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Self-care expressions, patterns, and practices of Latinos/Hispanics for the management of Type 2 diabetes

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
Karen A. Amirehsani (Creator)
Institution
The University of North Carolina at Greensboro (UNCG )
Web Site: http://library.uncg.edu/
Advisor
Debra Wallace

Abstract: The purpose of this cross-sectional, correlational study was to explore the use of traditional, complementary, and alternative (TCA) self-care expressions, patterns, and practices of Latinos/Hispanics for the management of type 2 diabetes. The target population was adult men and women living in a nonborder, emerging Latino/Hispanic area. Specifically, this study explored the use of herbal remedies, faith-based interventions, consulting traditional healers, and self-medication/self-prescription practices and assessed their association to glycemic control. Leininger's culture care diversity and universality theory and sunrise enabler were used as the conceptual framework. A total of 75 Latino/Hispanic immigrants living in central and western North Carolina were enrolled. Approximately 67% of participants were female and the mean age was 47 years. High levels of hypertension, overweight/obesity, and diabetes-related comorbidities were reported. Glycemic control was poor, as measured by A1C. Limited financial resources and low acculturation levels were reported by the men and women. Sixty-nine percent of the sample reported using herbal/plant products on a daily, weekly, or monthly basis for diabetes self-care. Forty-nine different products were used. The most frequently used herbal remedies were prickly pear cactus (nopale), aloe vera (salvia or sábila), celery (apio), vegetable pear (chayote), cinnamon (canela), cat's claw (uña de gato), Herbalife, beets (betabel), bitter gourd/melon (cundeamor or yerba mora), nin, horsetail (la cola de caballo), and oats (aveno). Forty-one percent of the sample reported using faith-based interventions, such as personal prayer or going to mass/church. Eight percent of the sample consulted with traditional healers, and approximately 15% used self-medication/self-prescription to manage diabetes. Participants reported not communicating the use of TCA modalities with their health care provider. Persons identified reasons for not disclosing this information as: beliefs that American healthcare providers do not believe in or lack knowledge of Latino/Hispanic natural medicine; "it's not relevant"; a translator was required to explain TCA practices; and prior experiences with healthcare providers "being in a hurry" and "not asking questions" of patients. Multiple linear regression analyses were used to examine the association of individual characteristics, cultural and social structure dimensions, and environmental context factors with the use of TCA modalities and with glycemic control (A1C level). The effect of herbal remedies, faith-based interventions, consulting traditional healers, and self-medication/self-prescription on A1C level was examined. Predictors of TCA usage and glycemic control were not found. New knowledge of the emic practices of Latinos/Hispanics for the management of type 2 diabetes was developed. Understanding self-care practices of Latinos/Hispanics and improving provider cultural competency are critical for alleviating diabetes-related health disparities of this population. Study findings inform implications in the areas of practice, education, healthcare systems and policy, and future research to alleviate disparities in access, care, and health outcomes for Latinos/Hispanics with diabetes.

Additional Information

Publication
Dissertation
Language: English
Date: 2011
Keywords
Diabetes, Faith, Healers, Herbs, Latinos/Hispanics, Self-care
Subjects
Non-insulin-dependent diabetes $x Alternative treatment $z North Carolina $v Case studies
Non-insulin-dependent diabetes $z North Carolina $v Case studies
Hispanic Americans $x Diseases $z North Carolina
Self-care, Health $z North Carolina