Adrienne Martinez-Hollingsworth1, Nalo Hamilton2, Kristen Choi3, MarySue Heilemann4. 1. University of California, Los Angeles, 1100 Glendon Ave. Suite 900, Los Angeles, CA, USA. Electronic address: asmartinez@mednet.ucla.edu. 2. University of California, Los Angeles, 5-659 Factor Building, Los Angeles, CA, USA. Electronic address: nhamilton@sonnet.ucla.edu. 3. University of California, Los Angeles, Factor Building 3-238, Los Angeles, CA, USA. Electronic address: krchoi@ucla.edu. 4. University of California, Los Angeles, Factor Building: 5-252, Los Angeles, CA, USA. Electronic address: mheilema@sonnet.ucla.edu.
Abstract
AIMS: The purpose of this study was to examine how older Latina women emotionally experience type 2 diabetes mellitus and interactions with care providers using a grounded theory approach. METHODS: Sixteen English-speaking, Latina women, 60 years and older, diagnosed with type 2 diabetes mellitus and experiencing symptoms of depression or anxiety participated in 21 phone interviews guided by a semi-structured interview guide. Data was collected and analyzed using Grounded Theory methodology; theoretical sampling was used to achieve data saturation. RESULTS: Participant data informed the creation of a theory, The Secret Self-Management Loop, with four interconnected phases: 1) having a negative relationship origin story; 2) doubting provider motivation; 3) reacting to doubts about provider; and 4) engaging in secret self-management. These phases reflected participants' lost trust in their providers and the medical system, resulting in undisclosed self-management strategies that complicated clinical management of their type 2 diabetes mellitus diagnosis. Primary sources of loss of trust were interactions that lacked empathy or caused them to question their providers' motivation. CONCLUSION: The Secret Self-Management Loop negatively influences patient disclosure and distorts providers' ability to adequately render care for this group.
AIMS: The purpose of this study was to examine how older Latina women emotionally experience type 2 diabetes mellitus and interactions with care providers using a grounded theory approach. METHODS: Sixteen English-speaking, Latina women, 60 years and older, diagnosed with type 2 diabetes mellitus and experiencing symptoms of depression or anxiety participated in 21 phone interviews guided by a semi-structured interview guide. Data was collected and analyzed using Grounded Theory methodology; theoretical sampling was used to achieve data saturation. RESULTS:Participant data informed the creation of a theory, The Secret Self-Management Loop, with four interconnected phases: 1) having a negative relationship origin story; 2) doubting provider motivation; 3) reacting to doubts about provider; and 4) engaging in secret self-management. These phases reflected participants' lost trust in their providers and the medical system, resulting in undisclosed self-management strategies that complicated clinical management of their type 2 diabetes mellitus diagnosis. Primary sources of loss of trust were interactions that lacked empathy or caused them to question their providers' motivation. CONCLUSION: The Secret Self-Management Loop negatively influences patient disclosure and distorts providers' ability to adequately render care for this group.
Authors: Adrienne Martinez-Hollingsworth; Linda Kim; Tabia Graham Richardson; Marco Angulo; Roger Liu; Theodore Friedman; Kristen Choi Journal: J Ambul Care Manage Date: 2021 Jul-Sep 01