ABSTRACT

Objective

Type 2 Diabetes Mellitus (T2DM) is a complicated disease that disproportionately affects African American men. Understanding the experiences of African American men living with T2DM is important for developing effective, culturally sensitive interventions. The purpose of this study was to describe how African American men view their T2DM and describe their perspectives on living with and self-managing T2DM.

Design

In-depth semi-structured qualitative interviews were conducted with 22 African American men aged 40–85 years diagnosed with T2DM. Interviews were transcribed and analyzed using NVivo 10 with thematic analysis.

Results

Disbelief, shock, and denial were commonly experienced reactions at initial diagnosis. Many participants defined diabetes using words such as ‘sugar’ or ‘glucose’ and reported an awareness of health complications caused by diabetes, such as amputations and diabetic comas. Participants expressed various perspectives and attitudes towards having diabetes, including avoidance/apathy, fatalism, guilt and shame, fear and concern, and self-mastery. The majority of men described efforts to self-manage diabetes via glucose monitoring, changing dietary habits, and exercise. Many participants expressed concern over the financial burden associated with managing diabetes and reported that high costs can hinder a patient’s ability to maintain active self-monitoring and deter patients from attending needed doctor’s visits. Many participants expressed confidence in their healthcare providers, although a few expressed feelings of distrust and being uninformed. Participants tended to most appreciate physicians who spent time discussing their condition and who made an effort to engage in open patient-provider communication.

Conclusion

Living with diabetes can be emotionally, physically, and mentally challenging. Efforts to improve adoption and maintenance of self-management behaviors may benefit from sensitivity to the patient’s attitude and perspectives towards diabetes self-management, assistance overcoming the financial burden of managing diabetes, and open patient-provider communication.

中文翻译：

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患有 2 型糖尿病的中年和老年非裔美国男性的经历

摘要

客观的

2 型糖尿病 (T2DM) 是一种复杂的疾病，对非裔美国男性的影响尤为严重。了解患有 T2DM 的非裔美国男性的经历对于制定有效的、具有文化敏感性的干预措施非常重要。本研究的目的是描述非裔美国男性如何看待他们的 T2DM，并描述他们对患有 T2DM 和自我管理 T2DM 的看法。

设计

对 22 名 40-85 岁被诊断患有 T2DM 的非裔美国男性进行了深入的半结构化定性访谈。使用带有主题分析的 NVivo 10 转录和分析访谈内容。

结果

怀疑、震惊和否认是最初诊断时常见的反应。许多参与者使用诸如“糖”或“葡萄糖”之类的词来定义糖尿病，并报告了对糖尿病引起的健康并发症的认识，例如截肢和糖尿病昏迷。参与者表达了对糖尿病的不同观点和态度，包括回避/冷漠、宿命论、内疚和羞耻、恐惧和担忧以及自我控制。大多数男性描述了通过血糖监测、改变饮食习惯和锻炼来自我管理糖尿病的努力。许多参与者对与管理糖尿病相关的财务负担表示担忧，并报告说高成本会阻碍患者保持积极自我监测的能力，并阻止患者参加必要的医生就诊。许多参与者表达了对他们的医疗保健提供者的信心，尽管少数人表达了不信任和不知情的感觉。参与者往往最欣赏那些花时间讨论他们的病情并努力参与开放的医患沟通的医生。

结论

患有糖尿病可能在情感上、身体上和精神上都具有挑战性。改善采用和维持自我管理行为的努力可能受益于对患者对糖尿病自我管理的态度和观点的敏感性，帮助克服管理糖尿病的经济负担，以及开放的患者与提供者之间的沟通。