The big challenge out here is getting stuff: How the social determinants of health affect diabetes self-management education for seniors
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://scielo.pt/scielo.php?script=sci_arttext&pid=S2184-77702022000200012 |
Resumo: | Abstract: In Canada, diabetes self-management education (DSME) programs are offered to enable individuals with diabetes to successfully implement and sustain lifestyle changes, with the goal of reducing risk of complications and morbidity. Researchers have demonstrated how older adults with diabetes often fail to achieve or maintain diabetes self-management (DSM) competencies, increasing complication risk. Further, little is known about the influence of the social determinants of health (SDH) on DSME, potentially producing additional inequalities for these adults; the WHO defines SDH as non-medical factors (e.g., education; food insecurity) that impact health outcomes. The study goal was to better understand how the SDH affect DSME for older adults living with diabetes. Methods: In our qualitative study we used participatory, art-based, and hermeneutic phenomenology research methodologies. Data collection included photovoice and semi-structured phone interviews. Fourteen older adults with diabetes participated (11 men, 3 women; aged 65 years or older). A SDH framework (Loppie-Reading and Wien) guided the thematic analysis. Results: The findings illuminate how participants live with the effects and pressures of the SDH. Proximal determinants of health revealed in participants’ stories included health behaviours (diabetes self-management practices), physical environments (rurality), socioeconomic status (income), and food insecurity (accessing healthy food). Intermediate determinants comprised health-care systems (accessing DSME in their community) and community resources and capacities (limited infrastructure due to rurality). Distal determinants involved the pandemic (isolation due to mobilization restrictions). Conclusion: Our study demonstrated how the SDH affect DSME and DSM for older adults. Participants were continuously rearranging their diabetes needs to accommodate other life priorities. Additionally, rural living is described as a barrier to DSM, as accessing diabetes education, food, medications, and gas is at a distance-a particular inconvenience during wintertime. Our findings will guide future design, planning and implementation of DSME programs for older adults in this rural setting. |
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The big challenge out here is getting stuff: How the social determinants of health affect diabetes self-management education for seniorsOlder adultsDiabetes self-managementDeterminants of healthArt-basedPhenomenology.Abstract: In Canada, diabetes self-management education (DSME) programs are offered to enable individuals with diabetes to successfully implement and sustain lifestyle changes, with the goal of reducing risk of complications and morbidity. Researchers have demonstrated how older adults with diabetes often fail to achieve or maintain diabetes self-management (DSM) competencies, increasing complication risk. Further, little is known about the influence of the social determinants of health (SDH) on DSME, potentially producing additional inequalities for these adults; the WHO defines SDH as non-medical factors (e.g., education; food insecurity) that impact health outcomes. The study goal was to better understand how the SDH affect DSME for older adults living with diabetes. Methods: In our qualitative study we used participatory, art-based, and hermeneutic phenomenology research methodologies. Data collection included photovoice and semi-structured phone interviews. Fourteen older adults with diabetes participated (11 men, 3 women; aged 65 years or older). A SDH framework (Loppie-Reading and Wien) guided the thematic analysis. Results: The findings illuminate how participants live with the effects and pressures of the SDH. Proximal determinants of health revealed in participants’ stories included health behaviours (diabetes self-management practices), physical environments (rurality), socioeconomic status (income), and food insecurity (accessing healthy food). Intermediate determinants comprised health-care systems (accessing DSME in their community) and community resources and capacities (limited infrastructure due to rurality). Distal determinants involved the pandemic (isolation due to mobilization restrictions). Conclusion: Our study demonstrated how the SDH affect DSME and DSM for older adults. Participants were continuously rearranging their diabetes needs to accommodate other life priorities. Additionally, rural living is described as a barrier to DSM, as accessing diabetes education, food, medications, and gas is at a distance-a particular inconvenience during wintertime. Our findings will guide future design, planning and implementation of DSME programs for older adults in this rural setting.Ludomedia2022-10-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articletext/htmlhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S2184-77702022000200012New Trends in Qualitative Research v.11 2022reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttp://scielo.pt/scielo.php?script=sci_arttext&pid=S2184-77702022000200012Camargo-Plazas,PilarRobertson,MadisonCosta,Idevania G.Paré,Geneviève C.Alvarado,BeatrizDuhn,Lenorainfo:eu-repo/semantics/openAccess2024-02-06T17:33:19Zoai:scielo:S2184-77702022000200012Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T02:35:43.406445Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
