Accommodating Type 2 Diabetes in the Chinese American Family

Abstract

In this interpretive study, the authors aimed to describe family responses to type 2 diabetes in Chinese Americans as reported by persons with diabetes (PWD) and spouses. Twenty participants representing 16 families completed multiple group interviews. The authors elicited positive and difficult diabetes care narratives and conducted narrative and thematic analysis of transcribed interview texts. Accommodation, the key family response, comprised the enactment of social concerns and practices to balance quality of life for individuals and families with quality of diabetes care. PWDs' accommodation included negotiating disease disclosure, protecting the family's meals, and maintaining ease in family relations despite diabetes symptoms. Accommodation by family members included developing shared diabetes care practices and indirect approaches to disagreements about diabetes management.

Health Communication With Chinese Americans About Type 2 Diabetes

“…17 This authority is so great that patients' spouses often want providers to adopt a more active role because they are seen as more persuasive than the spouse himself or herself. 17 CAs with diabetes often choose what they will discuss and with whom they will disclose their diabetes and how best to manage their disease. While this may not be unique to CAs with diabetes, it is important to recognize how CAs negotiate this often sensitive area of communication with family and friends given the cultural value of relational harmony.…”

“…28 In addition, CAs often encourage family members with diabetes to increase their consumption of particular foods (eg, bitter teas, pumpkin, or bitter melon) to strengthen their constitution. 17 It can be especially distressing for families if these food items contradict medical diabetes diet restrictions. 17 Food practices are so important that CAs with diabetes may avoid social functions because of food restrictions 29 especially if they cause families and hosts to make special accommodations and/or draw unwanted attention.…”

“…17 It can be especially distressing for families if these food items contradict medical diabetes diet restrictions. 17 Food practices are so important that CAs with diabetes may avoid social functions because of food restrictions 29 especially if they cause families and hosts to make special accommodations and/or draw unwanted attention. 27 CAs with diabetes often accommodate their families by ensuring that their own food restrictions do not affect family or friends' food enjoyment.…”

Evidence produced by qualitative investigations on type 2 diabetes: a review of the literature

“…Em geral, as análises sobre pacientes adotaram, pelo menos, um dos seguintes recortes: a) étnico/racial (Cabassa et al, 2008;Struthers et al, 2008;Polzer, Miles, 2007;Naemiratch, Manderson, 2006;Chesla, Chun, 2005;Lawton et al, 2005;Arcury, et al, 2004;Aikins, 2002;Egede, 2002;Daaleman, Cobb, Frey, 2001 Alguns estudos sobre pacientes os selecionaram segundo características clínicas, enfocando pacientes não insulino-dependentes (Schoenberg, Amey, Coward, 1998) ou com um determinado nível de controle glicêmico (Garcia et al, 2007;Zoffmann, Kirkevold, 2005;Savoca, Miller, Quandt, 2004), ou ainda segundo a sua vulnerabilidade (Ciechanowski, Katon, 2006;Williams, 2002). Dois estudos privilegiaram o recorte etário (Mulvaney et al, 2006;Schoenberg, Amey, Coward, 1998) e um, o fato de o paciente ser portador de necessidades especiais (Williams, 2002).…”

Ajustamento familiar no contexto do diabetes tipo 2

“…Desse modo, Chesla & Chun (2005) consideram que a família sofre um processo de ajustamento da doença em seu cenário que abrange os interesses sociais e as práticas cotidianas relacionadas com a qualidade de vida desejada tanto pela pessoa com diabetes quanto pelos outros membros da família. Assim, a família negocia a atenção ao cuidado do diabetes com outros papéis e obrigações sociais, estabelecendo, por exemplo, as formas de divulgação do estado diabético para a sociedade, as maneiras de manter a qualidade de vida protegendo o prazer em comer para a família e meios que facilitam as relações sociais da família, apesar dos sintomas do diabetes e das exigências que a doença impõe.…”