Narrative inquiry in diabetes research: Illuminating the psychosocial aspects of diabetes

Acuff, Lisa M.; Paulus, Trena M.

doi:10.17125/plaid.2016.60

Cited by 4 publications

(3 citation statements)

References 39 publications

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“…The participant provides insights into the relevance of their narration, greatly enhancing the analysis and interpretation (Chase, 2003). Illness narratives thus elicit how people make meaning and understand their lived experience with illness (Acuff & Paulus, 2016;Crabtree et al, 1992;Kleinman, 1988;Phoenix et al, 2010).…”

Section: Methodsmentioning

confidence: 99%

“How I Can Help Me”: Self-Care Priorities and Structural Pressures Among Black Older Adults With Diabetes

et al. 2021

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Background and Objectives Disparities in Type 2 diabetes mellitus (diabetes) represent an ongoing public health challenge. Black older adults are at high risk of diabetes and diabetes' complications. Diet, physical activity, and medication can control these risks, yet disease rates remain elevated. Utilizing an Intersectionality framework, we seek to extend understanding of the social dimensions of diabetes through an examination of the diabetes self-care process from the perspective of Black older adults. Research Design and Methods This project involved a thematic analysis of diabetes illness narrative interviews with Black participants (N=41) in our National Institute on Aging-funded study of diabetes. In a narrative approach, the participant communicates the significance of actions and events. Results The findings suggest that diabetes self-care involves interconnected struggles across four domains of care: 1) multimorbidity management, 2) financial well-being, 3) family support, and 4) formal health care. Discussion and Implications Black older adult self-care reflects an active process of pursuing meaningful social goals and critical health needs. An Intersectional framework, however, reveals the ongoing histories of inequity that shape this process. Further intervention to address the racist policies and practices found in Black older adults' communities and clinical care is needed to make true progress on diabetes disparities.

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Section: Methodsmentioning

confidence: 99%

“How I Can Help Me”: Self-Care Priorities and Structural Pressures Among Black Older Adults With Diabetes

et al. 2021

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“…Participants can emphasize areas of relief or accomplishment as well as misgivings. The illness narrative thus is a window into how illness unfolds and is experienced by an individual within the broader social context (Acuff & Paulus, 2016; Phoenix et al, 2010). The ability to reflect on the meaning of a story as it is told greatly enhances the analysis and interpretation (Chase, 2003).…”

Section: Methodsmentioning

confidence: 99%

“Here it was waiting for me:” Diabetes Diagnosis Pathways and Implications for Health Policy

Chard¹,

Girling²,

Harris-Wallace³

et al. 2022

Journal of Elder Policy

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Diabetes in older adults is a growing public health concern with nearly 30% of Americans 65 and older having diabetes. This includes 2.6 million older adults with undiagnosed diabetes who are at high risk of microvascular and cardiovascular complications (Centers for Disease Control and Prevention, 2022). The majority of cases are Type-2 diabetes. The past decade has witnessed an expansion in screening recommendations in an effort to reduce rates of undiagnosed older adults. Drawing on the sociology of diagnosis, we suggest further attention to the social factors that shape the diagnosis process is needed. We examine the diabetes diagnosis process from the perspective of older adults with type 2 diabetes. The data derive from diabetes illness narrative interviews with non-Hispanic White and African American older adult men and women (age ≥50) with type 2 diabetes (N=83). Our thematic analysis reveals four pathways to diagnosis: 1. Annual wellness exam, 2. Workplace screening, 3. Community-based opportunities, and 4. Health event or alarm. Diabetes' early symptoms are often normalized within daily life, with health insurance gaps, providers' dismissal of symptoms, and nonprescription medications reinforcing efforts to address initial symptoms within the home. Wellness visits, as well as worksite and community-based screening, critically intercede in the unfolding of symptoms. In contrast, diagnosis in connection with a health event or alarm carries an additional toll on social and emotional well-being. These findings have implications for national screening policies and local diabetes control efforts.

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“…(See Online Supplementary Material Section 1 for the complete parent study interview guide) Probes encouraged participants to elaborate on the historic and present-day context of their diabetes, beliefs surrounding diabetes, and approaches to diabetes management. Narrative inquiry brings the scholar to deeper understanding of the way people make meaning and understand their lived experience with illness generally (Crabtree et al, 1992;Kleinman, 1988;Phoenix et al, 2010), and specifically with diabetes (Acuff & Paulus, 2016). By inviting participants to tell a story, the participant takes responsibility for communicating its meaning and relevance to the exchange, thereby becoming part of the analysis and interpretation (Chase, 2003).…”

Section: Methodsmentioning

confidence: 99%

Affective Practices of Diabetes Self-Management Among Older Adults: Cumulative Effects of Childhood Adversity

Roth

Chard

2021

The Gerontologist

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Background and Objectives A strong correlation exists between Type 2 diabetes mellitus and adverse childhood experiences. How adverse childhood experiences inform later life diabetes management is less understood. This article examines diabetes management from the perspective of affective practice to explore the lingering impact of trauma biographies in diabetes management. Research Design and Methods This secondary narrative analysis of 15 in-depth interviews with community-dwelling older adults with diabetes (subsample of The Subjective Experiences of Diabetes Study), focuses on the ways their reported childhood adversity impacts perceptions of and responses to diabetes self-management. Results The experiences of adversity in childhood accumulate, throughout the life course, in the affective practices informing diabetes self-management, from blood glucose testing, to food consumption, to the emotions invested in body size. We identify three thematic areas that emerged across participants: 1) Undermining self-worth; 2) (Over)eating and food as comfort; and 3) Weight and body size. Discussion and Implications Our findings highlight affective practices as a mechanism through which adverse events accumulate and shape well-being over the life course. This analysis also suggests the potential for (de)accumulation of affective practices to improve diabetes management. The findings support recent calls for trauma-informed clinical care.

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Narrative inquiry in diabetes research: Illuminating the psychosocial aspects of diabetes

Cited by 4 publications

References 39 publications

“How I Can Help Me”: Self-Care Priorities and Structural Pressures Among Black Older Adults With Diabetes

“How I Can Help Me”: Self-Care Priorities and Structural Pressures Among Black Older Adults With Diabetes

“Here it was waiting for me:” Diabetes Diagnosis Pathways and Implications for Health Policy

Affective Practices of Diabetes Self-Management Among Older Adults: Cumulative Effects of Childhood Adversity

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