Lay Explanation of Diabetes and Self Care

本研究的目的是收集有用的试点数据，以确定不同种族/民族的老年人对糖尿病（DM）的解释方式是否在他们决定采用自我护理方面发挥作用。糖尿病是一个重大的公共卫生问题，特别是对少数民族成年人而言。在收集这些试点数据的过程中，我们试图为在不同种族和民族的老年人群体中进行更大规模的自我保健管理策略的多地点研究建立基础设施。需要解决的具体研究问题包括：来自不同种族/民族群体的老年人对糖尿病的概念/解释是否相同或不同？种族或民族是否使老年糖尿病患者倾向于使用某些自我保健管理策略？在不同种族/民族的老年人中，糖尿病的特定解释模型是否与特定自我保健管理策略的使用相关？对于非裔美国人（凯斯西储大学）、拉丁裔美国人（托莱多大学）、美洲印第安人（韦恩州立大学）和农村白人（肯塔基大学）四组中的每一组，将对20名年龄在55岁或以上的确诊糖尿病患者和10名年龄在55岁或以上的无糖尿病患者进行访谈。研究信息者将构成一个有目的的样本，而不是统计上具有代表性的样本，这种设计选择强调回答的范围和变化，而不是样本的代表。访谈将包括两个组成部分：(1)半结构化访谈，包括收集社会和人口统计数据；(2)自我管理多因素疾病意义问卷（MIQ）和两种糖尿病专用工具。半结构化访谈指南探讨症状经验、因果归因和自我护理策略。MIG已被用于不同慢性疾病人群的研究，这里也适用于糖尿病患者。访谈的笔录将采用不断比较的方法进行数据分析。因子分析将用于明确这类不同种族/民族的老年人智商的因子结构。类似的策略将适用于糖尿病专用仪器。

The goal of this research is to collect pilot data useful for determining whether the way in which diabetes mellitus (DM) is explained by elderly from different racial/ethnic groups plays a role in their decisions to employ self care. DM is a significant public health problem, especially for minority adults. In collecting this pilot data, we attempt to establish infrastructure for a larger multi-site study of self-care management strategies among racially and ethnically diverse groups of elderly individuals. Specific research questions to be addressed include: Do elderly individuals from differential racial/ethnic groups conceptualize/explain diabetes in the same or different ways? Does race or ethnicity predispose elderly with diabetes to the use of certain self-care management strategies? Among elderly from different racial/ethnic groups, do specific lay explanatory models of diabetes correlate with the use of specific self-care management strategies? For each of four groups, African Americans (Case Western Reserve Univ.), Latinos (University of Toledo), American Indians (Wayne State Univ.), and rural Whites (University of Kentucky), interviews will be conducted with 20 respondents 55 years of age or older identified has having diabetes and 10 individuals 55 years of age or older without diabetes. Study informants will constitute a purposive rather than a statistically representative sample, a design chosen to emphasize the range and variation of responses rather than the representatives of samples. Interviews will include two component parts: (1) A semi-structured interview, including collection of social and demographic data; and (2) self-administration of the multi-factorial Meaning of Illness Questionnaire (MIQ) and two diabetes-specific instruments. The semi-structured interview guide explores symptom experience, causal attributions, and self-care strategies. The MIG has been used in studies of different chronically ill populations, and is here adapted for use with diabetics. Transcriptions of the interviews will be subject to the constant comparative method for data analysis. Factor analysis will be used to specify the factor structure of the MIQ in this population of racially/ethnically diverse elderly adults. A similar strategy will be applied to the diabetes-specific instruments.