Resolving disease management problems in European-American and Latino couples with type 2 diabetes: the effects of ethnicity and patient gender

The management of type 2 diabetes requires major life style changes. How patients and family members resolve disagreements about disease management affects how well the disease is managed over time. Our goal was to identify differences in how couples resolved disagreements about diabetes management based on ethnicity and patient gender. We recruited 65 Latino and 110 European-American (EA) couples in which one spouse had type 2 diabetes. Couples participated in a 10-minute videotaped, revealed differences interaction task that was evaluated with 7 reliable observer ratings: warm-engagement, hostility, avoidance, amount of conflict resolution, off-task behavior, patient dominance, and dialogue. A series of 2 x 2, Ethnicity x Sex ANOVAs indicated significant effects for Ethnicity and for the Ethnicity x Sex interaction, but not for Sex. Latino couples were rated as significantly more emotionally close, less avoidant, less hostile toward each other, and had less dominant patients than EA couples; however, Latino couples achieved significantly less problem resolution and were more frequently off-task than EA couples. These findings were qualified by patient gender. The findings highlight important differences     

Family predictors of disease management over one year in Latino and European American patients with type 2 diabetes

Family context is thought to influence chronic disease management but few studies have longitudinally examined these relationships. Research on families and chronic illness has focused almost exclusively on European American families. In this prospective study we tested a multidimensional model of family influence on disease management in type 2 diabetes in a bi-ethnic sample of European Americans and Latinos. Specifically, we tested how baseline family characteristics (structure, world view, and emotion management) predicted change in disease management over one year in 104 European American and 57 Latino patients with type 2 diabetes. We found that emotion management predicted change in disease management in both groups of patients as hypothesized, while family world view predicted change in both ethnic groups but in the predicted direction only for European Americans. Examining family context within ethnic groups is required to elucidate unique cultural patterns. Attending to culturally unique interpretations of constructs and measures is warranted. The import of family emotion management, specifically conflict resolution, in disease management deserves further study to support clinical intervention development. Examining multiple domains of family life and multidimensional health outcomes strengthens our capacity to develop theory about family contexts and individual health.     

成人日常问题解决的老化研究

日常问题解决能力是近十几年来老年心理学中研究比较活跃的一个领域。本文介绍了有关日常问题解决研究的四种理论,即心理测量的智力内隐理论、形式后思维的辨证思维理论、信息加工理论和社会认知与智慧理论,及其初步的研究成果,并进一步指出在理论上整合和在实践中开展干预的研究方向。     

Cultural issues in disease management for chinese americans with type 2 diabetes

The purpose of this study is to highlight culturally unique experiences and responses to type 2 diabetes among Chinese immigrant families. Patient and spouse narratives from 16 different families were elicited in a series of group interviews on this topic. Using interpretive phenomenology, 5 primary cultural considerations in diabetes management emerged from the narratives: (1) conceptualization of diabetes, illness and health, (2) significance and meaning of food, (3) perceptions of Chinese and Western medicines, (4) exercise and physical activity, and (5) effects of the disease on family dynamics. The relation of these cultural considerations to an interdependent view of the self, collectivistic social orientation, Chinese cultural beliefs and norms, and acculturation processes are discussed. Clinical recommendations for culturally appropriate disease management strategies are outlined.     

Ecological Factors that Impact Adjustment Processes and Development of Ugandan Adolescent Immigrant Females

Existing literature suggests that acculturation and integration processes for immigrant youth from East Africa are complicated by family values, interaction styles, and social roles that are in conflict with those of the US host culture. The purpose of this study was to explore first-generation female Ugandan immigrant youth perceptions, beliefs and attitudes toward self-development and identify factors among their social contexts that impact their development and adjustment. This study utilized dimensional analysis, an approach to the generation of grounded theory. Data collection included over 100?h of community participatory observation and 28 interviews in total. Participants included 20 English speaking Ugandan females aged 16–25 years who immigrated to the US after age of eight. Participants’ adaptations and adjustments led to an altered developmental path, including their beliefs about gender, ethnic and racial identities, and how they balanced and integrated US culture into their existing understandings and cultural awareness. Conditions that impacted the identity development process include timing of their immigration, the contexts of reception, media, the Ugandan Community, the school social setting, the perceived value of Ugandan cultural maintenance vs. the value of adopting certain American traits, and experiences of prejudice and discrimination vs. new future opportunities. The findings represent an in-depth consideration of the cultural, linguistic, religious, racial, and social attributes of the female Ugandan immigrant youth population and can therefore be seen as an important step in the direction of developing an understanding of the developmental assets and risk/protective factors that characterize this young immigrant population.     

A Contextual Model of Control Beliefs,Behavior, and Health: Latino and European Americans with Type 2 Diabetes

Sense of control is frequently found to be related to health. A model of control beliefs, disease-management behaviors, and health indicators was tested in a sample of 74 Latino Americans and 115 European Americans with Type 2 diabetes. Two measures of control beliefs, one diabetes-specific (diabetes self-efficacy) and one global (mastery), were examined for their effects on management behaviors (diet and exercise) and on health (Hb_A1C and general health). Results indicated that the relationship between control and management behaviors varied by measure of control and by group. For Latino participants, global mastery was related to management behaviors; whereas, self-efficacy was related to such behaviors among European Americans. The relationship between control and health did not appear to be mediated by management behaviors. This study provides support for a diversified approach to control, behavior, and health.