The effects of centering in care on self-management of type II diabetes in medically underserved co-residing adults
Desandre, Carolynn Anne
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Guided by Critical, Humanistic, and Social Support theories this mixed methods study uses the tenets of Hermeneutic Phenomenology and quantitative data trends to illuminate the lived experience of medically underserved co-residing adults living with diabetes. In addition the researcher evaluates the impact of a novel approach to healthcare, the Centering in Care model, on self-management of diabetes in medically underserved co-residing adults. Overarching research questions include the following: (1) What is the day-today lived experience of medically underserved adults living with type II diabetes mellitus?; (2) How does participation in group care health visits affect health locus of control in medically underserved co-residing adults living with type II diabetes mellitus?; (3) What are the effects on self-management of diabetes in medically underserved co-residing adults who participate in a group care model for health visits and education?; (4) How does having a partner participate in group care impact co-residing adults’ ability to self-manage diabetes outside the care environment?; (5) What is the relation between health locus of control and physical weight, body mass index, Hemoglobin A1c, and waist circumference? The final study yielded 10 study participants (5 medically underserved co-residing adult pairs). Participants were interviewed both pre- and post-participation in six group care meetings designed to address the key diabetes education topics designated by the American Diabetes Association. Thematic analyses were performed on both pre- and post-participation interview data and researcher field notes collected throughout the study. Following thematic analyses, quantitative data were analyzed using SPSS program to elicit descriptive statistical data, and data trends were compared with qualitative themes for congruency. Findings support previous research which suggests that medically underserved populations can be very successful at self-management of diabetes when methods of delivering care and education are tailored to meet client and family needs. In addition, group care provides an effective means for delivering care to medically underserved families to improve self-management of diabetes.