Doctor talk and diabetes: towards an analysis of the clinical construction of chronic illness

Loewe, Ronald; Schwartzman, John; Freeman, Joshua; Quinn, Laurie; Zuckerman, Stephen

doi:10.1016/s0277-9536(98)00192-0

Cited by 40 publications

(21 citation statements)

References 13 publications

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“…Medical providers' practice models reflect both their personal construction of the disease as well as the bio-medical construction acquired through medical training (Stein 1990). Stereotypical paradigms of culturally diverse populations may significantly interfere with patient education and care (Loewe et al 1998). Health care providers must be able to make an assessment of the role that culture plays in individual patients, as well as for themselves.…”

Section: Discussionmentioning

confidence: 99%

Divergent Models of Diabetes among American Indian Elders

Henderson

2010

J Cross Cult Gerontol

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The purpose of this study was to examine belief systems about diabetes in American Indian elders, and the effects of culture on care-seeking, adherence, and diabetes self-care. Health belief theory predicts that care-seeking and medical adherence are a function of culturally mediated beliefs that result in behaviors that effect health status. In order to elicit cultural meanings of diabetes, in-depth interviews were conducted with an intensity sample of 30 American Indian diabetic elders (55+). Two models of diabetes were identified, divergent in terms of 1) health behaviors, and 2) cultural identification. One model was characterized by delayed care-seeking, and a non-valuing of adherence to diabetes self-care. Non-adherence to medical recommendations was perceived as being socially desirable, because adherence placed the elder outside their peer group. The second model was characterized by early care-seeking and improved adherence to diabetes self-care. These divergent models of diabetes, in which care-seeking, diabetes self-care, and adherence vary as a function of cultural immersion, has implications for health education and disease management and may contribute substantially to health disparities.

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Section: Discussionmentioning

confidence: 99%

Divergent Models of Diabetes among American Indian Elders

Henderson

2010

J Cross Cult Gerontol

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“…These aspects of ''doctor talk'' in diabetes have been noted before. 20 Participants saw patients as being reluctant to start insulin, fearing needles, and the risk of hypoglycaemic episodes. They felt some patients saw insulin as representing failure, associated with inevitable complications.…”

Section: Discussionmentioning

confidence: 99%

Patients with poorly controlled diabetes in primary care: healthcare clinicians' beliefs and attitudes

Jeavons

Hungin

Cornford

2006

Postgraduate Medical Journal

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Objective: To determine doctors' and nurses' attitudes and beliefs about treating patients with type 2 diabetes with less than ideal glycaemic control while receiving maximal oral treatment in primary care. Design: Focus groups. Setting: Primary care. Participants: Four focus groups of 23 GPs and practice nurses. Results: General practice was thought to be the best setting for managing all patients with type 2 diabetes but there were concerns about a lack of resources and unfamiliarity with starting insulin. Issues around compliance were extensively discussed; the ''failing diabetic'' had dual meanings of failing glycaemic control and failing compliance and effort by both patient and doctor. Although views about insulin therapy differed, patients were understood to be resistant to starting insulin, representing for them a more serious stage of diabetes, with fears of needles and hypoglycaemia. Conclusion: The role of diabetes specialist nurses working in primary care will be crucial in managing such patients to improve knowledge, for extra resources, for their experience of insulin use, and to change attitudes.

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“…Em 17 pesquisas foram utilizados softwares para análise de dados qualitativos, com destaque para o Ethnograph (Arcury et al, 2004;Broom, Whittaker, 2004;Savoca, Miller, Quandt, 2004;MercadoMartinez, Ramos-Herrera, 2002;Liburd et al, 1999) e o NUD.IST (Lawton et al, 2005;Sarkadi, Rosenqvist, 2003;Daaleman, Cobb, Frey, 2001;Samuel-Hodge et al, 2000;Loewe et al, 1998), seguidos pelo Atlas.ti (Cabassa et al, 2008;Lutfey, Freese, 2007) e pelo NVivo (Polzer, Miles, 2007;Lawton, Peel, Parry, 2008).…”

Section: Metamétodounclassified

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

Castellanos

Barros

Spadacio

et al. 2011

Interface (Botucatu)

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Type 2 diabetes has a major impact on patients lives and the healthcare network. Given the growth in qualitative information on diabetes, it becomes important to systematize this knowledge. A meta-study on diabetes was conducted through analysis on 42 articles that were made in journals at the periodicals portal of the Coordination Office for Advancement of Higher-level Personnel (Capes). We found that the studies reviewed had a good theoretical basis, which included: care management, health-disease concepts, professional-patient relationships, professional practices and treatment compliance. The articles clearly described the methodological procedures used. The use of interviews and focal groups for data gathering predominated, and it was sought to explore different views of the individuals investigated. It was reaffirmed that it was important for health professionals and managers to implement healthcare policies, programs and models that are appropriate for the specific features of chronic illness, guided by comprehensive care and co-responsibility.

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Doctor talk and diabetes: towards an analysis of the clinical construction of chronic illness

Cited by 40 publications

References 13 publications

Divergent Models of Diabetes among American Indian Elders

Divergent Models of Diabetes among American Indian Elders

Patients with poorly controlled diabetes in primary care: healthcare clinicians' beliefs and attitudes

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

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