Adherence to diabetes self-care behaviors in English- and Spanish-speaking Hispanic men

Abstract

We conducted a qualitative study to elicit attitudes, attributions, and self-efficacy related to diabetes self-care in both English- and Spanish-speaking Hispanic men. Transcripts from six focus groups (three in English and three in Spanish) were reviewed by the authors to extract principal and secondary themes. Participants could describe their medication and lifestyle regimens and were aware of whether they were adherent or nonadherent to physician recommendations. Lack of skills on how to incorporate diet and regular physical activity into daily living, lack of will power, and reluctance to change culturally rooted behaviors emerged as significant barriers to diabetes self-management. Medication adherence is for some men the principal diabetes self-care behavior. Nonadherence appeared to fit two profiles: 1) intentional, and 2) nonintentional. In both instances low self-efficacy emerged as a significant influence on attainment and maintenance of diabetes self-care goals. Participants also expressed a strong sense of fatalism regarding the course of their disease, and seemed to have little motivation to attempt long-term dietary control. Educational and counseling messages should stress that a diagnosis of diabetes is not a death sentence, and full functional capacity can be maintained with good control.

Prototype evaluation of a self-management Internet diary for patients with ulcerative colitis

“…A recent paper in Patient Preference and Adherence illustrates how "full functional capacity can be maintained with good control (in patients with another chronic illness that requires self-management, ie, diabetes)." 19 Our study shows that self-management with an Internet diary seems feasible.…”

Type 2 Diabetes Self-management Among Spanish-Speaking Hispanic Immigrants

“…The purpose of Model 3 was to build upon the success of the Models 1 and 2 by incorporating SE. Diabetes SE was the only SE measure included in the model, a decision that was based on participant scores on the instrument and SE as a contributor to healthy life style behaviors and role in HbA1c [16,66]. Model 3 was the most complex model, yet still exhibited good statistical properties, including an acceptable Hoelter N. Theory would suggest that SE plays a role in T2DM self-management and the SEM performed is consistent with this theory.…”

“…Limited English proficiency negatively affects an individual's health literacy within the US healthcare system, contributes to low diabetes knowledge, undermines T2DM self-efficacy and is associated with worse health outcomes [14][15][16][17][18][19][20][21].…”

“…SE is behavior specific and is not transferable from one domain to another, therefore diabetes SE is limited to diabetes selfmanagement, while exercise and eating self-efficacy are coupled to those behaviors [16,22,25].…”

“…Health literacy is generally defined as the ability to access health services and understand and act on health information; low health literacy is associated with a decreased ability to self-manage chronic conditions such as diabetes [15,16,27]. Although health literacy has been explored among Hispanic populations, the inclusion criterion often requires English-language proficiency and recruits participants from hospital or clinic waiting rooms thereby excluding limited-English proficient immigrants and those who do not regularly access healthcare services [18][19][20]28].…”