Chesla C A, Skaff M M, Bartz R J, Mullan J T, Fisher L
Department of Family Health Care Nursing, University of California, San Francisco 94143-0606, USA.
Diabetes Care. 2000 Dec;23(12):1780-5. doi: 10.2337/diacare.23.12.1780.
To describe and contrast the personal models of type 2 diabetes in European Americans (EAs) and Latinos and to highlight differences that require a reorientation of clinical care.
A total of 116 EAs and 76 Latino individuals with type 2 diabetes were interviewed about their personal model of diabetes. Responses to open-ended questions about the perceived cause, nature, seriousness, course, and future course of diabetes and its impact on everyday life were analyzed using an iterative process, and categories of response were established. Responses were examined within ethnic group, and comparisons across ethnic groups were made for clinically significant differences.
Disease descriptions about the nature of the disease were categorized as experiential, biomedical, or psychosocial. Disease descriptions varied significantly by ethnicity (chi2 = 35.92, 2 df, P < 0.001), with more Latinos using an experiential model and more EAs using a biomedical model. Significant differences in life changes caused by the disease were found, with EAs reporting changes in exercise and spontaneity and Latinos in fatigue and mood. Individuals with diabetes from both ethnic groups gave comparable assessments about the cause, seriousness, and effectiveness of treatments for the disease.
Clinical practice that attends to the concerns and experiences of individuals with diabetes from diverse ethnic groups is warranted. Broad assessment of personal models in diverse ethnic groups is recommended.
描述并对比欧裔美国人（EA）和拉丁裔2型糖尿病患者的个人疾病模型，并强调那些需要重新调整临床护理方向的差异。
对116名患有2型糖尿病的欧裔美国人和76名患有2型糖尿病的拉丁裔个体进行了访谈，询问他们关于糖尿病的个人疾病模型。通过迭代过程分析了对有关糖尿病的感知病因、性质、严重程度、病程、未来病程及其对日常生活影响的开放式问题的回答，并建立了回答类别。在种族群体内部对回答进行了检查，并对种族群体之间具有临床意义的差异进行了比较。
关于疾病性质的疾病描述分为经验性、生物医学性或心理社会性。疾病描述因种族不同而有显著差异（χ2 = 35.92，自由度为2，P < 0.001），更多拉丁裔使用经验性模型，更多欧裔美国人使用生物医学模型。发现疾病导致的生活变化存在显著差异，欧裔美国人报告锻炼和自发性方面的变化，拉丁裔报告疲劳和情绪方面的变化。来自两个种族群体的糖尿病患者对疾病的病因、严重程度和治疗效果给出了相当的评估。
关注不同种族糖尿病患者的担忧和经历的临床实践是必要的。建议对不同种族群体的个人疾病模型进行广泛评估。
