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Moody JG. Spiritual Self-Care Practices, Diabetes Knowledge, and Diabetes Self-Care Practices for African Americans. J Holist Nurs 2025; 43:38-48. [PMID: 39584834 DOI: 10.1177/08980101241296402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2024]
Abstract
Purpose: The purpose of this descriptive study was to examine holistic spiritual self-care practices, diabetes knowledge, and its association with self-care practices among African Americans diagnosed with type 2 diabetes. The objective was to determine if spiritual self-care practices correlated with diabetes self-care practices among African Americans. Design: A descriptive research design was used for African Americans living in a Midwestern urban area. Participants were at least 18 years of age and diagnosed with type 2 diabetes. Participants were excluded if they had a diagnosis of type 1 or gestational diabetes, and/or a history of dementia or psychiatric illness. Method: Ninety African American participants between 28 and 88 years of age completed four instruments to measure diabetes knowledge, diabetes self-care practices, and spiritual self-care practices. Findings: Statistically significant correlations were found between general diet and diabetic self-care practices, spiritual self-care practices, physical spiritual self-care practices, and interpersonal spiritual self-care practices. Conclusion: This research project provided evidence that nursing staff caring for African Americans diagnosed with type 2 DM may consider incorporating spiritual self-care practices with other holistic self-care practices when helping African Americans manage their DM. This study found that spiritual self-care practices were important for African Americans who participated with this study.
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Yildirim Keskin A, Şentürk S, Teke ZB. Ramadan as religious ritual: Experiences of Muslim people with Type 2 Diabetes in Türkiye regarding Ramadan. Diabetes Res Clin Pract 2024; 215:111802. [PMID: 39094742 DOI: 10.1016/j.diabres.2024.111802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 06/24/2024] [Accepted: 07/29/2024] [Indexed: 08/04/2024]
Abstract
This study aims to determine the experiences of Muslim people with Type 2 Diabetes Mellitus (DM) about Ramadan in Türkiye. This phenomenological study was conducted with 30 Muslim people with Type 2 DM. The data were collected by holding in-depth individual interviews with a semi-structured interview form and analyzed using Colaizzi's seven-stage analysis and the MAXQDA-20 program. As a result, three main themes with 12 categories were determined as follows: (i) "the month of Ramadan and the meaning of fasting", (ii) "the effects of fasting", and (iii) "coping with difficulties". The participants stated that the month of Ramadan is one of the pillars of Islam and that it includes worshiping, finding peace, completing oneself in the religious sense, purifying oneself from sins, resting physically and spiritually, and appreciating the meaning of hunger, thirst, and blessings. However, some people reported that there was social pressure when they did not fast. Health professionals should provide people with DM with regular and safe training specific to Ramadan, establish support groups, and cooperate with religious officials (imams) to meet their religious demands.
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Affiliation(s)
- Alev Yildirim Keskin
- Associate Professor, Department of Nursing, Akşehir Kadir Yallagöz Health School, Selçuk University, Akşehir-Konya, Turkiye.
| | - Sibel Şentürk
- Associate Professor, Department of Nursing, Bucak Health School, Burdur Mehmet Akif Ersoy University, Bucak-Burdur, Turkiye.
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Lekha PPS, Azeez EPA. Psychosocial Facilitators and Barriers to Type 2 Diabetes Management in Adults: A Meta-Synthesis. Curr Diabetes Rev 2024; 20:110-123. [PMID: 38310483 DOI: 10.2174/0115733998283436231207093250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/10/2023] [Accepted: 11/29/2023] [Indexed: 02/05/2024]
Abstract
BACKGROUND Globally, the cases of type 2 diabetes are increasing, and this is largely attributed to lifestyle changes. Though diabetes is primarily a metabolic disease determined by biological factors, psychosocial aspects play a crucial role in its progression and management. However, the literature on psychosocial dimensions of diabetes management is minuscule and scattered. OBJECTIVE This synthesis sought to understand the psychosocial facilitators and barriers to type 2 diabetes management and coping among adults. METHODS We have adopted a meta-synthesis to review available qualitative studies using Pub- Med and Scopus databases. Based on inclusion criteria, we have chosen 24 studies published between 2010 and 2023. We have considered studies across countries, among which 63% of the studies included were from Western countries, and most have employed qualitative descriptive design. The selected studies were analyzed thematically using a deductive framework. RESULTS Six themes emerged as the psychosocial barriers and facilitators of managing and coping with type 2 diabetes: 1) cognitive-emotional factors, 2) faith, 3) constraints to behavioural change, 4) social constraints and support, 5) healthcare provider-patient relationship, and 6) awareness. Further, a conceptual framework was developed from the synthesis. CONCLUSION The patients' experiences evident from this synthesis signify the crucial role of psychosocial factors in diabetes management and coping. This evidence emphasizes the need for integrated care so that psychosocial aspects are addressed by healthcare providers and behavioural health professionals, which may lead to the promotion of facilitators and the minimization of barriers.
