ABSTRACT
PURPOSE: The purpose of this study was to explore the psychosocial impact of type 1 diabetes (T1DM) on low-income families of various racial/ethnic backgrounds. METHODS: A qualitative study using qualitative descriptive methods was conducted with a total of 21 patient-parent dyads from African American, Hispanic, and white heritage, respectively. An interview guide was developed to explore each family's attitudes and beliefs related to diabetes. RESULTS: Although all subjects were in excellent metabolic control (mean A1C levels were between 7.3% and 7.6%), there were a number of identifiable differences in the perception of the impact of T1DM among the 3 groups. Themes in the data demonstrated differences in the following areas: (1) view of diabetes and its effects on the family; (2) ability to successfully treat diabetes; (3) ability to cope with diabetes; and (4) experiences with the health care system. Most notable themes include a disparity across racial/ethnic groups in the preoccupation with the disease after diagnosis, cultural and financial factors identified, and differences in treatment modalities and reasons for their use. CONCLUSIONS: Diabetes education and care need to carefully address such differences. Although these differences are likely multifactorial, with components of socioeconomic status, family structure, and family experiences involved, it is evident that ethnicity itself is an important factor that can affect the ability of families to manage and cope with diabetes.
Subject(s)
Diabetes Mellitus, Type 1/psychology , Perception , Poverty , Adaptation, Psychological , Adolescent , Attitude to Health , Child , Delivery of Health Care/standards , Diabetes Mellitus, Type 1/blood , Family , Female , Glycated Hemoglobin/analysis , Health Knowledge, Attitudes, Practice , Humans , Income , Interviews as Topic , Male , Single Parent/statistics & numerical dataABSTRACT
OBJECTIVE: We examined the impact of arrest and incarceration on primary care patients in the Bronx, New York. METHODS: Patients at three clinics were asked eight questions concerning current and past involvement in criminal proceedings, arrest, and incarceration. RESULTS: One hundred eighteen patients were surveyed. Eleven (9%) patients were currently involved in criminal proceedings. Twenty-one (18%) currently had a family member in jail or prison. Twenty-nine (25%) reported ever being arrested; 65 (55%) reported that they or a family member had been arrested. Twenty-one (18%) had been incarcerated; 60 (51%) reported they or a family member had spent time in jail or prison. For most variables, rates were higher for men and the adults accompanying children at pediatric visits. Clinicians reported positive experiences discussing incarceration. CONCLUSIONS: Involvement with the criminal justice system was common among our patients. Discussion of incarceration did not appear to have a negative impact on the clinical relationship.
