Differentiating Approaches to Diabetes Self-Management of Multi-Ethnic Rural Older Adults at the Extremes of Glycemic Control

Autor/inn/en	Brewer-Lowry, Aleshia Nichol; Arcury, Thomas A.; Bell, Ronny A.; Quandt, Sara A.
Titel	Differentiating Approaches to Diabetes Self-Management of Multi-Ethnic Rural Older Adults at the Extremes of Glycemic Control
Quelle	In: Gerontologist, 50 (2010) 5, S.657-667 (11 Seiten) PDF als Volltext Verfügbarkeit
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	0016-9013
DOI	10.1093/geront/gnq001
Schlagwörter	Medical Services; American Indians; Economically Disadvantaged; Diabetes; Older Adults; Rural Areas; Self Management; Intervention; Interviews; Qualitative Research; African Americans; Whites; Eating Habits; Food; Biochemistry; Symptoms (Individual Disorders) + Suchen Sie Ihr Suchwort? Arzt; American Indian; Indianer; Älterer Erwachsener; Rural area; Ländlicher Raum; Selbstmanagement; Interviewing; Interviewtechnik; Qualitative Forschung; Afroamerikaner; White; Weißer; Ernährungsgewohnheit; Essgewohnheit; Lebensmittel; Biochemie; Psychiatrische Symptomatik
Abstract	Purpose of the Study: This study identified approaches to diabetes self-management that differentiate persons with well-controlled from poorly controlled diabetes. Previous research has focused largely on persons participating in self-management interventions. Design and Methods: In-depth qualitative interviews were conducted with 48 adults, drawn from a population-based sample aged 65 years or older with diabetes. The sample was stratified by sex and ethnic group (African American, American Indian, and White) from the low (A1C less than 6%) and high (A1C greater than 8%) extremes of the glycemic control distribution. Case-based text analysis was guided by a model, including six self-management domains and four resource types (self-care, informal support, formal services, and medical care). Results: A "structured" approach to self-management differentiated respondents in good glycemic control from those in poor glycemic control. Those in good glycemic control were more likely to practice specific food behaviors to limit food consumption and practice regular blood glucose monitoring with specific target values. This approach was facilitated by a greater use of home aides to assist with diabetes care. Respondents in poor glycemic control demonstrated less structure, naming general food categories and checking blood glucose in reaction to symptoms. Implications: Results provide evidence that degree of structure differentiates self-management approaches of persons with good and poor glycemic control. Findings should provide a foundation for further research to develop effective self-management programs for older adults with diabetes. (As Provided).
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Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2017/4/10