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Affiliation(s)
- P Padma Sri Lekha
- School of Social Sciences and Languages, Vellore Institute of Technology, Vellore, India
| | - E P Abdul Azeez
- School of Social Sciences and Languages, Vellore Institute of Technology, Vellore, India
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Jordan H, Jeremiah R, Watson K, Corte C, Steffen A, Matthews AK. Exploring Preventive Health Care Utilization Among Black/African American Men. Am J Mens Health 2024; 18:15579883231225548. [PMID: 38243644 PMCID: PMC10799604 DOI: 10.1177/15579883231225548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 09/21/2023] [Accepted: 12/19/2023] [Indexed: 01/21/2024] Open
Abstract
Black/African American (BAA) men have the lowest life expectancy among other major demographic groups in the United States, with BAA male mortality rates 40% higher than their White male counterparts. Despite known benefits of preventive health care utilization, BAA men are 43% more likely to use the emergency department for usual care. Many intersecting factors like medical mistrust and religion have been identified as common barriers BAA men face in health care utilization with few studies exploring factors that impact their current preventive health care utilization. In addition, BAA men's perceptions of health and ability to identify or seek help have always been disproportionately lower than other racial groups despite higher rates of preventable diseases. Using the tenets of the Andersen Healthcare Utilization Model, this cross-sectional study of 176 BAA men explores BAA men's current preventive health care practices while examining the intersection of predisposing, enabling, and need factors on BAA men's preventive health care utilization. While it is well known that higher income levels and higher education positively influence health care utilization, the intersection of religious affiliation and higher levels of medical mistrust was associated with BAA men's decreased engagement with health care as religion posed as a buffer to health care utilization. This study demonstrated that BAA men's perception of health differed by sexual orientation, educational status, and income. However, across all groups the participants' perspective of their health was not in alignment with their current health outcomes. Future studies should evaluate the impact of masculine norms as potential enabling factors on BAA men's preventive health care utilization.
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Affiliation(s)
- Harrell Jordan
- College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Rohan Jeremiah
- College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Karriem Watson
- College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Colleen Corte
- College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Alana Steffen
- College of Nursing, University of Illinois Chicago, Chicago, IL, USA
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5
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Akkuş Y, Kiliç SP. Feelings, Difficulties and Attitudes in relation to Fasting: A Qualitative Study on Spiritual Coping Among Turkish Patients with Type 2 Diabetes. JOURNAL OF RELIGION AND HEALTH 2023; 62:4382-4398. [PMID: 36495355 DOI: 10.1007/s10943-022-01713-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/30/2022] [Indexed: 06/17/2023]
Abstract
This study aims to reveal the feelings, difficulties, attitudes, and spiritual coping status of Turkish patients with Type 2 diabetes mellitus toward fasting during Ramadan. The sample of this descriptive qualitative study consists of 14 patients diagnosed with Type 2 diabetes. We determined two main themes and relevant sub-themes. The first was "the feelings and difficulties experienced due to diabetes mellitus" with the sub-themes of "negative emotions" and "difficulties in fasting." The second theme was identified as "religious and spiritual coping" with the sub-themes of "believing the disease comes from God," "having difficulty in adhering to disease-specific practices while fasting," and "feeling that fasting facilitates coping and provides relief." In conclusion, it was determined that the patients continued to fast despite the difficulties and that fasting facilitated coping and provided relaxation.
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Affiliation(s)
- Yeliz Akkuş
- Nursing Department, Faculty of Health Science, Kafkas University, 36100, Kars, Turkey.
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6
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Boateng ACO, Webster J, Richmond TS. Spiritual coping behaviors among injured urban black men in Philadelphia. Arch Psychiatr Nurs 2023; 46:91-97. [PMID: 37813511 PMCID: PMC10562640 DOI: 10.1016/j.apnu.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 08/16/2023] [Indexed: 10/11/2023]
Abstract
PURPOSE High rates of firearm injury among urban Black men in the US can lead to long physical and psychological recovery times, worsened by limited access to mental health services. Spirituality can propel positive thoughts, actions, perceptions and behaviors about self and others yet how it is used among Black men recovering from firearm injury is underexplored. This study examined the role of spirituality in the recovery of Black male survivors of firearm injury. METHOD Ten injured urban Black men in Philadelphia were interviewed using descriptive phenomenology. A subset of participants from the Emotional Responses and Recovery from Injury in Urban Black Men study who agreed to be recontacted for future studies were enrolled. Informed consent was obtained, semi-structured interviews were conducted via phone and were audiotaped, transcribed, and de-identified. Thematic content analysis was used to understand perceptions of spirituality and to identify spiritual coping behavior themes. RESULTS Findings suggest that injured urban Black men engaged in theistic and non-theistic spiritual activities that resulted in positive character development, reduced risk of re-injury, hope, improved mental health and social bonds. CONCLUSION Spirituality may serve as a protective factor against firearm re-injury or retaliation by promoting desired behaviors and mental health among injured urban Black men. Combining culturally sensitive spiritual resources and psychotherapy may lead to effective trauma-informed care in addressing spiritual and existential challenges of injured urban Black men who may find spirituality important.
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Affiliation(s)
- Augustine C O Boateng
- University of Pennsylvania School of Nursing, Department of Biobehavioral Health Sciences, United States of America; Penn Injury Science Center, United States of America.
| | - Jessica Webster
- University of Pennsylvania School of Nursing, Department of Biobehavioral Health Sciences, United States of America
| | - Therese S Richmond
- University of Pennsylvania School of Nursing, Department of Biobehavioral Health Sciences, United States of America; Penn Injury Science Center, United States of America
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Onyishi CN, Eseadi C, Ilechukwu LC, Okoro KN, Okolie CN, Egbule E, Asogwa E. Potential influences of religiosity and religious coping strategies on people with diabetes. World J Clin Cases 2022; 10:8816-8826. [PMID: 36157650 PMCID: PMC9477035 DOI: 10.12998/wjcc.v10.i25.8816] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 07/06/2022] [Accepted: 07/18/2022] [Indexed: 02/05/2023] Open
Abstract
Diabetes is a significant health issue that threatens patients’ overall wellbeing and quality of life. Critical public health concerns center on creating the best approach for diabetes management. Patients and caregivers have different approaches to diabetes management; however, this and the associated physiological, physical and mental health issues remain challenging. This review explores the potential influences of religiosity and religious coping strategies on people with diabetes. This study used a literature review approach to investigate how religiosity and religious coping strategies can influence the effective management of diabetes among patients. Based on the literature search, the researchers were able to identify and cite published papers that were analyzed using the descriptive-narrative analysis. An important goal of the descriptive-narrative analysis was to provide descriptions of the selected literature and take implications from the literature. The results of studies reviewed show some religious coping strategies for managing chronic diseases such as diabetes. The studies did establish a relationship between religiosity and diabetes management and suggest that religious coping strategies could positively impact the management of diabetes; however, they reported some adverse effects. Hence, we propose a pathway for the development of religion-oriented interventions and support framework for the management of diabetes.
