RURAL ELDERS' DIABETES SELF MANAGEMENT--ETHNIC VARIATION

描述：患有糖尿病的老年人适当地自我管理这种疾病 可以降低严重并发症的风险，更成功地衰老。 糖尿病和糖尿病并发症是死亡的主要原因， 发病率;他们往往是毁灭性的病人和极其昂贵的 医疗保健系统。糖尿病不成比例地影响少数群体， 使其成为健康差距的主要来源。具体的自我管理 存在干预方案，农村和少数民族人口的成员 很少有机会获得这些节目和节目可能不符合文化 适当很少有计划是为满足老年人的特殊需要而设计的 人口。很少有研究考虑糖尿病自我管理策略 老年人使用，特别是农村和少数民族老年人。这 项目重点是农村老年人使用的自我管理战略， 不同种族（非洲裔美国人，美洲原住民，欧洲裔美国人）， 2型糖尿病的治疗本研究采用问卷调查和定性研究相结合的方法， 深入了解自我管理。具体目标是： (1)记录社区居民的糖尿病自我管理策略 农村老年2型糖尿病患者;（2）比较和对比糖尿病 按种族划分的老年人自我管理策略;（3）确定 文化、社会、经济和生命历程的预测因素和障碍， 糖尿病自我管理;（4）评估糖尿病自我管理策略 使用一系列社会心理和功能测量的老年人。这 研究将以健康自我管理的概念框架为指导， 调查人员正在进行的工作，并将在2个农村 调查人员已成功派驻的县。的 研究有两个组成部分。第一部分是对482名65岁以上的成年人进行的调查， 2型糖尿病的治疗方法该样本将平均分配给 6个性别-种族群体，它将使用HCFA文件绘制。计算机 将使用辅助个人访谈来收集背景特征， 人格、自我管理资源、自我管理活动和结果 措施（例如，血红蛋白A1 C、抑郁症、生活质量）。构成部分2 包括对15位提供糖尿病服务的专家的深入访谈， 48例老年糖尿病患者专家的选择将基于 调查人员对县的了解;老年人将从 调查按性别、种族和血糖水平进行抽样， 控制深入访谈数据将用于探索社区背景 糖尿病自我管理，以及老年人 制定并实施自我管理战略。多变量技术将 用于调查数据的分析。将采用系统的方法 分析定性数据。

DESCRIPTION: Older adults with diabetes who properly self-manage this disease can decrease their risk of severe complications and age more successfully. Diabetes and diabetic complications are major causes of mortality and morbidity; they are often devastating for patients and extremely costly to the health care system. Diabetes disproportionately affects minority populations, making it a major source of health disparity. While specific self-management intervention programs exist, members of rural and ethnic minority populations have little access to such programs and programs may not be culturally appropriate. Few programs are designed to meet the special needs of elderly populations. Little research has considered diabetes self-management strategies used by older adults, particularly older rural and minority adults. This project focuses on the self-management strategies used by rural older adults of different ethnicities (African American, Native American, European American) to manage Type 2 diabetes. The research combines survey and qualitative methods to produce an in-depth understanding of self-management. The specific aims are to: (1) document the diabetes self- management strategies of community-dwelling rural older adults with Type 2 diabetes; (2) compare and contrast the diabetes self-management strategies of older adults by ethnic group; (3) identify cultural, social, economic, and life course predictors of and barriers to diabetes self-management; and (4) evaluate diabetes self-management strategies of older adults using a series of psychosocial and functional measures. This study will be guided by a conceptual framework of health self-management based on the investigators' ongoing work, and it will be conducted in 2 rural counties where the investigators have established a successful presence. The study has 2 components. Component 1 is a survey of 482 adults, aged 65 and older with diagnosed Type 2 diabetes. This sample will be equally divided among the 6 gender- ethnic groups, and it will be drawn using HCFA files. A computer assisted personal interview will be used to collect background characteristics, personality, self-management resources, self-management activities and outcome measures (e.g., Hemoglobin A1C, depression, quality of life). Component 2 includes in-depth interviews with 15 experts who provide diabetes services, and 48 older adults with diabetes. Expert selection will be based on the investigators' knowledge of the counties; older adults will be selected from the survey sample and include equal numbers by gender, ethnicity and glucose control. In-depth interview data will be used to explore the community context for diabetes self- management, as well as the processes by which older adults develop and maintain a self-management strategy. Multivariate techniques will be used in the analysis of the survey data. A systematic approach will be used to analyze the qualitative data.