Fran and Earl Ziegler College of Nursing, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
National Committee for Quality Assurance (NCQA), Washington, DC, USA.
West J Nurs Res. 2023 Mar;45(3):262-271. doi: 10.1177/01939459221128123. Epub 2022 Oct 17.
Prevalence of chronic illnesses, including type 2 diabetes (T2DM), is increasing disproportionately among Latinx adults in the United States. Health care inequities such as health care discrimination contribute to the disparities in this population. Academic and clinical nurses must address health care discrimination from a strong theoretical framework. In this article, we integrate the minority stress theory and ecosocial theory of disease distribution to offer a whole-person model that identifies the concepts most relevant to Latinx older adults who function at multiple levels of intersectionality. This paper uses T2DM as an exemplar of chronic illness. The integrated model depicts possible pathways of physiological and psychological embodiment of lived experiences of minoritized older persons managing chronic illness who are living in a society deeply embedded with structural racism and oppression. This model may guide future research aimed at elucidating the social and structural determinants that impact health-related outcomes among Latinx older adults.
慢性疾病（包括 2 型糖尿病）在拉丁裔美国成年人中的发病率不成比例地上升。医疗保健方面的不平等，如医疗保健歧视，导致了这一人群的差异。学术和临床护士必须从强有力的理论框架出发来解决医疗保健歧视问题。在本文中，我们整合了少数民族压力理论和疾病分布的生态社会理论，提供了一个整体的个体模型，确定了与在多种交叉层面上发挥作用的拉丁裔老年人群体最相关的概念。本文以 2 型糖尿病为例，说明了慢性疾病。该综合模型描绘了少数族裔老年人在一个深深嵌入种族主义和压迫结构的社会中管理慢性疾病的生活经历的生理和心理体现的可能途径。该模型可能为未来旨在阐明影响拉丁裔老年人健康相关结果的社会和结构决定因素的研究提供指导。