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Affiliation(s)
- Charity Neejide Onyishi
- Department of Educational Psychology, University of Johannesburg, Johannesburg 2006, Gauteng, South Africa
| | - Chiedu Eseadi
- Department of Educational Psychology, University of Johannesburg, Johannesburg 2006, Gauteng, South Africa
| | | | - Kingsley Nwannennaya Okoro
- Department of Philosophy/Religion and Cultural Studies, Alex Ekwueme Federal University, Ndufu-Alike Ikwo 1010, Ebonyi, Nigeria
| | - Charles Nkem Okolie
- Department of Philosophy/Religion and Cultural Studies, Alex Ekwueme Federal University, Ndufu-Alike Ikwo 1010, Ebonyi, Nigeria
| | - Emmanuel Egbule
- Department of Philosophy/Religion and Cultural Studies, Alex Ekwueme Federal University, Ndufu-Alike Ikwo 1010, Ebonyi, Nigeria
| | - Emmanuel Asogwa
- Department of Philosophy/Religion and Cultural Studies, Alex Ekwueme Federal University, Ndufu-Alike Ikwo 1010, Ebonyi, Nigeria
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8
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Conley C, Gonzalez-Guarda R, Randolph S, Hardison-Moody A, Fisher EB, Lipkus I. Religious social capital and minority health: A concept analysis. Public Health Nurs 2022; 39:1041-1047. [PMID: 35436366 PMCID: PMC11878107 DOI: 10.1111/phn.13082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/28/2022] [Accepted: 03/30/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Optimizing resources within environments where people live, work, and pray can aid nurses in improving public health. Religion and social capital significantly influence the health of individuals and communities, particularly among racial and ethnic minorities in the United States. A concept analysis of religious social capital was conducted to clarify how this resource is used in the context of health. DESIGN AND SAMPLE Rodgers' evolutionary concept analysis method guided this analysis. A search of PubMed, CINAHL, and PsycINFO, using keywords "religious social capital" and "health" yielded 152 publications. RESULTS Antecedents were "defined religious social network," "voluntary membership," "shared values," and "trust." Attributes were "relationships (bonding bridging, and linking)," "information exchange and resource sharing," and "reciprocal participation." Consequences were "increased productivity," "increased resources," "better personal and community health," and "trust." A model case of African American women and HIV prevention was included to illustrate how religious social capital can be developed and optimized to promote health. CONCLUSION Religious social capital is defined as increased individual and collective capabilities that result from voluntary and reciprocal participation in bonding, bridging, or linking social network relationships and activities. Religious social capital is an accessible resource that can be leveraged to improve minority health.
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Affiliation(s)
- Cherie Conley
- Duke University School of Nursing, Durham, North Carolina, USA
| | | | | | | | - Edwin B. Fisher
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Isaac Lipkus
- Duke University School of Nursing, Durham, North Carolina, USA
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9
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Jia J, Jenkins AJ, Quintiliani LM, Truong V, Lasser KE. Resilience and diabetes self-management among African-American men receiving primary care at an urban safety-net hospital: a cross-sectional survey. ETHNICITY & HEALTH 2022; 27:1178-1187. [PMID: 33249921 DOI: 10.1080/13557858.2020.1849566] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 11/02/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Resilience is the ability to adapt to adverse life events. Studies that explore diabetes self-management interventions integrating resilience in African-Americans with diabetes include few African-American men, who have higher diabetes-related mortality and complication rates compared to African-American women. DESIGN We conducted a cross-sectional study of African-American men with uncontrolled diabetes living in diabetes hotspots. We measured resilience levels using the General Self Efficacy Scale (GSES), adherence to diabetes self-management behaviors using the Diabetes Self-Management Questionnaire (DSMQ), and incarceration history by phone survey. We categorized participants as higher or lower resilience level and higher or lower adherence to diabetes self-management behaviors. Using multivariable logistic regression, we examined the relationship between resilience and adherence to diabetes self-management behaviors. Our model accounted for potential confounders, including age, incarceration history, and socioeconomic factors. RESULTS Of 234 patients contacted by mail and phone, 94 (40.2%) completed the survey. Mean age was 60.6 years, 59.5% reported an annual household income of less than $20,000, and 29.8% reported a history of incarceration. The mean unadjusted GSES score was 25.0 (sd 5.2; range: 0-30, higher scores indicate greater resilience), and the mean DSMQ score was 7.34 (sd 1.78; range: 0-10, higher scores indicate greater adherence to diabetes self-management behaviors). In multivariable analyses, higher levels of resilience were associated with higher adherence to diabetes self-management behaviors (aOR = 9.68, 95% CI 3.01, 31.12). History of incarceration was negatively associated with higher adherence to diabetes self-management behaviors (aOR = 0.23, 95% CI 0.06, 0.81). CONCLUSIONS Resilience and personal history of incarceration are associated with adherence to diabetes self-management behaviors among African-American men residing in diabetes hotspots. Future interventions should incorporate resilience training to improve diabetes self-management behaviors. At a societal level, social determinants of health that adversely affect African-American men, such as structural racism and mass incarceration, need to be eliminated.