The big challenge out here is getting stuff: How the social determinants of health affect diabetes self-management education for seniors |
title |
The big challenge out here is getting stuff: How the social determinants of health affect diabetes self-management education for seniors |
spellingShingle |
The big challenge out here is getting stuff: How the social determinants of health affect diabetes self-management education for seniors Camargo-Plazas,Pilar Older adults Diabetes self-management Determinants of health Art-based Phenomenology. |
title_short |
The big challenge out here is getting stuff: How the social determinants of health affect diabetes self-management education for seniors |
title_full |
The big challenge out here is getting stuff: How the social determinants of health affect diabetes self-management education for seniors |
title_fullStr |
The big challenge out here is getting stuff: How the social determinants of health affect diabetes self-management education for seniors |
title_full_unstemmed |
The big challenge out here is getting stuff: How the social determinants of health affect diabetes self-management education for seniors |
title_sort |
The big challenge out here is getting stuff: How the social determinants of health affect diabetes self-management education for seniors |
author |
Camargo-Plazas,Pilar |
author_facet |
Camargo-Plazas,Pilar Robertson,Madison Costa,Idevania G. Paré,Geneviève C. Alvarado,Beatriz Duhn,Lenora |
author_role |
author |
author2 |
Robertson,Madison Costa,Idevania G. Paré,Geneviève C. Alvarado,Beatriz Duhn,Lenora |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Camargo-Plazas,Pilar Robertson,Madison Costa,Idevania G. Paré,Geneviève C. Alvarado,Beatriz Duhn,Lenora |
dc.subject.por.fl_str_mv |
Older adults Diabetes self-management Determinants of health Art-based Phenomenology. |
topic |
Older adults Diabetes self-management Determinants of health Art-based Phenomenology. |
description |
Abstract: In Canada, diabetes self-management education (DSME) programs are offered to enable individuals with diabetes to successfully implement and sustain lifestyle changes, with the goal of reducing risk of complications and morbidity. Researchers have demonstrated how older adults with diabetes often fail to achieve or maintain diabetes self-management (DSM) competencies, increasing complication risk. Further, little is known about the influence of the social determinants of health (SDH) on DSME, potentially producing additional inequalities for these adults; the WHO defines SDH as non-medical factors (e.g., education; food insecurity) that impact health outcomes. The study goal was to better understand how the SDH affect DSME for older adults living with diabetes. Methods: In our qualitative study we used participatory, art-based, and hermeneutic phenomenology research methodologies. Data collection included photovoice and semi-structured phone interviews. Fourteen older adults with diabetes participated (11 men, 3 women; aged 65 years or older). A SDH framework (Loppie-Reading and Wien) guided the thematic analysis. Results: The findings illuminate how participants live with the effects and pressures of the SDH. Proximal determinants of health revealed in participants’ stories included health behaviours (diabetes self-management practices), physical environments (rurality), socioeconomic status (income), and food insecurity (accessing healthy food). Intermediate determinants comprised health-care systems (accessing DSME in their community) and community resources and capacities (limited infrastructure due to rurality). Distal determinants involved the pandemic (isolation due to mobilization restrictions). Conclusion: Our study demonstrated how the SDH affect DSME and DSM for older adults. Participants were continuously rearranging their diabetes needs to accommodate other life priorities. Additionally, rural living is described as a barrier to DSM, as accessing diabetes education, food, medications, and gas is at a distance-a particular inconvenience during wintertime. Our findings will guide future design, planning and implementation of DSME programs for older adults in this rural setting. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-10-01 |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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publishedVersion |
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http://scielo.pt/scielo.php?script=sci_arttext&pid=S2184-77702022000200012 |
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http://scielo.pt/scielo.php?script=sci_arttext&pid=S2184-77702022000200012 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
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http://scielo.pt/scielo.php?script=sci_arttext&pid=S2184-77702022000200012 |
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info:eu-repo/semantics/openAccess |
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openAccess |
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text/html |
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Ludomedia |
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Ludomedia |
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New Trends in Qualitative Research v.11 2022 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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