Perceptions of Barriers in Managing Diabetes

Abstract

Hispanics show poorer self-management of type 2 diabetes than non-Hispanic Whites. Although previous studies have reported socioeconomic and cultural barriers to diabetes self-management by Hispanics, little is known about perceived barriers to diabetes self-management from the perspectives of both Hispanics and their family members. Purpose The purpose of the study was to explore perceived barriers among Hispanic immigrants with diabetes and their family members. Methods A qualitative study using five focus groups was conducted. A total of 73 Hispanic immigrants with type 2 diabetes (n=36) and family members (n=37) were recruited in the southeastern United States for a family-based intervention study of diabetes-self management. Participants were asked to describe their perceptions of barriers to self-management. The five sessions were audiotaped and transcribed, translated from Spanish into English, and analyzed using standard content analysis. Demographics, hemoglobin A1C levels, blood pressure and BMI were obtained both for participants with diabetes and for their family members. Results Barriers to diabetes self-management themes identified by participants with diabetes were in three major themes categorize: suffering from diabetes, difficulties in managing the disease, and lack of resources/support. Two key themes emerged pertaining to family members: we can provide support and we lack knowledge. Conclusions Perceived barriers to diabetes self-management described by Hispanic immigrants with diabetes and family members indicate a lack of intervention strategies to meet their needs. Interventions should include culturally relevant resources, family support, and diabetes self-management skills education.

Partnering With Families to Refine and Expand a Diabetes Intervention for Mexican Americans

“…For Mexican American adults, the family is a critical social context in which T2DM disease management occurs. 24,37 The primary importance of the extended family or familismo has been well documented in the Hispanic culture. 38-42 Familismo includes perceived obligations for helping family members, living near immediate and extended family members, reliance on support from family, and the use of family as behavioral and attitudinal referents.…”

“…12,20,37 Our culturally tailored, family approach shifts diabetes management from the common individual-focused approach to T2DM within a family context. The relationship established with the participants and their family members using CBPR principles afforded valuable information on which to build an effective, culturally tailored intervention for Mexican American adults with T2DM and their families.…”

Susto, Coraje, y Fatalismo: Cultural-Bound Beliefs and the Treatment of Diabetes Among Socioeconomically Disadvantaged Hispanics

“…Involving a family member is important, not only because familismo is a Hispanic cultural trait that promotes family ties but because lack of support from the family has been reported as a barrier for successful self-management. 18 A study by Sorkin et al 19 showed that an intervention including obese women who attended with an obese or overweight daughter had greater weight loss and better adherence to healthy eating patterns than in the group of obese women who attended alone. Peer coaches may assist in behavior change by role modeling and providing both information and emotional support.…”

Cultural Differences and Considerations When Initiating Insulin

“…Latino women find it challenging to change their lifestyle or behavior while continuing to keep their husbands and children happy (39). Often, the use of insulin is considered to be a burden on the family, which can be difficult for Latino women given that they tend to assume the caregiver role for the entire family, and not vice versa.…”