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Affiliation(s)
- Jenny Jia
- Section of General Internal Medicine, Department of Medicine, Boston Medical Center, Boston, MA, USA
- Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | | | - Lisa M Quintiliani
- Section of General Internal Medicine, Department of Medicine, Boston Medical Center, Boston, MA, USA
- School of Medicine, Boston University, Boston, MA, USA
| | - Ve Truong
- Section of General Internal Medicine, Department of Medicine, Boston Medical Center, Boston, MA, USA
| | - Karen E Lasser
- Section of General Internal Medicine, Department of Medicine, Boston Medical Center, Boston, MA, USA
- School of Medicine, Boston University, Boston, MA, USA
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Botchway M, Davis RE, Appiah LT, Moore S, Merchant AT. The Influence of Religious Participation and Use of Traditional Medicine on Type 2 Diabetes Control in Urban Ghana. JOURNAL OF RELIGION AND HEALTH 2022; 61:1966-1979. [PMID: 33517523 DOI: 10.1007/s10943-021-01187-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/16/2021] [Indexed: 06/12/2023]
Abstract
This study examined whether the frequency of participation in religious activities and seeking care from spiritual and other traditional medicine (TM) practitioners were associated with blood glucose (HbA1c) control among urban Ghanaians with type 2 diabetes mellitus (T2DM). Findings revealed that increased frequency of participation in religious activities was significantly associated with decreased HbA1c levels, whereas increased use of TM practitioners was significantly associated with increased HbA1c levels. These findings suggest that strategically integrating religious activities into disease management plans for Ghanaians with T2DM who identify as being religious may be a viable intervention mechanism.
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Affiliation(s)
- Marian Botchway
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.
- Eck Institute for Global Health, University of Notre Dame, 4143 Jenkins and Nanovic Halls, Notre Dame, IN, 46556, USA.
| | - Rachel E Davis
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Lambert T Appiah
- Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Spencer Moore
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
- Health & Society Group, Wageningen University & Research, De Leeuwenborch, Hollandseweg 1, 6707, KN, Wageningen, Netherlands
| | - Anwar T Merchant
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
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Celik S, Taskin Yilmaz F, Anataca G. The Effect of Religious Coping on Disease Acceptance and Management Among Patients with Diabetes in Turkey. JOURNAL OF RELIGION AND HEALTH 2022; 61:1980-1993. [PMID: 33905006 DOI: 10.1007/s10943-021-01260-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/09/2021] [Indexed: 06/12/2023]
Abstract
Religious coping is considered an important factor for assisting with the management of chronic diseases. This study was conducted to determine the relationship between religious coping and disease acceptance and management among patients with diabetes. A total of 504 individuals with type 2 diabetes were included in this descriptive-correlational study. In this study, individuals who did not use their medications regularly, those who did not pay attention to their diet and those who did not exercise regularly had higher levels of positive religious coping. No significant relationship was found between the level of acceptance of illness and religious coping styles among participants with diabetes. However, it was found out that there was a positive relationship between HbA1C levels and the mean score of positive religious coping and positive religious coping accounted for 7% of the total variance in the glycemic control parameter.
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Affiliation(s)
- Selda Celik
- Hamidiye Faculty of Nursing, University of Health Sciences Turkey, Selimiye Mah. Tıbbiye Cad. No:38, 34668, Üsküdar, Istanbul, Turkey.
| | - Feride Taskin Yilmaz
- Department of Internal Disease Nursing, Sivas Cumhuriyet University, Health High School of Susehri, 58140, Sivas, Turkey
| | - Gulden Anataca
- University of Health Sciences, Kanuni Sultan Suleyman Education and Research Hospital - Istanbul, Istanbul, Turkey
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Ahmad A, Khan MU, Aslani P. The Role of Religion, Spirituality and Fasting in Coping with Diabetes among Indian Migrants in Australia: A Qualitative Exploratory Study. JOURNAL OF RELIGION AND HEALTH 2022; 61:1994-2017. [PMID: 34617198 DOI: 10.1007/s10943-021-01438-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/28/2021] [Indexed: 06/13/2023]
Abstract
Australia has a high proportion of migrants, with an increasing migration rate from India. While many factors influence diabetes self-management among Indian migrants, very little is known about the influence of religious beliefs and spirituality. This study explored the religious beliefs of Indian migrants in Australia and the influence of those beliefs on their diabetes self-management. Semi-structured interviews were conducted with a convenience sample of 23 Indian migrants. All interviews were audio-recorded, transcribed verbatim and thematically analysed. Most participants believed that prayers helped them alleviate stress and improve diabetes management participants also believed that receiving blessings/prayers from religious leaders prevent or cure diseases including diabetes. There were mixed views on beliefs about using insulin obtained from animal sources. Some participants were concerned about the use of animal-based insulin as it was against their religious beliefs and teachings. Some participants believed that religious fasting does not have any impact on their diabetes while others believed that it can be detrimental to their health. Religious beliefs therefore played an important role in how Indian migrants managed their diabetes. Healthcare professionals should consider their patients' religious beliefs during consultations, enlist support, such as religious scholars, to better address people's misconceptions, and identify strategies for effective diabetes management that consider religious beliefs.
