Weiler Dawn M, Crist Janice D
The Department of Nursing, Boise State University, Boise, Idaho (Dr Weiler)
The College of Nursing, University of Arizona, Tucson (Dr Crist)
Diabetes Educ. 2009 Mar-Apr;35(2):285-92. doi: 10.1177/0145721708329545. Epub 2009 Feb 9.
The purpose of this qualitative descriptive study was to explore the sociocultural influences and social context associated with living with type 2 diabetes among migrant Latino adults.
A qualitative descriptive study using grounded theory techniques was conducted. In-depth semistructured interviews were completed with 10 participants (6 female and 4 male) ranging in age from 46 to 65 years and with a duration of diabetes diagnosis ranging from 1.5 to 40 years.
An overarching meta-theme of self-management in a social environment emerged. Every aspect of the process of self-management, as described in the 4 major themes-(1) family cohesion, (2) social stigma of disease, (3) social expectations/perception of "illness," and (4) disease knowledge and understanding-was influenced by the social context.
The familist traditions, central to the Mexican culture, had both positive and negative consequences on diabetes management. Tailoring clinical care and developing novel education approaches, to include family and community, is central to improving the health of this population. Recognizing and acknowledging the social stigma associated with diabetes, for this population, will promote understanding and improve clinician-patient communication. The sociocultural influences that affect diabetes management practices (eg, include family, in particular the primary female caregiver, and establish community- and home-based education sessions) must be integrated into clinical practice. Future research focused on population-defined health and disease self-management, novel educational interventions, and family and community interventions focusing on the concept of social stigma of disease is indicated to further affect the health disparities of this population.
这项定性描述性研究的目的是探讨拉丁裔成年移民2型糖尿病患者的社会文化影响因素及与之相关的社会背景。
采用扎根理论技术进行定性描述性研究。对10名参与者（6名女性和4名男性）进行了深入的半结构化访谈，他们的年龄在46至65岁之间，糖尿病诊断时长在1.5至40年之间。
出现了一个关于在社会环境中自我管理的总体元主题。自我管理过程的各个方面，如在4个主要主题中所描述的——（1）家庭凝聚力，（2）疾病的社会耻辱感，（3）社会期望/对“疾病”的认知，以及（4）疾病知识与理解——均受到社会背景的影响。
墨西哥文化核心的家族主义传统对糖尿病管理既有积极影响，也有消极影响。调整临床护理并开发新颖的教育方法，将家庭和社区纳入其中，对于改善这一人群的健康状况至关重要。认识并承认与该人群相关的糖尿病社会耻辱感，将促进理解并改善医患沟通。影响糖尿病管理实践的社会文化因素（例如，纳入家庭，特别是主要女性照顾者，并开展社区和家庭层面的教育课程）必须融入临床实践。未来的研究应聚焦于特定人群的健康与疾病自我管理、新颖的教育干预措施，以及关注疾病社会耻辱感概念的家庭和社区干预措施，以进一步影响该人群的健康差异。
