Abstract
This study examined how aspects of culture, social support, isolation, and loneliness are perceived as influences in chronic illness management by pre-diabetic (Glycated hemoglobin A1c levels between 5.7 and 6.4) or Type 2 diabetic patients (A1c levels between 6.4 and 8). Twenty-eight Middle Eastern immigrants in the greater Philadelphia area were interviewed using a semi-structured approach. Results were consistent with other research which suggests that patients benefit from family and community support in the management of their illness. However, findings also suggest that even in the presence of strong family and social support, patients report increased feelings of isolation and loneliness because they have to manage a complex illness that requires many lifestyle changes. For immigrant suffering from chronic illnesses, social gatherings, especially those that center on the consumption of traditional ethnic food, can be highly stressful because they need to avoid such foods as part of their daily treatment regimen. The results of this study have significant implications for patients, physicians, and psychologists who can benefit from an increased sensitivity to patients’ challenges in illness management by understanding how cultural factors affect compliance in diabetes treatment regimens.
Similar content being viewed by others
References
Bernstein, M., & Munoz, N. (2016). Nutrition for the older adult (2nded.). Burlington: Jones & Bartlett Learning.
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101.
Briscoe, V. J. (2014). Older adults and diabetes. Diabetes Spectrum, 27(1), 6–7.
Burns, R. J., Deschênes, S. S., & Schmitz, N. (2016). Association between coping strategies and mental health in individuals with type 2 diabetes: Prospective analysis. Health Psychology, 35(1), 78–86. https://doi.org/10.1037/hea0000250.
Campos, B., & Kim, S. H. (2017). Incorporating the cultural diversity of family and close relationships into the study of health. American Psychologist, 72, 543–554. https://doi.org/10.1037/amp0000122.
Cheng, T. Y. L., & Boey, K. W. (2000). Coping, social support, and depressive symptoms of older adults with type II diabetes mellitus. Clinical Gerontologist, 22(1), 15–30. https://doi.org/10.1300/J018v22n01_03.
Cornwell, E. Y., & Waite, L. J. (2009). Social disconnectedness, perceived isolation, and health among older adults. Journal of Health and Social Behavior, 50(1), 31–48. https://doi.org/10.1177/002214650905000103.
Gallant, M. P., Spitze, G., & Grove, J. G. (2010). Chronic illness self-care and the family lives of older adults: A synthetic review across four ethnic groups. Journal of Cross Cultural Gerontology, 25, 21–43. https://doi.org/10.1007/s10823-010-9112-z.
Hawkley, L. C., & Cacioppo, J. T. (2010). Loneliness matters: A theoretical and empirical review of consequences and mechanisms. Annals of Behavior Medicine, 40(2), 218–227. https://doi.org/10.1007/s12160-010-9210-8.
Hobfoll, S. E., Freedy, J., Lane, C., & Geller, P. (1990). Conservation of social resources: Social support resource theory. Journal of Personal and Social Relationships, 7, 465–478.
Krause, N. (1990). Stress measurement. Stress and Health, 6(3), 201–208. https://doi.org/10.1002/smi.2460060305.
Livneh, H. (2001). Psychosocial adaptation to chronic illness and disability: A conceptual framework. Rehabilitation Counseling Bulletin, 44(3), 151–160. https://doi.org/10.1177/003435520104400305.
Lynch, C. P., Hernandez-Tejada, M. A., Strom, J. L., & Egede, L. E. (2012). Association between spirituality and depression in adults with type 2 diabetes. Diabetes Educator, 38(3), 427–435. https://doi.org/10.1177/0145721712440335.
McConatha, J. T., Volkwein-Caplan, K., & DiGregorio, N. (2011). Community and well-being among older women in the Russia diaspora. Making connections. Interdisciplinary Approaches to Cultural Diversity, 3(1), 43–53.
National Council on Aging [NCOA] (2015). Healthy aging fact sheet. https://www.ncoa.org/news/resources- for-reporters/get-the-facts/healthy-aging-facts/ Accessed 23 March 2018.
National Institute on Aging [NIH]. Diabetes in older people (2015). https://www.nia.nih.gov/health/diabetes-older-people. Accessed 23 March 2018.
Prakash, R. S., Hussain, M. A., & Schirda, B. (2015). The role of emotion regulation and cognitive control in the association between mindfulness disposition and stress. Psychology and Aging, 30(1), 160–171. https://doi.org/10.1037/a0038544.
Ridder, D., Geenen, R., Kuijer, R., & Middendorp, H. (2008). Psychological adjustment to chronic disease. Lancet, 372, 246–255. https://doi.org/10.1016/S0140-6736(08)61078-8.
Rook, K. S., & Charles, S. T. (2017). Close social ties and health in later life: Strengths and vulnerabilities. American Psychologist, 72(6), 567–577. https://doi.org/10.1037/amp0000104.
Russell, D., Peplau, L. A., & Ferguson, M. L. (1978). Developing a measure of loneliness. Journal of Personality Assessment, 42, 290–294. https://doi.org/10.1207/s15327752jpa4203_11.
Ryan, F., Coughlan, M., & Cronin, P. (2009). Interviewing in qualitative research: The one-to-one interview. International Journal of Therapy and Rehabilitation, 6(6), 309–314. https://doi.org/10.12968/ijtr.2009.16.6.42433.
Samuel-Hodge, C. D., Headen, S. W., Skelly, A. H., Ingram, A. F., Keyserling, T. C., Jackson, E. J., Ammerman, A. S., & Elasy, T. A. (2000). Influences on day-to-day self-management of type 2 diabetes among African American women. Diabetes Care, 23(7), 928–933. https://doi.org/10.2337/diacare.23.7.928.
Song, Y., Song, H., Han, H., Park, S., Nam, S., & Kim, M. (2012). Unmet needs for social support and effects on diabetes self-care activities in Korean Americans with type 2 diabetes. The Diabetes Educator, 38(1), 77–85. https://doi.org/10.1177/0145721711432456.
Stankiewicz, G. (2015). Challenges in self-care in older adults with diabetes. Australian Nursing and Midwifery Journal, 22(7), 33.
Stepoe, A., Shankar, A., Demakakos, P., & Wardle, J. (2013). Social isolation, and all-cause mortality in older men and women. Proceedings of the National Academy of Sciences of the United States of America, 110(15), 5797–5801. https://doi.org/10.1073/pnas.1219686110.
Strom, J., & Egede, L. (2012). The impact of social support on outcomes in adult patients with type 2 diabetes: A systematic review. Current Diabetes Reports, 12, 769–781. https://doi.org/10.1007/s11892-012-0317-0.
Vassilev, I., Rogers, A., Blickem, C., Brooks, H., Kapadia, D., Kennedy, A., Sanders, C., Kirk, S., & Reeves, D. (2013). Social networks, the ‘work’ and work force of chronic illness self-management: A survey analysis of personal communities. PLoS One, 8(4), e59723. https://doi.org/10.1371/journal.pone.0059723.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
Ethical Approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The research project was approved by the Institutional Review Board of West Chester University of Pennsylvania, West Chester, PA 19383.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
McConatha, J.T., Kumar, V.K., Raymond, E. et al. Cultural Dimensions of Diabetes Management: a Qualitative Study of Middle Eastern Immigrants in the U.S.. J Cross Cult Gerontol 35, 85–98 (2020). https://doi.org/10.1007/s10823-019-09383-7
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10823-019-09383-7