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Affiliation(s)
- Akram Ahmad
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia.
| | - Muhammad Umair Khan
- Aston Pharmacy School, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Parisa Aslani
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
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13
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Duke N. Type 2 diabetes self-management: spirituality, coping and responsibility. J Res Nurs 2021; 26:743-760. [PMID: 35251282 PMCID: PMC8894753 DOI: 10.1177/17449871211026958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background In England, although The National Institute of Health and Care Excellence recommends that patients’ religious beliefs should be incorporated into individual healthcare plans, these components are often neglected in diabetes management care plans. A literature review identified a paucity of research regarding how the spirituality of British people may influence their approach to their self-management of type 2 diabetes (T2D). Aims To explore how the spirituality of a small group of adults with T2D, living in England, influenced their coping strategies and self-management of diet and exercise. Methods Biographic Narrative Interpretive Method of two interviews per participant and thematic analysis for data interrogation ( n = 8). Data as glycated haemoglobin, living situation, age, length of time since T2D diagnosis, body mass index and diabetic medicines contextualised the interview data. Results Participants’ spirituality, health beliefs, coping and sense of responsibility for T2D self-management overlapped in complex layers. Three themes were generated: (a) spirituality influences expectations in life; (b) beliefs influence coping styles of diabetes self-management; and (c) responsibility influences diabetes self-management. A model was created to assist nurses in addressing these components. Conclusion Nurses should consider how patients’ self-management of T2D may be influenced by their spirituality, health beliefs, coping and sense of responsibility.
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Affiliation(s)
- Natasha Duke
- Independent Consultant, School of Health Sciences, University of Southampton, UK
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14
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Walker RJ, Walker RE, Mosley-Johnson E, Egede LE. Exploring the Lived Experience of Food Insecure African Americans with Type 2 Diabetes Living in the Inner City. Ethn Dis 2021; 31:527-536. [PMID: 34720556 PMCID: PMC8545483 DOI: 10.18865/ed.31.4.527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Purpose Despite evidence that food insecure African Americans with type 2 diabetes are at particularly high risk for poor health outcomes, there is currently a lack of information on their lived experience. This qualitative study aimed to identify challenges, facilitators, and barriers to effective diabetes care for food insecure African Americans with type 2 diabetes residing in an inner city. Methods In fall 2018, we conducted two focus groups attended by a total of 16 food insecure adults with type 2 diabetes residing in the inner city of Milwaukee, Wisconsin. A standardized moderator guide included questions to explore the role of food insecurity in managing diabetes, and facilitators that improve diabetes management within the context of food insecurity. Focus groups were audio recorded and recordings were transcribed by a professional transcription service. A grounded theory approach was used for analysis. Results Six major challenges existed at the individual level (diet/nutrition, exercise, diabetes knowledge and skills, complications from diabetes, a family history of diabetes, and a preoccupation with food). Five major barriers and facilitators existed both internally and externally to the individuals (access to food, medications, stress, cost of health-related needs and religion/spirituality). Conclusions This study identified multiple challenges, barriers, and facilitators to effective care for food insecure African American adults with type 2 diabetes. It is imperative to incorporate this understanding in future work by using an ecological approach to investigate strategies to address food insecurity beyond a singular focus on access to food.
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Affiliation(s)
- Rebekah J Walker
- Division of General Internal Medicine, Department of Medicine, Froedtert & The Medical College of Wisconsin, Milwaukee, WI.,Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI
| | - Renee E Walker
- Zilber School of Public Health, University of Wisconsin at Milwaukee, Milwaukee, WI
| | - Elise Mosley-Johnson
- Division of General Internal Medicine, Department of Medicine, Froedtert & The Medical College of Wisconsin, Milwaukee, WI.,Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI
| | - Leonard E Egede
- Division of General Internal Medicine, Department of Medicine, Froedtert & The Medical College of Wisconsin, Milwaukee, WI.,Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI
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Ahmad A, Khan MU, Aslani P. A Qualitative Study on Medication Taking Behaviour Among People With Diabetes in Australia. Front Pharmacol 2021; 12:693748. [PMID: 34616293 PMCID: PMC8488297 DOI: 10.3389/fphar.2021.693748] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 08/24/2021] [Indexed: 11/27/2022] Open
Abstract
Background: Australia has a high proportion of migrants with an increasing migration rate from India. Type II diabetes is a long-term condition common amongst the Indian population. Aims: To investigate patients’ medication-taking behaviour and factors that influence adherence at the three phases of adherence. Methods: Semi-structured interviews were conducted with a convenience sample of 23 Indian migrants living in Sydney. All interviews were audio-recorded, transcribed verbatim and thematically analysed. Results: 1) Initiation: The majority of participants were initially prescribed oral antidiabetic medicine and only two were started on insulin. Most started taking their medicine immediately while some delayed initiating therapy due to fear of side-effects. 2) Implementation: Most participants reported taking their medicine as prescribed. However, some reported forgetting their medicine especially when they were in a hurry for work or were out for social events. 3) Discontinuation: A few participants discontinued taking their medicine. Those who discontinued did so to try Ayurvedic medicine. Their trial continued for a few weeks to a few years. Those who did not receive expected results from the Ayurvedic medicine restarted their prescribed conventional medicine. Conclusion: A range of medication-taking behaviours were observed, ranging from delays in initiation to long-term discontinuation, and swapping of prescribed medicine with Ayurvedic medicine. This study highlights the need for tailored interventions, including education, that focus on factors that impact medication adherence from initiation to discontinuation of therapy.
