Document Type

Dissertation

Date of Degree

Fall 2014

Degree Name

PhD (Doctor of Philosophy)

Degree In

Social Work

First Advisor

Mercedes Bern-Klug

Abstract

Latinos are the fastest growing minority group in the Unites States (Fry, 2008). One in eight adult Latinos living in the United States has diabetes (CDC, 2011), and by the year 2020 diabetes is expected to increase by 107% in the Latino population (Caballero & Tenzer, 2007). Within the general diabetic population approximately 26% of the diabetic population requires the use of insulin in the management of their diabetes (DHHS: NDIC, 2011), making insulin-dependent diabetes a prevalent experience.

The literature on how diabetes is experienced is divided. Clinical assessment literature strives to measure how people are coping with the illness and how one's experience with the disease impacts self-care. Literature on the diabetes experience is limited; however, the overall image that emerges is the negative expectation associated with having diabetes such as loss and suffering.

Little is known about insulin-dependent diabetes as a lived experience, particularly among Latinos. The purpose of this research is to understand the experience of having insulin-dependent diabetes among adult Latinos, because focusing on this experience clarifies how daily nuances of living with the illness gives meaning to insulin-dependent diabetes. Increased understanding of how people interpret their illness can improve diabetes management, specifically within patient and social work interactions, and promote competent social work practice. The guiding research question for this research is, "what is the lived experience of insulin-dependent diabetes among Adult Latinos in a Primary Care Clinic in San Antonio?" This study uses van Manen's (1990) hermeneutic phenomenological approach to guide the research in capturing the nature of the phenomenon in order to gain a deeper understanding of the meaning Latinos attribute to daily experiences of having insulin-dependent diabetes. Utilizing a phenomenologically designed interview guide, this study includes interviews with 10 participants from a predominantly Latino, safety-net clinic in Texas with a 60% diabetes diagnosis rate.

Five essential themes arose in exploring the lived experience of insulin-dependent diabetes among adult Latinos in a primary clinic in San Antonio. The themes include 1. diabetes goes against the natural state of the human body; 2. diabetes rules everything 3. insulin is the fast track to deterioration; 4. the relationships don't end, but they're not the same; and 5. managing diabetes with a broken system. The theme "diabetes goes against the natural state of the human body" is considered a core theme because it represents the other themes. Of those themes identified three support the current literature found on living with diabetes. The three themes insulin is the fast track to deterioration, managing diabetes with a broken system, and the subtheme love hate relationship with food are emerging themes identified by the study

Public Abstract

One in eight adult Latinos living in the United States has diabetes (CDC, 2011). Within the general diabetic population, approximately 26% of the diabetic population requires the use of insulin in the management of their diabetes (DHHS: NDIC, 2011), making insulin-dependent diabetes a prevalent experience. Little is known about insulin-dependent diabetes among Latinos as a lived experience. The purpose of this research is to understand the experience of having insulin-dependent diabetes among adult Latinos, because focusing on this experience clarifies how daily nuances of living with the illness gives meaning to insulin-dependent diabetes. Increased understanding of how people interpret their illness can improve diabetes management, impacting social work practice. The guiding research question is, “what is the lived experience of insulin-dependent diabetes among Adult Latinos in a Primary Care Clinic in San Antonio?” This study uses van Manen’s (1990) hermeneutic phenomenological approach to explore the lived experience. This study includes interviews with 10 participants from a primary care clinic in San Antonio. Five essential themes led to the final description of living with insulin-dependent diabetes among adult Latinos in a primary clinic in San Antonio. These five themes include: 1. diabetes goes against the natural state of the human body; 2. diabetes rules everything; 3. the relationships don't end, but they're not the same; 4. insulin is the fast track to deterioration; and 5. managing diabetes with a broken system. The findings have psychosocial implications for low-income and underinsured Latinos with insulin-dependent diabetes and impact how social workers practice with this population.

Keywords

publicabstract, Diabetes, Insulin-dependent Diabetes, Public Health, Qualitative, Social Work

Pages

xiii, 274 pages

Bibliography

Includes bibliographical references (pages 257-274).

Copyright

Copyright 2014 Inez Isabel Cruz

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