kara McGee
- Duke University School of Nursing, Durham, NC, USA
| | - Adaora A Adimora
- Sarah Graham Kenan Distinguished Professor of Medicine, Department of Epidemiology, School of Medicine, Gillings School of Global Public Health at the University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Catalina Ramirez
- School of Medicine and the Project Director for the Women's Interagency HIV Study at the University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Lauren Holt
- Duke University School of Nursing, Durham, NC, USA
| | - Amie Koch
- Duke University School of Nursing, Durham, NC, USA
| | | | - Tiarney Ritchwood
- Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, NC, USA
| | - Michael V Relf
- Duke University School of Nursing, Durham, NC, USA
- Duke Global Health Institute, Durham, NC, USA
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Bailey DE, Caiola C, Adimora AA, Ramirez C, Holt L, Johnson R, Koch A, McGee K, McMillian-Bohler JM, Randolph SD, Ritchwood TD, Relf MV. Adaptive Challenges, Adaptive Work, and Adaptive Leadership Among Women Living With HIV in the Southern United States: Findings From a Qualitative Study. J Assoc Nurses AIDS Care 2022; 33:259-269. [PMID: 35500057 PMCID: PMC9244859 DOI: 10.1097/jnc.0000000000000288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Women living with HIV have a higher burden of non-AIDS comorbidities and prevalence of chronic conditions. The Adaptive Leadership Framework for Chronic Illness clarifies living with complex health challenges by delineating the technical work of health care providers as well as the adaptive work and leadership behaviors of patients and their providers. We conducted a descriptive, qualitative study of women residing in the Southern United States who were participating in the Women's Interagency HIV Study in North Carolina. Twenty-two participants (mean age = 52.2 years; 90.9% self-identifying as Black or African American) completed semi-structured qualitative interviews. We identified adaptive challenges (e.g., affective and disclosure challenges) and adaptive work and leadership behaviors. Women learned skills to care for their health and support their families and to work with their providers to manage their care. Findings support the importance of identifying leadership behaviors for the purpose of developing person-centered interventions.
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Affiliation(s)
- Donald E. Bailey
- Duke University School of Nursing, Durham, North Carolina, USA. Courtney Caiola
| | - Courtney Caiola
- East Carolina University, School of Nursing, Greenville, North Carolina, USA
| | - Adaora A. Adimora
- Sarah Graham Kenan Distinguished Professor of Medicine, School of Medicine, and Professor of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Catalina Ramirez
- School of Medicine, and Project Director, Women’s Interagency HIV Study, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Lauren Holt
- Duke University School of Nursing, Durham, NorthCarolina, USA
| | - Ragan Johnson
- Duke University School of Nursing, Durham, North Carolina, USA
| | - Amie Koch
- Duke University School of Nursing, and Palliative Care and Hospice Family Nurse Practitioner, Transitions LifeCare, and a COVID Nurse Practitioner, Lincoln Community Health Clinic, Durham, North Carolina, USA
| | - Kara McGee
- Duke University School of Nursing, Durham, North Carolina, USA
| | | | | | - Tiarney D. Ritchwood
- Department of Family Medicine and Community Health, Duke University School of Medicine, Durham,NorthCarolina,USA
| | - Michael V. Relf
- Associate Dean for Global and Community Health Affairs, Duke University School of Nursing, and an Associate Professor, Duke Global Health Institute, Durham, North Carolina, USA
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Rascón AM, McEwen MM, Crist JD. "My problems aren't their fault": Mexican American women managing diabetes while caring for grandchildren. J Women Aging 2021; 34:745-756. [PMID: 34494937 DOI: 10.1080/08952841.2021.1969861] [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: 10/20/2022]
Abstract
Diabetes affects many aspects of family life for the Mexican American (MA) population. Caregiving grandmothers, the traditional family nurturers, are often simultaneously managing their type 2 diabetes (T2DM). The purpose of this qualitative descriptive study was to describe the perceptions of MA grandmothers managing T2DM while caring for a grandchild. Eight participants were interviewed. Participants consistently reported feeling a personal responsibility for their T2DM self-management as well as for the health and wellbeing of their families, including their grandchildren. Regardless of associated caregiving stress, grandchildren were described as the main source of positive motivation for T2DM self-management.
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Affiliation(s)
- Aliria Muñoz Rascón
- Edson College of Nursing and Health Innovation, Arizona State University, Tempe, Arizona, USA
| | | | - Janice D Crist
- College of Nursing, University of Arizona, Tucson, Arizona, USA
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Stevenson EL, McEleny KR, Moody E, Bailey DE. Applying the Adaptive Leadership Framework for Chronic Illness to understand how American and British men navigate the infertility process. Health Psychol Open 2019; 6:2055102919871647. [PMID: 31489202 PMCID: PMC6710696 DOI: 10.1177/2055102919871647] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
In this article, we sought to understand the adaptive challenges and work faced by men with male factor infertility. Using a prospective qualitative study in private (the United States) and academic (the United Kingdom) urology clinics, we recruited seven American and five British men with primary infertility after their urology consultation for male factor infertility between December 2015 and April 2017. Individual in-depth qualitative interviews were conducted shortly after male factor infertility urology consultation and then two additional interviews at about 3 and 6 months. We found three themes related to adaptive challenges faced during fertility treatment: avoidance (not disclosing, avoided social network), uncertainty (about ability to have a child, fertility-related information, and male factor infertility status), and affective symptoms (sadness, shock, disbelief, denial, about not achieving fatherhood, and poor outcomes). Four themes about adaptive work included focusing on goal (having clear, actionable steps; knowledge received from urologist; exhausted all options; focus on parenthood), support from partner (relationship and communication), support from health care team (provision of emotional support, increased comfort with staff over time, disclosure of knowing others with same condition), and acquired information (understanding issue, support from urologist, seeking information). We concluded that men with male factor infertility face adaptive challenges including avoidance, uncertainty, and affective symptoms. To manage during the treatment process, they use adaptive work including focusing on the goal, receiving support from their partner and health care team, and acquiring information. Although qualitative results cannot be generalized to larger populations, they might be applicable to men with male factor infertility during infertility treatment.
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Affiliation(s)
| | | | - Eilis Moody
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, UK
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