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Affiliation(s)
- Akram Ahmad
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, Sydney, NSW, Australia
| | - Muhammad Umair Khan
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, Sydney, NSW, Australia
| | - Parisa Aslani
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, Sydney, NSW, Australia
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Ischaq Nabil Asshiddiqi M, Yodchai K, Taniwattananon P. Predictors of diabetes distress among older persons with type 2 diabetes mellitus in Indonesia. J Res Nurs 2021; 26:307-317. [DOI: 10.1177/1744987120943936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Older persons living with diabetes have an obligation to change their daily lifestyle, which may contribute to diabetes distress. Furthermore, predictive factors of diabetes distress in older persons might be different from other age groups due to age-related factors. Aims The purpose of the study was to examine the predictive factors of diabetes distress in older persons diagnosed with type 2 diabetes mellitus (T2DM) in Indonesia. Methods A cross-sectional design was used in this study. Participants were recruited from an outpatient department of a tertiary hospital in Klaten City, Central Java, Indonesia. Data were analysed using multiple linear regression with a stepwise method. Results A total 198 older persons were included in the study. The study demonstrated self-efficacy (β = −0.298, P < 0.01), spirituality (β = −0.139, P < 0.05), blood glucose (β = 0.134, P < 0.05), and non-supportive family behaviour (β = 0.135, P < 0.05) as the variables that could statistically predict diabetes distress in older persons with T2DM. Conclusions Self-efficacy is the strongest predictor of diabetes distress. Moreover, the findings can be used as evidence to guide identification and future management of diabetes distress among older persons with T2DM.
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Affiliation(s)
- M Ischaq Nabil Asshiddiqi
- Student, Master of Nursing Science, Department of Adult and Gerontological Nursing, Prince of Songkla University, Thailand
- Lecturer, Faculty member, Department of Gerontological Nursing, Alma Ata University, Indonesia
| | - Kantaporn Yodchai
- Assistant Professor, Department of Adult and Gerontological Nursing, Prince of Songkla University, Thailand
| | - Ploenpit Taniwattananon
- Associate Professor, Department of Adult and Gerontological Nursing, Prince of Songkla University, Thailand
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Onyishi CN, Ilechukwu LC, Victor-Aigbodion V, Eseadi C. Impact of spiritual beliefs and faith-based interventions on diabetes management. World J Diabetes 2021; 12:630-641. [PMID: 33995850 PMCID: PMC8107980 DOI: 10.4239/wjd.v12.i5.630] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 02/23/2021] [Accepted: 03/25/2021] [Indexed: 02/06/2023] Open
Abstract
Management of diabetes constitutes significant social and economic burdens worldwide. There is a shortage of empirical studies on the management of diabetes and the associated mental health issues through spiritual beliefs and faith-based interventions (FBIs). It is not also clear how spiritual beliefs and FBIs account for the effective management of diabetic conditions. This article discusses the impact of spiritual beliefs and FBIs in the management of diabetes, from relationship and efficacy studies that report outcomes from experimental procedures of related interventions. The majority of the relationship studies showed positive relationships, while efficacy studies showed a high efficacy of interventions in faith-based approaches. However, none of the studies clearly reported the mechanisms of change or modality of operation in a FBI that can serve as a model across culture and context. Possible mechanisms of change were discussed for further development of a standard faith-based model, and finally, suggestions for future research were also highlighted by the authors.
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Affiliation(s)
- Charity Neejide Onyishi
- Department of Educational Psychology, University of Johannesburg, Gauteng, 2006, South Africa
- Department of Educational Foundations, University of Nigeria, Nsukka, Enugu 410001, Nigeria
| | | | - Vera Victor-Aigbodion
- Department of Educational Psychology, University of Johannesburg, Gauteng, 2006, South Africa
- Department of Educational Foundations, University of Nigeria, Nsukka, Enugu 410001, Nigeria
| | - Chiedu Eseadi
- Department of Educational Foundations, University of Nigeria, Nsukka, Enugu 410001, Nigeria
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Palmer Kelly E, Paredes AZ, DiFilippo S, Hyer M, Myers B, McGee J, Rice D, Bae J, Tsilimigras DI, Pawlik TM. Do Religious/Spiritual Preferences and Needs of Cancer Patients Vary Based on Clinical- and Treatment-Level Factors? Ann Surg Oncol 2020; 28:59-66. [PMID: 32424588 DOI: 10.1245/s10434-020-08607-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND The objective of this study is to characterize the religion and spiritual (R&S) needs of patients who undergo cancer-directed surgery. In addition, we seek to examine how R&S needs vary based on R&S identity and clinical and surgical treatment characteristics. PATIENTS AND METHODS A cross-sectional survey was administered to potential participants who were recruited through outpatient clinics and online. Respondent desires for R&S resources and engagement with the healthcare team around R&S topics were assessed. RESULTS Among 383 potential participants who were identified, 236 respondents were included in the analytic cohort. Mean age was 58.8 (SD 12.10) years, and most participants were female (75.8%) and White/Caucasian (94.1%). The majority (78.4%) identified as currently cancer free. Commonly treated malignancies included breast (43.2%), male reproductive (8.9%), skin (8.5%), and gastrointestinal (GI) (7.2%). Two-thirds of the respondents indicated a desire to have R&S incorporated into their cancer treatment (63.3%). Patients who identified as highly/moderately religious reported wanting R&S more often (highly religious: 95.2% versus moderately religious: 71.4% vs. nonreligious but spiritual: 4.5%). On multivariable analysis, patients who believed their health would improve in the future were more likely to report wanting R&S service (OR 2.2, 95% CI 1.0-4.7) as well as wanting to engage their healthcare providers on R&S topics (OR 2.4, 95% CI 1.2-4.7). In contrast, perception of current or future health status was not associated with patient desire for the actual surgeon/doctor him/herself to be involved in R&S activities (OR 1.83, 95% CI 0.97-3.45). CONCLUSIONS Two-thirds of patients undergoing cancer-directed surgery expressed a desire to have R&S incorporated into their cancer treatment. Incorporating R&S into cancer treatment can help a subset of patients throughout their cancer experience.
