Chard Sarah, Harris-Wallace Brandy, Roth Erin G, Girling Laura M, Rubinstein Robert, Reese Ashanté M, Quinn Charlene C, Eckert J Kevin
Department of Sociology, Anthropology, and Health Administration & Policy, Center for Aging Studies, UMBC, Baltimore, Maryland.
Sociology and Anthropology, Spelman College, Atlanta, Georgia.
J Gerontol B Psychol Sci Soc Sci. 2017 Mar 1;72(2):319-327. doi: 10.1093/geronb/gbw119.
Rowe and Kahn's concept of successful aging remains an important model of well-being; additional research is needed, however, to identify how economically and socially disadvantaged older adults experience well-being, including the role of life events. The findings presented here help address this gap by examining the subjective construction of well-being among urban African American adults (age ≥ 50) with Type 2 diabetes.
As part of the National Institute on Aging-funded Subjective Experience of Diabetes among Urban Older Adults study, ethnographers interviewed African American older adults with diabetes (n = 41) using an adaptation of the McGill Illness Narrative Interview. Data were coded using an inductively derived codebook. Codes related to aging, disease prognosis, and "worldview" were thematically analyzed to identify constructions of well-being.
Participants evaluate their well-being through comparisons to the past and to the illnesses of friends and family. Diabetes self-care motivates social engagement and care of others. At times, distrust of medical institutions means well-being also is established through nonadherence to suggested biomedical treatment.
Hardship and illness in participants' lives frame their diabetes experience and notions of well-being. Providers need to be aware of the social, economic, and political lenses shaping diabetes self-management and subjective well-being.
罗和卡恩的成功老龄化概念仍然是幸福的一个重要模型；然而，还需要更多研究来确定经济和社会处境不利的老年人如何体验幸福，包括生活事件的作用。此处呈现的研究结果通过考察患有2型糖尿病的城市非裔美国成年人（年龄≥50岁）对幸福的主观构建，有助于填补这一空白。
作为美国国立衰老研究所资助的城市老年人糖尿病主观体验研究的一部分，人种志学者采用麦吉尔疾病叙事访谈的改编版，对患有糖尿病的非裔美国老年人（n = 41）进行了访谈。数据使用归纳得出的编码手册进行编码。对与衰老、疾病预后和“世界观”相关的编码进行主题分析，以确定幸福的构建方式。
参与者通过与过去以及朋友和家人的疾病进行比较来评估自己的幸福。糖尿病自我护理激发了社交参与和对他人的照顾。有时，对医疗机构的不信任意味着幸福也通过不遵循建议的生物医学治疗来确立。
参与者生活中的艰难困苦和疾病构成了他们的糖尿病经历和幸福观念。医疗服务提供者需要意识到影响糖尿病自我管理和主观幸福的社会、经济和政治因素。
