College of Health and Human Sciences, Western Carolina University, Cullowhee, NC, USA.
College of Nursing, University of Colorado Denver, Aurora, CO, USA.
Ethn Health. 2020 Nov;25(8):1055-1071. doi: 10.1080/13557858.2018.1493092. Epub 2018 Jul 3.
The purpose of this study was to examine beliefs, attitudes, and practices of older American Indians regarding their type 2 diabetes mellitus (T2DM) management. T2DM is one of the leading causes of morbidity and mortality among American Indians. American Indians are more than twice as likely to have T2DM and have over three times a T2DM mortality rate as Whites. Study participants were older members of a federally recognized tribe who had T2DM. A low-inference qualitative descriptive design was used. Data were collected through semi-structured in-depth qualitative interviews with a mixed inductive, deductive, and reflexive analytic team process. Our study sample included 28 participants with a mean age of 73.0 ± 6.4 years of whom 16 (57%) were women. Participants' mean self-confidence score of successful T2DM management was 8.0 ± 1.7 on a scale from 1 to 10 with 10 representing the greatest amount of confidence. Participants' mean HbA1c was 7.3% ± 1.5%. Overall, participants discussed T2DM management within five themes: 1) sociocultural factors, 2) causes and consequences, 3) cognitive and affective assessment, 4) diet and exercise, and 5) medical management. It is important to be aware of the beliefs and attitudes of patients. Lay understandings can help identify factors underlying health and illness behaviors including motivations to maintain healthy behaviors or to change unhealthy behaviors. Such information can be helpful for health educators and health promotion program staff to ensure their efforts are effective and in alignment with patients' realities.
这项研究的目的是调查美国老年印第安人对 2 型糖尿病（T2DM）管理的信念、态度和实践。T2DM 是导致印第安人发病率和死亡率的主要原因之一。美国印第安人患 T2DM 的可能性是白人的两倍多，T2DM 死亡率是白人的三倍多。研究参与者是具有 T2DM 的联邦认可部落的老年成员。采用低推断定性描述性设计。通过混合归纳、演绎和反思分析团队过程的半结构化深入定性访谈收集数据。我们的研究样本包括 28 名参与者，平均年龄为 73.0±6.4 岁，其中 16 名（57%）为女性。参与者成功管理 T2DM 的自我信心平均得分为 1 到 10 分的 8.0±1.7 分，其中 10 分表示最大的信心。参与者的平均 HbA1c 为 7.3%±1.5%。总的来说，参与者讨论了 T2DM 管理的五个主题：1）社会文化因素，2）原因和后果，3）认知和情感评估，4）饮食和运动，5）医疗管理。了解患者的信念和态度非常重要。常识可以帮助确定健康和疾病行为背后的因素，包括保持健康行为或改变不健康行为的动机。这些信息对健康教育者和健康促进计划工作人员很有帮助，可以确保他们的努力是有效的，并与患者的实际情况相一致。
