Parental/Caregiver Distress among Oklahoma Chotaws Coping w/ Dependents w/T1&2D

项目总结(见说明)： 这项纵向研究的目的是引出父母/照顾者痛苦(P/CD)的文化模型，因为它在应对被诊断为1型糖尿病(T1D)的家属的家庭中在两年多的时间内演变，并用于比较。2型糖尿病(T2D)，在婴儿和儿童中持续到18岁。痛苦的文化模式将从父母/照顾者的实验角度进行分析确定，这些观点是通过为这些年轻的糖尿病患者提供护理而获得的。受试者将是参加乔克托国家儿童糖尿病诊所的20个患有儿童糖尿病的俄克拉荷马州乔克托家庭(婴儿-18岁)：10个患有T1D的家庭和10个患有T2D的家庭。研究采用了五种数据收集策略：1)面对面的人口学和其他社会数据，2)亨德森文化认同程度问卷以确定文化适应状况，3)自由列表以确定P/CD的主题派生类别，4)非结构化访谈引出P/CD上的直接话语，5)基于非结构化访谈数据的半结构化访谈，加上理论上派生的P/CD类别。数据分析使用一种混合的归纳-演绎策略，其中定义了一组与P/CD相关的兴趣类别，并从主题和理论中派生出来。评分员之间的可靠性计算通常与与程序员的日常会议一起进行。将审查不同类别的痛苦是否受到当代不同的乔克托文化因素的影响，包括适应状况、部落保健服务的使用、照料在亲属群体中的传播、宗教/精神参与以及土著和多数文化替代治疗技术。这些发现将被用来促进改善照顾者的应对、受抚养者的健康，并在俄克拉荷马州乔克托人的提供者的背景下提供新的家庭衍生和实践相关的糖尿病事实。研究结果的传播和翻译将由乔克托国家医院行为医学部在职培训讲习班以及专业科学报告和出版物完成。

PROJECT SUMMARY (See instructions): The goal of this longitudinal research is to elicit cultural models of parental/caregiver distress (P/CD) as it evolves over two years of time among families coping with dependents diagnosed with Type 1 diabetes (T1D), and for comparison. Type 2 diabetes (T2D), in infants and children through age 18. Cultural models of distress will be analytically ascertained from parent/caregiver experimentally-based perspectives gained by providing care to these young diabetics. The subject populations will be 20 Oklahoma Choctaw families coping with diabetes in children (ages infant-18 years): 10 families with T1D and 10 families with T2D participating in the Choctaw Nation Pediatric Diabetes Clinic. Five data collection strategies are used: 1) Face page for demographic and other social data, 2) the Henderson Degree of Cultural Identification Questionnaire to ascertain acculturation status, 3) Free Listing to ascertain subject-derived categories of P/CD, 4) unstructured interviews eliciting direct discourse on P/CD, and 5) semi-structured interviews based on data from the unstructured interviews, plus theoretically derived categories of P/CD. Data analysis uses a mixed inductive-deductive strategy with a defined set of categories of interest relevant to P/CD and derived both from subjects and theory. Inter-rater reliability calculations are routinely done along with daily meetings with coders. The categories of distress will be examined for influence by contemporary, heterogeneous Choctaw cultural factors, including acculturation status, use of tribal health services, diffusion of caregiving across the kinship group, and religious/spiritual participation in native as well as majority culture alternative healing techniques. The findings will be used to promote improved caregiver coping, health of the dependent, and provision of new family-derived and practice-relevant facts of diabetes in context for providers to Oklahoma Choctaw people. The dissemination and translation of the findings will be done by in service training workshops for the Behavioral Medicine Department of the Choctaw Nation Hospital and professional scientific presentations and publications.