Mixed-Methods Study of Disability Self-Management in Mexican Americans With Osteoarthritis.

BACKGROUND: Health disparities in osteoarthritis (OA) outcomes exist both in the occurrence and treatment of functional limitation and disability for Mexican Americans. Although the effect of self-management of chronic illness is well established, studies demonstrate little attention to self-management of function or disability, despite the strong potential effect on both and, consequently, on patients' lives. OBJECTIVE: The purpose of this study pilot was to develop and test key variable relationships for a measure of disability self-management among Mexican Americans. METHODS: In this sequential, two-phased, mixed-methods, biobehavioral pilot study of Mexican American women and men with OA, a culturally tailored measure of disability self-management was created, and initial relationships among key variables were explored. RESULTS: First, a qualitative study of 19 adults of Mexican American descent born in Texas (United States) or Mexico was conducted. The Mexican American Disability Self-Management Scale was created using a descriptive content analysis of interview data. The scale was tested and refined, resulting in 18 items and a descriptive frequency of therapeutic management efforts. Second, correlations between study variables were estimated: Disability and function were negatively correlated. Disability correlated positively with social support and activity effort. Disability correlated negatively with disability self-management, pain, and C-reactive protein. Function was positively correlated with age, pain, and depression. Liver enzymes (alanine transaminase) correlated positively with pain and anxiety. DISCUSSION: This mixed-methods study indicates directions for further testing and interventions for disability outcomes among Mexican Americans.

The Life-Course Perspectives of Mexican American Men With Mobility Limitation.

The life-history narratives of 10 Mexican American men with mobility limitations, age 55-77 years (mean = 63.8, SD = 5.8), were explored using a qualitatively driven, life-history mixed-methods study to understand perceptions of mobility limitations over the life course. Within that methodological and paradigmatic framework, conceptualizations of alterity and masculinity guided interpretation of data. Through an iterative, thematic analysis, we detail the way the men's lives were influenced by growing familial responsibility with age. Quantitative data were integrated into themes of narrative inheritance, family, and masculinity. It was posited that masculinity with mobility limitations shaped and was shaped by ethnic identity and responsibility. This has implications for understanding the experience of Mexican American men over the life course.

Intimate partner violence in Mexican-American women with disabilities: a secondary data analysis of cross-language research.

The aim of this qualitative descriptive study, guided by Antonovsky's salutogenic model, was to explore the manifestations of strength within the interviews of Spanish-speaking Mexican-American women aging with mobility impairments who also experienced intimate partner violence (IPV). IPV events gleaned from 26 audiotaped interviews from 7 Spanish-speaking Mexican-American women, who ranged in age from 55 to 75 years, constituted the sample for this secondary analysis. Five categories were identified: abuse from early on that shaped sense of coherence; violencia tan cruel--threatened sense of coherence; "salutogenic" choices within the context of IPV; a quest for peace; and strength amid struggle.

The pain and suffering of a Mexican American woman with mobility impairment.

There is a dearth of literature examining how adversity shapes the experiences of pain and/or suffering in middle-aged Mexican American women. The purpose of this qualitative descriptive study was to understand pain and suffering from a life course perspective as described by a Mexican American woman aging with early-onset mobility impairment. This Hispanic woman experienced episodes of abuse and rejection over the life course, which may have significantly influenced her pain and suffering experience in adulthood. This adds to the literature on how adversity influences later life pain experience and provides insight on why pharmacological treatment alone may not be as successful as a holistic intervention.

Mexican American women aging with childhood-onset paralytic polio.

In this study the life histories of 11 Latinas of Mexican American descent aging with permanent impairment related to childhood-onset paralytic polio were explored. These women, age 45 to 62 years, were interviewed 3 times each. Field notes, audiotaped interviews, life course charts, and demographic data were used to collect data chronicling childhood to present day. In the results we present a thematic representation of the societal and cultural influences on the life course trajectories of these women.