Diabetes Self-Management in a Latino Social Environment

Purpose: The purpose of this qualitative descriptive study was to explore the socio-cultural influences and social context associated with living with type 2 diabetes among rural, migrant Latino adults. Methods: A qualitative descriptive study using grounded theory techniques was conducted. In-depth semi-structured interviews were completed with ten participants (6 female and 4 male) ranging in age from 46-65 years and duration of diabetes diagnosis ranging from 1.5- 40 years. Results: An over-arching meta-theme Self Management in a Social Environment emerged. Every aspect of the process of self-management, as described in the four major themes, (1) Family Cohesion, (2) Social Stigma of Disease, (3) Social Expectations/ Perception of “Illness,” and (4) Disease Knowledge and Understanding, was influenced by the social context

Diabetes Self-Management in the Migrant Latino Population

This article will present an in-depth exploration and synthesis of current literature that informs nursing knowledge of diabetes self-management for the migrant Latino population. Extensive research in diabetes care has been conducted, however, there is a significant knowledge gap related to the factors that influence the achievement of glycemic control and self-management practices of the Latino population. Based on well-documented disparities in complications and health outcomes among Latinos when compared with White Americans, there is sufficient evidence to question whether traditional White beliefs about self-management are successful or appropriate for the Latino population in general and migrants specifically. Traditional models view self-management as an individual’s responsibility. Whether this view is congruent with the collectivist cultural tradition held by many Latinos is unclear. Equally unclear is the degree to which using traditional models of self-management in teaching about managing type 2 diabetes influences health outcomes in this population. Culturally congruent care and nursing interventions involve much more than an understanding of language and dietary preferences

Evasions in Interactions: Examples from the Transcultural Nursing Research Field

Transcultural qualitative research is known for its utility in eliciting in-depth narratives, resulting in increased understanding about cultural phenomena. However, sometimes specific phenomena in the researcher’s inquiry are ignored, evaded, or denied; or a seemingly crucial experience demonstrating society’s unfairness, which the researcher had been expecting, does not emerge. In this paper, the issue of evasions in narratives is addressed, with two examples in which participants evaded the issue about which they were asked: perceptions of discrimination for aging adults of Mexican descent, and perceptions of living with life-limiting illnesses for aging African American adults. The Ethno-Cultural Gerontological Nursing Model framework’s Macro-level factors (climate of stereotypes, attitudes and ascriptions of the majority group) and Group-based influences (“Cultural/historical traditions” and “Cohort influences”) organize our thinking about addressing evasions by minority research participants. Four tools synthesized from the literature and our research experiences are recommended: (1) self-assessment of one’s own cultural values and lenses, (2) co-collaborating during the data collection and analysis phases, (3) acknowledging the power position of the researcher, and (4) over-reading

You Learn When You Teach: A Narrative Pedagogy for Faculty and Doctoral-Level Student Teaching Assistants

The purpose of this study was to understand the meaning of online co-teaching for PhD faculty and teaching assistants (TAs). Narrative pedagogy underpinned the inquiry, which was designed to advance the discourse on mentorship of PhD future faculty. A faculty member and TA authors kept concurrent weekly journals or after-the-fact written reflections. The authors analyzed data as a team using a five-phase interpretive phenomenological analysis process to interpret the meaning of co-teaching for faculty and TAs. Lines of inquiry, central concerns, exemplars, shared meanings, and paradigm cases supported the overall interpretation, “You Learn When You Teach.” Co-mentorship should be a requirement for nursing faculty preparation programs. Five strategies for ensuring success of PhD nursing students’ development as professional nurse scholars are recommended. Doctoral programs (e.g., PhD; DNP) would benefit from a unified approach to faculty preparation, guided by theories such as narrative pedagogy

"I put diabetes on the shelf": African-American Women's Perceptions of Risk for Diabetes Complications

