title: Older adults' fears about diabetes: using common sense models of disease to understand fear origins and implications for self-management.
abstract: This study examines older adults' fears of diabetes complications and their effects on self-management practices. Existing models of diabetes self-management posit that patients' actions are grounded in disease beliefs and experience, but there is little supporting evidence. In-depth qualitative interviews were conducted with a community-based sample of 74 African American, American Indian, and white older adults with diabetes. Analysis uses Leventhal's Common Sense Model of Diabetes to link fears to early experience and current self-management. Sixty-three identified fears focused on complications that could limit carrying out normal activities: amputation, blindness, low blood glucose and coma, and disease progression to insulin use and dialysis. Most focused self-management on actions to prevent specific complications, rather than on managing the disease as a whole. Early experiences focused attention on the inevitability of complications and the limited ability of patients to prevent them. Addressing older adults' fears about diabetes may improve their diabetes self-management practices.
authors.affiliation: Department of Epidemiology and Prevention, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, 336-716-6015, 336-713-4157 (fax).
authors.forename: Sara A
authors.initials: SA
authors.lastname: Quandt
authors.affiliation: Department of Epidemiology and Prevention, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, 336-716-6722.
authors.forename: Teresa
authors.initials: T
authors.lastname: Reynolds
authors.affiliation: Department of Epidemiology and Prevention, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, 336-716-6015.
authors.forename: Christine
authors.initials: C
authors.lastname: Chapman
authors.affiliation: Department of Epidemiology and Prevention, Wake Forest School of Medicine, Medical Center Boulevard Winston-Salem, NC 27157 336-716-9736.
authors.forename: Ronny A
authors.initials: RA
authors.lastname: Bell
authors.affiliation: Department of Family and Community Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, 336-716-2237.
authors.forename: Joseph G
authors.initials: JG
authors.lastname: Grzywacz
authors.affiliation: Department of Biostatistical Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157 336-716-9833.
authors.forename: Edward H
authors.initials: EH
authors.lastname: Ip
authors.affiliation: Department of Family and Community Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, 336-716-9043.
authors.forename: Julienne K
authors.initials: JK
authors.lastname: Kirk
authors.affiliation: Department of Family and Community Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, 336-716-9438.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Arcury
mesh_terms: D001294:Attitude to Health; D048909:Diabetes Complications / Q000517:prevention & control / Q000523:psychology*; D003920:Diabetes Mellitus / Q000628:therapy*; D005239:Fear; D005260:Female; D015438:Health Behavior; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009657:North Carolina; D012424:Rural Population; D012648:Self Care
keywords: Rural; common sense model; qualitative methods