Johnson Jalil A, Cavanagh Stephen, Jacelon Cynthia S, Chasan-Taber Lisa
College of Nursing, University of Massachusetts, Amherst, MA, USA (Mr Johnson, Dr Cavanagh, Dr Jacelon, Dr Chasan-Taber).
Diabetes Educ. 2017 Apr;43(2):153-162. doi: 10.1177/0145721716687662. Epub 2017 Jan 22.
Purpose The purpose of this systematic review was to describe what is known about the diabetes disparity affecting Puerto Rican identified adults living in the continental United States as well as illuminate areas that merit further investigation. Methods The CINAHL and PubMed databases were searched using the keywords Hispanic, Puerto Rican, and type 2 diabetes. Search limits included < 10-year-old, peer-reviewed, systematic reviews, available in the English language. The abstracts of 124 articles were reviewed, and 7 articles were reviewed in depth. Results The Puerto Rican identified Hispanic subgroup is disproportionately affected by diabetes-the diabetes disparity. Puerto Rican identified Hispanic adults are less affected by citizenship status, may be less affected by English proficiency, use health care services differently, and have contextually different fatalistic views of diabetes compared with other Hispanic identified people. Spiritual/religious influences, associated mental health problems, and general cultural practices related to diabetes self-care are understudied in this group. Conclusion Ambiguous use of the term Hispanic should be avoided when describing Hispanic subgroups. Stronger, more robust studies are needed to understand the unique cultural forces influencing the poor diabetes outcomes and individual behaviors that contribute to generally suboptimal diabetes self-care for Puerto Rican adults with type 2 diabetes.
目的 本系统评价的目的是描述关于影响居住在美国大陆的已确定为波多黎各裔成年人的糖尿病差异的已知情况,并阐明值得进一步研究的领域。方法 使用关键词“西班牙裔”“波多黎各裔”和“2型糖尿病”检索CINAHL和PubMed数据库。检索限制包括年龄小于10岁、同行评审、系统评价、英文可用。对124篇文章的摘要进行了审查,并对7篇文章进行了深入审查。结果 已确定为波多黎各裔的西班牙裔亚组受糖尿病影响的比例过高——即糖尿病差异。与其他已确定为西班牙裔的人群相比,已确定为波多黎各裔的西班牙裔成年人受公民身份状态的影响较小,可能受英语水平的影响较小,使用医疗保健服务的方式不同,并且对糖尿病有不同的宿命论观点。该群体中精神/宗教影响、相关心理健康问题以及与糖尿病自我护理相关的一般文化习俗的研究较少。结论 在描述西班牙裔亚组时应避免对“西班牙裔”一词的模糊使用。需要更强大、更有力的研究来了解影响糖尿病不良结局的独特文化因素以及导致2型糖尿病波多黎各裔成年人糖尿病自我护理普遍欠佳的个体行为。