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Affiliation(s)
| | - Anghela Z Paredes
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | | | - Madison Hyer
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Brian Myers
- The Ohio State University, Columbus, OH, USA
| | - Julia McGee
- The Ohio State University, Columbus, OH, USA
| | - Daniel Rice
- Lake Erie College of Osteopathic Medicine, Greensburg, PA, USA
| | - Junu Bae
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | | | - Timothy M Pawlik
- Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
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Sohail MM, Ahmad S, Maqsood F. The Role of Socio-demographics in Adoption of Religious-Spiritual and Other Coping Strategies Among Muslim Chronic Patients with Hepatitis C in Pakistan. JOURNAL OF RELIGION AND HEALTH 2020; 59:234-256. [PMID: 30659406 DOI: 10.1007/s10943-019-00761-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Coping has emerged as a vital indicator among patients in the chronic conditions. The current study examined the role of demographic characteristics (such as age, education, gender, marital status, residential background, family type and number of children) in adoption of coping (emotion-focused, problem-solving, religious-spiritual) strategies for nursing among hepatitis patients. A sample of 500 patients (of hepatitis C) was drawn from five most populous districts (Lahore, Faisalabad, Rawalpindi, Gujranwala and Multan) of Punjab, Pakistan, by using Epi Info software with an alpha level of 0.03. The data were collected using a well-structured multi-sectional interview schedule through multistage proportionate sampling technique. Descriptive analysis, regression analysis and reliability analysis were computed using SPSS (version 21.0). In the overall adoption of coping strategies, lower monthly household income, lower education, rural residences, nuclear family setting and married status were contributing to the adoption of higher coping strategies among Muslim chronic patients with hepatitis C. The results of socio-demographics are also discussed with other coping strategies (such as religious-spiritual coping strategies, problem-solving coping strategies, emotion-focused coping strategies and constructive coping strategies). It was the first quantitative study of adoption of coping strategies among Muslim hepatitis patients in Pakistan. The study highlighted the importance of socio-demographic resources to cope with chronic illness. The empirical findings would start a new discussion from hepatic, counseling and nursing perspective. For terminal patients, these socio-demographic characteristics can serve as a guideline to provide community sources of social support. Medical social workers and healthcare experts need to facilitate the efforts of patients to cope with chronic illness through revision of nursing policy according to the socio-demographic and spiritual-religious needs of the patients.
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Affiliation(s)
| | - Saeed Ahmad
- Department of Sociology, University of Gujrat, Room#A8, Al-Farabi Block, Hafiz Hayat Campus, Gujrat, 50700, Pakistan.
| | - Fauzia Maqsood
- Department of Sociology, University of Gujrat, Room#A8, Al-Farabi Block, Hafiz Hayat Campus, Gujrat, 50700, Pakistan
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Research Topic: The realities of religious coping experiences of patients with diabetes mellitus: Implications for policy formulation in Ghana. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2020. [DOI: 10.1016/j.ijans.2020.100245] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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'Diabetes is a gift from god' a qualitative study coping with diabetes distress by Indonesian outpatients. Qual Life Res 2019; 29:109-125. [PMID: 31549366 PMCID: PMC6962255 DOI: 10.1007/s11136-019-02299-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2019] [Indexed: 11/29/2022]
Abstract
Background More than two-thirds of patients diagnosed with type 2 diabetes mellitus (T2DM) in Indonesia encounter medical-related problems connected to routine self-management of medication and the social stigma related to T2DM. The current study aims to explore distress and coping strategies in Indonesian T2DM outpatients in a Primary Healthcare Centre (PHC) in Surabaya, East Java, Indonesia. Methods We conducted a qualitative study using two different data collection methods: focus group discussions and in-depth interviews. The guideline of interviews and discussions were developed based on seventeen questions derived from the DDS17 Bahasa Indonesia (a Bahasa Indonesia version of the Diabetes Distress Scale questionnaire), which covered physician distress domain, emotional burden domain, regimen distress domain and interpersonal distress domain. Results The majority of the 43 participants were females and aged 50 or older. Our study discovered two main themes: internal and external diabetes distress and coping strategies. Internal diabetes distress consists of disease burden, fatigue due to T2DM, fatigue not due to T2DM, emotional burden (fear, anxiety, etc.) and lack of knowledge. Internal coping strategies comprised spirituality, positive attitude, acceptance and getting more information about T2DM. External diabetes distress was evoked by distress concerning healthcare services, diet, routine medication, monthly blood sugar checks, interpersonal distress (family) and financial concern. External coping strategies included healthcare support, traditional medicine, vigilance, self-management, social and family support and obtaining information about health insurance. Conclusion Our study shows that for Indonesian T2DM-patients, spirituality and acceptance are the most common coping mechanisms for reducing DD. Furthermore, our study revealed an overall positive attitude towards dealing with T2DM as well as a need for more information about T2DM and potential coping strategies. Finally, an important finding of ours relates to differences in DD between males and females, potential DD associated with health services provision and the specific challenges faced by housewives with T2DM.
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Religious Faith and Diabetes Health Beliefs in a Homeless Population: A Qualitative Study. J Christ Nurs 2019; 36:228-235. [PMID: 31490877 DOI: 10.1097/cnj.0000000000000655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
This participatory action research project explored the perspectives and challenges of homeless persons living with, or at risk for, type 2 diabetes. Because these persons were sheltered in and served by a church, their perspectives provide understanding about how religious faith may influence diabetes self-management.