The purpose of this study was to describe the perceptions of African American (AA) women with Type 2 diabetes mellitus (T2DM) about developing diabetes mellitus (DM) complications and explore how their perceived risk influenced DM self-management. Ten (N = 10) AA women participated in the qualitative description study through semi-structured interviews. Thematic analysis informed by the Health Belief Model and Risk Perception Conceptual Model revealed the perceived probability of DM complications by AA women with T2DM and how they made judgments regarding the seriousness, extent, or severity of complications. Those with high levels of DM knowledge perceived themselves at high risk of developing DM complications and those with low DM knowledge perceived themselves at low risk of DM complications. Risk perceptions and health literacy also influenced DM self-management behaviors.This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Social Determinants of Health and Health Care Delivery: African American Women's T2DM Self-Management

African American (AA) women have high prevalence of Type 2 diabetes mellitus (T2DM) and complications. No studies have been conducted about how social determinants of health and health care delivery affect their T2DM self-management. The purpose was to describe how social determinants of health and healthcare delivery may influence AA women's T2DM self-management using qualitative descriptive methodology (N = 10). Ten participants were interviewed. Participants' geographical location, education, level of income, health literacy, and systemic racism, that is, healthcare delivery services, for example, inadequate healthcare services, providers' assumptions about the patient's knowledge of diabetes, providers' attitudes toward patients, and stigma related to diabetes as a disease were identified. Understanding the role of social determinants of health and the health care delivery system in influencing T2DM self-management is a powerful tool for providers and practitioners for improving practice and health care policies to decrease health disparities and improve health outcomes among AA women with T2DM.This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

You Learn When You Teach: Faculty Learning by Teaching with Doctoral-Level Student Teaching Assistants

Aim: The purpose of this study was to understand the meaning of online co-teaching qualitative and gerontological research courses for doctoral faculty teaching with graduate teaching assistants (TAs). Background: Narrative pedagogy underpinned the inquiry, which was designed to find the meaning of teaching with graduate TAs. Method: The faculty member and TAs used interpretive phenomenology. They kept concurrent weekly journals or after-the-fact written reflections about their experiences co-teaching two doctoral courses online. They analyzed narratives through a five-phase process identifying lines of inquiry, central concerns, exemplars, shared meanings, and paradigm cases which supported the overall interpretation Results: The overall interpretation, “You Learn When You Teach,” represents the faculty member’s improved teaching skills and curriculum find-tuning through collaborating with TAs. Conclusion: Mentorship designed for nursing faculty preparation programs also has benefits for faculty. Recommendations for improving faculty’s skills, besides ensuring success of doctoral nursing students’ development as professional nurse scholars, include requiring mentoring TAs as faculty practice, and TA practica as part of nursing doctoral programs; and frameworks such as narrative pedagogy to ensure meaningful collaboration during co-teaching

Early for Everyone: Reconceptualizing Palliative Care in the Neonatal Intensive Care Unit

Background: Palliative care (PC) in the neonatal intensive care unit (NICU) is often provided exclusively to infants expected to die. Standards of care support providing PC early after diagnosis with any condition likely to impact quality of life. Purpose: To determine the state of early PC practice across populations to derive elements of early PC applicable to neonates and their families and demonstrate their application in practice. Search Strategy: Multiple literature searches were conducted from 2016 to 2019. Common keywords used were: palliative care; early PC; end of life, neonate; NICU; perinatal PC; pediatric PC; family-centered care; advanced care planning; palliative care consultant; and shared decision-making. Findings: Early PC is an emerging practice in adult, pediatric, and perinatal populations that has been shown to be helpful for and recommended by families. Three key elements of early PC in the NICU are shared decision-making, care planning, and coping with distress. A hypothetical case of a 24-week infant is presented to illustrate how findings may be applied. Evidence supports expansion of neonatal PC to include infants and families without terminal diagnoses and initiation earlier in care.12 month embargo; published online: 30 April 2020This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]