ERIC Number: EJ897831
Record Type: Journal
Publication Date: 2010-Oct
Abstractor: As Provided
Reference Count: 0
Differentiating Approaches to Diabetes Self-Management of Multi-Ethnic Rural Older Adults at the Extremes of Glycemic Control
Brewer-Lowry, Aleshia Nichol; Arcury, Thomas A.; Bell, Ronny A.; Quandt, Sara A.
Gerontologist, v50 n5 p657-667 Oct 2010
Purpose of the Study: This study identified approaches to diabetes self-management that differentiate persons with well-controlled from poorly controlled diabetes. Previous research has focused largely on persons participating in self-management interventions. Design and Methods: In-depth qualitative interviews were conducted with 48 adults, drawn from a population-based sample aged 65 years or older with diabetes. The sample was stratified by sex and ethnic group (African American, American Indian, and White) from the low (A1C less than 6%) and high (A1C greater than 8%) extremes of the glycemic control distribution. Case-based text analysis was guided by a model, including six self-management domains and four resource types (self-care, informal support, formal services, and medical care). Results: A "structured" approach to self-management differentiated respondents in good glycemic control from those in poor glycemic control. Those in good glycemic control were more likely to practice specific food behaviors to limit food consumption and practice regular blood glucose monitoring with specific target values. This approach was facilitated by a greater use of home aides to assist with diabetes care. Respondents in poor glycemic control demonstrated less structure, naming general food categories and checking blood glucose in reaction to symptoms. Implications: Results provide evidence that degree of structure differentiates self-management approaches of persons with good and poor glycemic control. Findings should provide a foundation for further research to develop effective self-management programs for older adults with diabetes.
Descriptors: Medical Services, American Indians, Economically Disadvantaged, Diabetes, Older Adults, Rural Areas, Self Management, Intervention, Interviews, Qualitative Research, African Americans, Whites, Eating Habits, Food, Biochemistry, Symptoms (Individual Disorders)
Oxford University Press. Great Clarendon Street, Oxford, OX2 6DP, UK. Tel: +44-1865-353907; Fax: +44-1865-353485; e-mail: firstname.lastname@example.org; Web site: http://gerontologist.oxfordjournals.org
Publication Type: Journal Articles; Reports - Research
Education Level: N/A
Authoring Institution: N/A