IntroductionThe transition from paediatric to adult diabetes care in youth-onset diabetes (type 1 diabetes mellitus, Y-T1DM and type 2 diabetes mellitus, Y-T2DM) is associated with worsening glycaemic control, missed clinical visits, decreased medication adherence and the emergence of cardiometabolic complications. The socio-ecological challenges that influence transitioning to adult diabetes care may be distinct between Y-T1DM and Y-T2DM. The goal of this scoping review is to map the state of the literature on transitioning care in Y-T2DM compared with Y-T1DM and to identify the main sources and types of evidence available. The objectives are : (1) to identify the factors within the socio-ecological framework (individual, relationship, community, societal) associated with transitioning to adult care in Y-T2DM compared with Y- T1DM, and (2) to identify knowledge gaps related to transitioning to adult care.MethodsThe scoping review protocol and reporting will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for scoping reviews guidelines. A systematic search of scientific databases (PubMed, Embase, Cumulative Index to Nursing and Allied Health, Scopus and APA PsycNet will be undertaken for articles between 1 January 1990 and 30 September 2022. Study designs will include peer-reviewed experimental and quasi-experimental published studies without language or country-specific restrictions. We will exclude articles on other diabetes subtypes and will exclude non-peer reviewed articles such as opinion papers, anecdotal reports or supplementary commentaries.AnalysisReferences will be collated, sorted and extracted using Covidence. Factors associated with transition from paediatric to adult diabetes care in Y-T1DM and Y-T2DM will be identified using the socio-ecological framework and results will be presented in narrative format, tables, and summary graphs.Ethics and disseminationEthical approval will not be applicable for this review.Trial registration numberhttps://osf.io/k2pwc.
Objective To report a study that explored hypertension (HTN) stress and coping experiences of West‐Africa‐born immigrant (WABI) women in Washington DC Metropolitan area of the United States. Design and sample This qualitative study conducted from December 2017 to May 2018 involved WABI women (n = 15) in Washington Metropolitan area that self‐reported diagnosis of HTN. The transactional model of stress and coping (TMSC) provided the conceptual framework. Data collection was through semi‐structured one‐on‐one interviews. Data analysis was done through manual open‐hand coding of themes. Results Three themes emerged from the analysis: Perceived Stressors, Sources of Stress, and Coping Measures. Participants perceived that their HTN diagnosis contributed to their stress; reported other financial, school, work, trauma, household and marriage‐related stressors, and coping measures that include faith‐based and other recreational leisure activities. Conclusion Participants mentioned stressors related to lack of support with domestic house chores and described various religious practices as coping strategies. These findings provide additional insights relevant to several ongoing public health nursing conversations on acute and chronic stress management in different parts of the globe. Public health nurses need to utilize these findings when assessing stressors and considering safe coping measures that appeal to WABI women experiencing HTN or chronic illness.
BackgroundHypertension is a major risk factor for cardiovascular disease and the leading cause of premature deaths in the United States. Hypertension is a commonly reported chronic disease in foreign-born-adult immigrants living in the United States, and psychosocial-cultural factors such as lack of health insurance and poor transportation services have been reported particularly among foreign-born immigrant women with hypertension and other chronic diseases. However, little is known about the socio-cultural factors that influence access to and utilization of hypertension health services in West-African-born immigrant women in the United States.MethodsThis study utilized a qualitative design with a phenomenological approach to interview a purposeful sample of fifteen West-African-born immigrant women that reported diagnosis of hypertension (12 with health insurance and 3 without health insurance) in the Washington District of Columbia Metropolitan area. The Patient Centered Access to Health Care Model guided the conceptual framework of the study. Thematic analysis was used to identify patterns and generate categories and themes.ResultsFive themes emerged from the analysis: Health Insurance Coverage, Frequency of Hypertension Care Visits, Interaction with HCP, Culturally Sensitive HCP, and HTN Self-Care Incentives. Eighty percent of participants had medical insurance and transportation services, but delayed seeking HTN care because their health care providers did not listen to their concerns or discuss their preferences before prescribing treatment. More than 60 percent of the women reported that clinicians did not listen to their concerns or provide culturally appropriate guidance during their visits.ConclusionsThese findings could be helpful for larger scale studies, or smaller comparative studies in other regions of the United States. Cultural competence training should be included in the continuing education curriculum of healthcare providers serving the West-African-born immigrant population.
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