Psychosocial Impacts of Type 2 Diabetes Self-Management in a Rural African-American Population

Abstract

This qualitative study explored the underlying psychosocial factors and conditions that may influence type 2 diabetes (T2D) self-management among adult T2D-diagnosed African Americans in the Arkansas Delta. Listening to participants' narratives in their own voices provided meaningful insights in their real-life experiences of T2D-related psychological and emotional challenges in African American social cultural contexts. Self-determination theory was used to conceptualize the participants' motivations for making health behavior changes. Using purposive sampling, 31 participants total (16 women and 15 men) were interviewed. The study participants described their (1) concern over prescribed dietary and physical exercise guidelines as impractical and culturally not relevant to them; (2) doubts over the availability of social supports necessary to implement T2D self-management; and (3) fatalistic expectations of negative outcomes that undermined their self-motivation to follow self-management guidelines. Specific strategies for developing culturally competent T2D self management guidelines and community-based communication outreach initiatives are discussed.

Self-management as a mediator of the relationship between social support and health outcomes of African American adults with type 2 diabetes.

“…These attributes of social support described by Langford et al (1997) were consistently used throughout the literature (Strom & Egede, 2012 (Bhattacharya, 2012). In addition, personal variables such as gender, culture, and race of both the support person and the patient were important variables that strengthen or hinder social support (Cosansu & Erdogan, 2013;Hempler et al, 2013;Mathew et al, 2012;Strom & Egede, 2012;Venkatesh & Weatherspoon, 2013;Vest et al, 2013).…”

“…Conversely, negative outcomes were observed. These negative consequences are associated with the patient's feelings of being a burden to the social network members (Strom & Egede, 2012), being stigmatized due to the diagnosis of T2D (Bhattacharya, 2012), and being criticized for following the T2D therapeutic regimen (Mayberry & Osborn, 2012).…”

“…Although African Americans reported fear and uncertainty in following therapeutic guidelines, they consider their families the main source of support for T2D self-management, followed by their friends and churches (Bhattacharya, 2012).…”

“…Only 10 studies met the inclusion criteria; three of them were qualitative studies (Bhattacharya, 2012;Murrock, Taylor, & Marino, 2013;Nundy, Dick, Solomon, & Peek, 2013), which limit the generalizations of their conclusions due to small sample sizes. In addition, three of the reviewed studies were conducted only with women (KomarSamardzija, Braun, Keithley, & Quinn, 2012;Miller, 2011;Murrock et al, 2013).…”

“…Social support promotes self-efficacy, self-competence, and self-confidence in self-management of T2D (Ahia, Holt, & Krousel-Wood, 2014;Osborn, Bains, & Egede, 2010;Walker, Gebregziabher, Martin-Harris, & Egede, 2014). Bhattacharya (2012) explored the psychosocial variables that underlie self-management behaviors following a T2D diagnosis. Social support was essential to strengthen the patient's belief in his or her ability to engage in a behavior change and to strengthen the commitment to adhere to a T2D regimen.…”