Differentiating Approaches to Diabetes Self-Management of Multi-ethnic Rural Older Adults at the Extremes of Glycemic Control

被引:26
作者
Brewer-Lowry, Aleshia Nichol [1 ]
Arcury, Thomas A. [2 ]
Bell, Ronny A. [1 ]
Quandt, Sara A. [1 ]
机构
[1] Wake Forest Univ, Bowman Gray Sch Med, Dept Epidemiol & Prevent, Div Publ Hlth Sci, Winston Salem, NC 27157 USA
[2] Wake Forest Univ, Bowman Gray Sch Med, Dept Family & Community Med, Winston Salem, NC 27157 USA
基金
美国国家卫生研究院;
关键词
Self-management of chronic disease; African American; American Indian; Diabetes; Qualitative methods; NURSE CASE MANAGER; ETHNIC DISPARITIES; CARE; COMPLICATIONS; INTERVENTION; BEHAVIORS; MELLITUS; MODEL; RISK; LIFE;
D O I
10.1093/geront/gnq001
中图分类号
R4 [临床医学]; R592 [老年病学];
学科分类号
1002 ; 100203 ; 100602 ;
摘要
Purpose of the Study: This study identified approaches to diabetes self-management that differentiate persons with well-controlled from poorly controlled diabetes. Previous research has focused largely on persons participating in self-management interventions. Design and Methods: In-depth qualitative interviews were conducted with 48 adults, drawn from a population-based sample aged 65 years or older with diabetes. The sample was stratified by sex and ethnic group (African American, American Indian, and White) from the low (A1C <6%) and high (A1C >8%) extremes of the glycemic control distribution. Case-based text analysis was guided by a model, including six self-management domains and four resource types (self-care, informal support, formal services, and medical care). Results: A "structured" approach to self-management differentiated respondents in good glycemic control from those in poor glycemic control. Those in good glycemic control were more likely to practice specific food behaviors to limit food consumption and practice regular blood glucose monitoring with specific target values. This approach was facilitated by a greater use of home aides to assist with diabetes care. Respondents in poor glycemic control demonstrated less structure, naming general food categories and checking blood glucose in reaction to symptoms. Implications: Results provide evidence that degree of structure differentiates self-management approaches of persons with good and poor glycemic control. Findings should provide a foundation for further research to develop effective self-management programs for older adults with diabetes.
引用
收藏
页码:657 / 667
页数:11
相关论文
共 34 条
[1]   Self-care and professionally guided care in Osteoarthritis - Racial differences in a population-based sample [J].
Albert, Steven M. ;
Musa, Donald ;
Kwoh, C. Kent ;
Hanlon, Joseph T. ;
Silverman, Myrna .
JOURNAL OF AGING AND HEALTH, 2008, 20 (02) :198-216
[2]  
[Anonymous], 2008, NAT DIAB FACT SHEET
[3]  
[Anonymous], 2002, Diabetes care, V25, pS1
[4]   Physical activity among rural older adults with diabetes [J].
Arcury, TA ;
Snively, BM ;
Bell, RA ;
Smith, SL ;
Stafford, JM ;
Wetmore-Arkader, LK ;
Quandt, SA .
JOURNAL OF RURAL HEALTH, 2006, 22 (02) :164-168
[5]   Staying healthy: the salience and meaning of health maintenance behaviors among rural older adults in North Carolina [J].
Arcury, TA ;
Quandt, SA ;
Bell, RA .
SOCIAL SCIENCE & MEDICINE, 2001, 53 (11) :1541-1556
[6]  
Bandura A., 1986, SOCIAL FDN THOUGHT A
[7]   Hypoglycemia Unawareness in Older Compared With Middle-Aged Patients With Type 2 Diabetes [J].
Bremer, Jan P. ;
Jauch-Chara, Kamila ;
Hallschmid, Manfred ;
Schmid, Sebastian ;
Schultes, Bernd .
DIABETES CARE, 2009, 32 (08) :1513-1517
[8]   Overweight Latino children and adolescents have marked endothelial dysfunction and subclinical vascular inflammation in association with excess body fat and insulin resistance [J].
Caballero, A. Enrique ;
Bousquet-Santos, Kelb ;
Robles-Osorio, Ludivina ;
Montagnani, Valeria ;
Soodini, Geetha ;
Porramatikul, Sriurai ;
Hamdy, Osama ;
Nobrega, Antonio C. L. ;
Horton, Edward S. .
DIABETES CARE, 2008, 31 (03) :576-582
[9]  
Cameron L.D., 2003, SELF REGULATION HLTH
[10]  
Centers for Disease Control and Prevention, 2010, SUMM HLTH STAT US AD