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Choi SA, Hastings JF. Religion, spirituality, coping, and resilience among African Americans with diabetes. JOURNAL OF RELIGION & SPIRITUALITY IN SOCIAL WORK 2018; 38:93-114. [PMID: 31607831 PMCID: PMC6788765 DOI: 10.1080/15426432.2018.1524735] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 09/13/2018] [Indexed: 05/28/2023]
Abstract
Study aims were to explore how religion and spirituality impacted attitudes about self-management practices among African Americans with homelessness histories and to understand resilience in diabetes care practices. Qualitative semi-structured face-to-face interviews were conducted with 42 African Americans older than 18 years. All audio-taped interviews lasted between 1-1.5 hr, transcribed verbatim, and analyzed using ATLAS.ti (version 7.0). Five resilience themes emerged. While participants recognized diabetes as an illness requiring professional treatment, the context of balancing treatment with religion and spiritual practices mattered. The study findings highlight the importance of spirituality, religious beliefs, and coping strategies in diabetes self-care activities.
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Affiliation(s)
- Sung Ah Choi
- School of Social Welfare, University at Albany, SUNY, Albany, New York, USA
| | - Julia F. Hastings
- School of Social Welfare, University at Albany, SUNY, Albany, New York, USA
- School of Public Health, Health Policy, Management, & Behavior University at Albany, SUNY, Rensselaer, New York, USA
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Habte BM, Kebede T, Fenta TG, Boon H. Barriers and facilitators to adherence to anti-diabetic medications: Ethiopian patients' perspectives. Afr J Prim Health Care Fam Med 2017; 9:e1-e9. [PMID: 29113442 PMCID: PMC5675919 DOI: 10.4102/phcfm.v9i1.1411] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 08/02/2017] [Accepted: 08/10/2017] [Indexed: 12/20/2022] Open
Abstract
Background Little is known about the experiences of Ethiopian patients with type 2 diabetes related to adherence to their anti-diabetic medications. This may limit attempts to develop and implement patient-centred approaches that consider Ethiopian contexts. Objectives To conduct an exploratory study with a focus on identifying barriers and facilitators to anti-diabetic medications adherence in Ethiopian patients with type 2 diabetes. Methods Qualitative methods were used to conduct semi-structured interviews with 39 purposively selected participants attending clinic in three public hospitals in central Ethiopia. Open coding was used to analyse the data to identify key themes. Results A number of factors were identified as barriers and facilitators to participants’ adherence to their anti-diabetic medications. The most common factors were perceptions related to their illness including symptoms, consequences and curability; perceptions of medications including safety concerns, convenience and their necessity; religious healing practices and beliefs; perceptions about and experiences with their healthcare providers and the healthcare system including the availability of medications and diabetes education; and finally perceived self-efficacy and social support. Conclusions The findings of this study provide guidance to strengthen diabetes education programmes so that they reflect local patient contexts focusing among other things on the illness itself and the anti-diabetic medications.
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Affiliation(s)
- Bruck M Habte
- School of Pharmacy, College of Health Sciences, Addis Ababa University.
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Mortality Among Black Men in the USA. J Racial Ethn Health Disparities 2017; 5:50-61. [PMID: 28236289 DOI: 10.1007/s40615-017-0341-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 01/11/2017] [Accepted: 01/13/2017] [Indexed: 02/07/2023]
Abstract
IMPORTANCE Black men have the lowest life expectancy of all major ethnic-sex populations in the USA, yet no recent studies have comprehensively examined black male mortality. OBJECTIVE The purpose of this study was to analyze recent mortality trends for black men, including black to white (B to W) disparities. DESIGN The study design was national mortality surveillance for 2000 to 2014. SETTING The setting was the USA. POPULATION All black non-Hispanic males aged ≥15 years old in the USA, including institutionalized persons, were included. EXPOSURE The 15 leading causes of death were analyzed. MAIN OUTCOMES AND MEASURES Linear regression of log-transformed annual age-adjusted death rates was used to calculate average annual percent change (AAPC) in mortality. Black to white (B to W) disparity rate ratios (RR) and 95% confidence intervals (CI) were compared for 2000 and 2014. The most recent available social and economic profile data were obtained from the U.S. Census of Population. RESULTS The top five causes of death for black men in 2014, with percentage of total deaths, were (1) heart disease (24.8%), (2) cancer (23.0%), (3) unintentional injuries (5.8%), (4) stroke (5.1%), and (5) homicide (4.3%). Significant mortality declines for 12 of the 15 leading causes occurred through 2014, with the strongest decline for HIV/AIDS (AAPC -8.0, 95% CI -8.8 to -7.1). Only Alzheimer's disease, ranked #15, significantly increased (AAPC +2.5, 95% CI +1.4 to +3.7). Significant black disadvantage persisted for 10 of the 15 leading causes in 2014, including homicide (RR = 10.43, 95% CI 9.98 to 10.89), HIV/AIDS (RR = 8.01, 95% CI 7.50 to 8.54), diabetes (RR = 1.88, 95% CI 1.82 to 1.93), and stroke (RR = 1.61, 95% CI 1.57 to 1.65). The B to W disparity did not improve for heart disease (RR 1.24 in 2000 vs. RR 1.23 in 2014), but did improve for cancer (RR 1.39 in 2000 vs. 1.20 in 2014). Death rates were significantly lower in black men for five causes, including unintentional injuries (RR = 0.83, 95% CI 0.80 to 0.84), chronic lower respiratory diseases (RR = 0.75, 95% CI 0.73 to 0.78), and suicide (RR = 0.37, 95% CI 0.35 to 0.39). CONCLUSIONS AND RELEVANCE Total mortality significantly declined for black men from 2000 to 2014, and the overall B to W disparity narrowed to RR = 1.21 (95% CI 1.20 to 1.23) in 2014. However, significant black disadvantages relative to white men persisted for 10 leading causes of death.
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Affiliation(s)
- Julio A Rebolledo
- Midwestern University, Chicago College of Pharmacy, Downers Grove, IL
| | - Regina Arellano
- Midwestern University, Chicago College of Pharmacy, Downers Grove, IL
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