"So We Adapt Step by Step": Acculturation experiences affecting diabetes management and perceived health for Chinese American immigrants.
"So We Adapt Step by Step": Acculturation experiences affecting diabetes management and perceived health for Chinese American immigrants.
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DOI：
10.1016/j.socscimed.2010.11.010
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发表时间：
2011-01
影响因子：
5.4
通讯作者：
Kwan, Christine M. L.
中科院分区：
文献类型：
--
作者：
Chun, Kevin M.;Chesla, Catherine A.;Kwan, Christine M. L.
本研究旨在探讨文化适应如何影响2型糖尿病管理和感知健康的中国美国移民在美国的文化适应的经验或文化适应经验影响糖尿病管理和健康的移民患者和他们的配偶（N=40）在2005年至2008年进行的小组，夫妇和个人访谈的信息组征求。一个单独的移民患者和他们的配偶（N=19）符合纳入标准的受访者组审查和确认的举报人组产生的主题。使用解释现象学，确定了三个关键主题的患者和配偶的文化适应经验：a）利用医疗保健，B）保持家庭关系和角色，和c）建立社区关系和在美国的文化适应经验，反映这些主题的范围很广，目前的自我报告和代理文化适应措施没有完全捕获。在目前的研究中，家庭角色的转变以及对美国糖尿病护理和物理环境的评估显著影响了糖尿病管理和健康，但在文化适应和健康调查中被忽视了。此外，由于个人、家庭、发展和环境因素，特定文化适应经验对糖尿病管理和感知健康的影响在参与者中各不相同。在显着性方面，在美国保持孝顺和相互依赖的家庭关系是老年参与者特别关注的问题，而在美国应对医疗保险不足对于自称为中下层到中产阶级的参与者来说尤其令人沮丧。在影响方面，家庭分离和搬迁到美国种族相似的社区对糖尿病管理和健康的影响不同，这分别是由于参与者的不同家庭关系和移民前家庭支持水平以及不同的文化和语言背景。扩大目前的概念化和措施的涵化，以更好地理解其动态和多方面的特性和复杂的影响健康的影响进行了讨论。此外，还概述了为中国移民及其家庭制定适合文化的糖尿病管理建议的意义。
This study examines how acculturation affects type 2 diabetes management and perceived health for Chinese American immigrants in the U.S. Acculturation experiences or cultural adaptation experiences affecting diabetes management and health were solicited from an informant group of immigrant patients and their spouses (N=40) during group, couple and individual interviews conducted in 2005 to 2008. A separate respondent group of immigrant patients and their spouses (N=19) meeting inclusion criteria reviewed and confirmed themes generated by the informant group. Using interpretive phenomenology, three key themes in patients’ and spouses’ acculturation experiences were identified: a) utilizing health care, b) maintaining family relations and roles, and c) establishing community ties and groundedness in the U.S. Acculturation experiences reflecting these themes were broad in scope and not fully captured by current self-report and proxy acculturation measures. In the current study, shifting family roles and evaluations of diabetes care and physical environment in the U.S. significantly affected diabetes management and health, yet are overlooked in acculturation and health investigations. Furthermore, the salience and impact of specific acculturation experiences respective to diabetes management and perceived health varied across participants due to individual, family, developmental, and environmental factors. In regards to salience, maintaining filial and interdependent family relations in the U.S. was of particular concern for older participants and coping with inadequate health insurance in the U.S. was especially distressing for self-described lower-middle to middle-class participants. In terms of impact, family separation and relocating to ethnically similar neighborhoods in the U.S. differentially affected diabetes management and health due to participants’ varied family relations and pre-migration family support levels and diverse cultural and linguistic backgrounds, respectively. Implications for expanding current conceptualizations and measures of acculturation to better comprehend its dynamic and multidimensional properties and complex effects on health are discussed. Additionally, implications for developing culturally-appropriate diabetes management recommendations for Chinese immigrants and their families are outlined.
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