Developing a Conceptual Framework for Understanding Illness and Attitudes in Older, Urban African Americans With Diabetes

Abstract

Wide variation exists in the attitudes of older African Americans toward their diabetes and treatment. Patients frequently expressed ambivalence toward the care of their illness. Providers should explore these issues and help patients resolve their ambivalence if patient preferences are to be respected in the overall treatment plan.

The Role of Spirituality in the Self-management of Chronic Illness among Older African and Whites

“…Current research on spirituality and health has made important strides in understanding the role of race and ethnicity and has contributed to the literature (Abrums 2000;Arcury et al 2000;Chatters and Taylor 1994;Chin et al 2000;George et al 2000;Mansfield et al 2002;Matthews et al 1998;McAuley et al 2000). With the expanding literature base, it is important to examine the role of spirituality in the lives of older Americans as it pertains to their perception of chronic illness and disease management.…”

“…Many scholars have noted from the interviews with African American elders that spirituality is an integral part of the respondents' lives (Armstrong and Crowther 2002;McAuley et al 2000;Robinson 1985). Qualitative insights regarding the integration of spirituality and self-management were reported in older urban African American diabetics by Chin et al (2000), older rural African American adults by Arcury et al (2000) and African American women by Abrums (2000). In a study with 19 older African American diabetics, Chin et al found that respondents believed God directed their lives and justified their use of self-management by using the analogy that God works through others.…”

“…Ramsey and Blieszner (1999) suggested that older adults are using spirituality to manage the challenges associated with living with their chronic illness. According to Chin et al (2000), 11 of the 19 older African Americans in their study cited spirituality as a coping mechanism in dealing with their chronic illness. The aforementioned studies suggest that chronically ill older adults are using spirituality as a resource, but the available literature does not offer a clear description of how this process occurs.…”

Perspectiva de los pacientes sobre la diabetes tipo 2 y relación con los profesionales sanitarios de atención primaria: un estudio cualitativo

“…Cuando el paciente percibe que su perspectiva, vivencia y decisiones sobre la enfermedad se tienen en cuenta, su participación y cooperación en el plan de tratamiento son más activas y efectivas. Y, finalmente, los resultados son mejores 7 . Cuando paciente y profesional negocian, elaborando alternativas y decisiones conjuntas, mejoran tanto su satisfacción como los resultados clínicos 8,9 .…”

Identifying and Reaching Populations at Risk: The Paradox of Breast Cancer Control

“…Further, the concept of unnatural, "foreign" substances being introduced into the body echoed other comments about the possibility of injury due to social transgression such as doing work foreign to one's gender status or social expectations causing breast cancer. Social transgression and immoral behavior are strongly implicated means of pollution and hence disease in many cultural traditions, including African American health traditions [17][18][19]. It is clear that the above postulated disease prevention framework above strongly incorporates a purity/pollution construct.…”