It is Not Easy Living with This Illness : A Syndemic Approach to Medication Adherence and Lifestyle Change among Low-income Diabetes Patients in Lima, Peru
It is Not Easy Living with This Illness : A Syndemic Approach to Medication Adherence and Lifestyle Change among Low-income Diabetes Patients in Lima, Peru
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DOI：
10.17730/0018-7259.78.1.85
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发表时间：
2019-03-01
影响因子：
0.8
通讯作者：
Jaime Miranda, J.
中科院分区：
文献类型：
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作者：
Amalia Pesantes, M.;Tetens, Anne;Jaime Miranda, J.
这项研究分析了秘鲁利马低收入2型糖尿病患者的经历。我们使用共性的方法来描述和讨论他们在遵循医生关于服药依从性和饮食改变方面的建议方面的挑战。我们使用“治疗负担”的概念来分析患者的故事，并了解在一个中等收入国家的医疗系统仍然没有准备好提供慢性护理的情况下，坚持服药和饮食变化的复杂性。分析表明，情绪、社会经济和结构因素在患者遵循处方建议的能力中发挥着作用。我们表明，患者的疾病经历与当地卫生系统满足他们需求的能力密切相关，但在促进自我管理行为时并不总是得到承认。我们的研究表明，综合方法对于理解个体和结构性因素之间的相互作用具有相关性，从而为改善糖尿病的管理和慢性病的整体体验提出建议。
This study analyzes the experiences of low-income people living with type 2 diabetes in Lima, Peru. We use a syndemic approach to describe and discuss their challenges in following physicians' recommendations around medication adherence and dietary changes. We use the concept of "burden of treatment" to analyze patients' stories and to understand the complexity of medication adherence and dietary changes in a middle-income country where the health system is still unprepared to provide chronic care. Analysis demonstrates that emotional, socioeconomic, and structural components play a role in patients' capabilities for following the prescribed recommendations. We show that patient's illness experiences are intimately linked to the capacity of the local health system to attend to their needs but are not always acknowledged when promoting self-management behaviors. Our study shows the relevance of a syndemics approach for understanding the interaction between individual and structural factors to make suggestions for improving the management of diabetes and the overall experience of chronicity.