Paper: Facilitating Self-Care in Older Diabetic Chinese-Americans: A Need for Interventions (19th International Nursing Research Congress Focusing on Evidence-Based Practice)

Wednesday, 9 July 2008

Ming Fang Wang-Letzkus, EdD , School of Nursing, California State University, Los Angeles, Los Angeles, CA

Gail Terry Washington, DNS, RN , School of Nursing, Cal State University, Los Angeles, Los Angeles, CA

Learning Objective 1: The learner will be able to describe three self-care practices used by elder diabetic Chinese Americans.

Learning Objective 2: The learner will be able to state three barriers that limit self-care practice among elder diabetic Chinese Americans.

Type II diabetes is becoming more prevalent in Chinese Americans despite the absence of obesity. Strategies are needed to address this problem. The purpose of this study is twofold: first, to describe self-care practices of Chinese Americans with type II diabetes and secondly, to explore the need for appropriate interventions to facilitate appropriate self-care practices.

Methods: Qualitative and community based participatory research methods were used to describe self-care practices and to explore the need for effective interventions to facilitate appropriate self-care practices in this community. Two adult day care centers in Southern California participated in this study. Thirteen in-depth individual and two focus group recorded interviews were used to gain participant's' beliefs, attitudes and knowledge regarding their self-care practices. Data was transcribed, translated, and systemically coded to assess for themes and inter-rater reliability.

Results: Western medicines and glucose monitoring were used intermittently, and Chinese Americans continued to use traditional diet, exercises and herbs to self-manage diabetes. Many did not perceive diabetes as a serious disease since there was no pain. Consequently, they were unaware of insidious complications. Lack of knowledge, non-adherence and co-morbidities impeded self-care. Self-reliance was identified as the most important attribute for self-care while media, friends, and relatives significantly influenced self-care practices. An expressed need for better interpersonal communication and accurate information regarding self-care management from professional care providers was requested.

Conclusion: While this study provides insight into the health beliefs, attitudes, and self-care practices of older diabetic Chinese Americans, the results are based upon a limited sample size and geographical location. Findings could be generalized to a global population. Future studies to develop and implement evidence-based, culturally significant, community based educational interventions with innovative strategies are urgently needed.

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