Cultural and family challenges to managing type 2 diabetes in immigrant Chinese Americans.
Cultural and family challenges to managing type 2 diabetes in immigrant Chinese Americans.
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DOI：
10.2337/dc09-0278
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发表时间：
2009-10
期刊：
影响因子：
16.2
通讯作者：
Kwan CM
中科院分区：
文献类型：
--
作者：
Chesla CA;Chun KM;Kwan CM
虽然亚洲人表现出2型糖尿病的水平升高，但很少有人关注他们独特的文化信仰和糖尿病实践。我们描述了在外国出生的华裔美国2型糖尿病患者及其配偶的疾病管理的文化和家庭挑战。这是一项解释性比较访谈研究，20对外国出生的华裔美国夫妇（n = 40）患有2型糖尿病。多个（六至七个）半结构化访谈与每对夫妇在个人，团体和夫妇设置引起的信念，糖尿病和护理的叙述在家庭和社区。完成了解释性叙述和专题分析。一个由19名符合纳入标准的患者及其配偶组成的单独的应答组审查并确认了从最初的夫妇发展而来的主题。在外国出生的华裔美国家庭中，糖尿病管理面临的文化和家庭挑战包括：1）糖尿病症状如何挑战家庭和谐，2）饮食处方如何挑战食物信仰和实践，3）疾病管理要求如何挑战既定的家庭角色责任。对华裔移民的文化细致入微的护理需要注意疾病管理的社会背景。病人和家属的疾病管理决定很少独立于他们对家庭福祉、家庭面子和不同家庭角色所要求的相互责任的关注。制定疾病建议，包括对平衡和重要的食物仪式的文化关注是必要的。
Although Asians demonstrate elevated levels of type 2 diabetes, little attention has been directed to their unique cultural beliefs and practices regarding diabetes. We describe cultural and family challenges to illness management in foreign-born Chinese American patients with type 2 diabetes and their spouses. This was an interpretive comparative interview study with 20 foreign-born Chinese American couples (n = 40) living with type 2 diabetes. Multiple (six to seven) semistructured interviews with each couple in individual, group, and couple settings elicited beliefs about diabetes and narratives of care within the family and community. Interpretive narrative and thematic analysis were completed. A separate respondent group of 19 patients and spouses who met the inclusion criteria reviewed and confirmed the themes developed from the initial couples. Cultural and family challenges to diabetes management within foreign-born Chinese American families included how 1) diabetes symptoms challenged family harmony, 2) dietary prescriptions challenged food beliefs and practices, and 3) disease management requirements challenged established family role responsibilities. Culturally nuanced care with immigrant Chinese Americans requires attentiveness to the social context of disease management. Patients' and families' disease management decisions are seldom made independent of their concerns for family well-being, family face, and the reciprocal responsibilities required by varied family roles. Framing disease recommendations to include cultural concerns for balance and significant food rituals are warranted.
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