title: Mid-life African-American women with type 2 diabetes: influence on work and the multicaregiver role.
abstract: OBJECTIVE
  Few studies have examined the multicaregiver role, including the work role, of African-American women and the influence of that role on diabetes self-management and the ability to cope with type 2 diabetes. Therefore, the purpose of this study was to explore the perceptions of work and the multicaregiver role of a group of such women to more clearly identify the influence of these factors on diabetic self-management and personal coping.
  
  
  METHODS
  Focus group methodology was used to collect data from 12 mid-life African-American women. After data inspection, the research team extracted themes related to work and the multicaregiver role. Identification of relationships among and between themes helped delineate explanations of data and refine questions for future research.
  
  
  RESULTS
  Focus group analysis of participant responses elicited 4 themes. Family as core represented the participant's role as leader of her household. Work as survival defined the stresses of work and the physical and psychosocial responses to not working due to the social and economic costs of diabetes. Participants also identified pressures of balancing work and family responsibilities due to diabetes, a theme of impaired role function. The final theme, inner-strengthening, defined participants' methods of self-preservation through introspection and spiritual behaviors.
  
  
  CONCLUSIONS
  Despite their identification of physical and psychosocial struggles with diabetes, participants did not think of diabetes as a life-long illness because it affected their ability to remain at "the head of the table," to continue engaging in paid work outside the home, and to provide for their families. Historical, social, political, and economic factors supported the themes of the study and provide a foundation for further research and healthcare delivery system changes focused on improving the lives of these women and their families, who are facing the challenges of chronic illness.
authors.affiliation: Harris School of Nursing, Texas Christian University, Fort Worth, Texas 6129, USA. c.cagle@tcu.edu
authors.forename: Carolyn S
authors.initials: CS
authors.lastname: Cagle
authors.forename: Susan
authors.initials: S
authors.lastname: Appel
authors.forename: Anne H
authors.initials: AH
authors.lastname: Skelly
authors.forename: Lori
authors.initials: L
authors.lastname: Carter-Edwards
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D017028:Caregivers / Q000523:psychology*; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology*; D004651:Employment; D005260:Female; D017144:Focus Groups; D006801:Humans; D008016:Life Change Events; D016015:Logistic Models; D008875:Middle Aged; D012380:Role; D012648:Self Care; D014481:United States / Q000453:epidemiology