title: Perceptions and Concerns Regarding Diabetes Mellitus During Pregnancy Among American Indian Women.
abstract: Diabetes among American Indian (AI) people is a. condition that creates excessive morbidity and mortality and is a significant health disparity. This research delineated culturally constructed models of diabetes mellitus (DM) among 97 pregnant women in 2 large AI Nations to Oklahoma. Analysis of data revealed intense anxiety, fear, and dread related to DM during pregnancy. The sample was stratified by DM status: (a) absence of DM (n= 66), (b) DM prior to pregnancy (n= 4), and (c) gestational (n= 27). Structured and semistructured interviews elicited patient culturally based explanatory models (EMs) of etiology, course, and treatment. The research incorporated an integrated phenomenologic and ethnographic approach and yielded both quantitative and qualitative data. General findings comprised the following main categories of patients' concerns regarding DM as an illness: (a) care-seeking behaviors, (b) medical management, (c) adherence and self-management, (d) complications, and (e) the conceptual sense of DM as a "severe" and feared condition. Many findings varied according to acculturation status, but all included significant fear and anxiety surrounding (a) the health and well-being of the unborn child, (b) the use of insulin injections, (c) blindness, (d) amputation, and (e) death, but with (f) a paradoxically lowered anxiety level about diabetes severityoverall,while at the same time expressing extreme dread of specific outcomes. The latter finding is considered consistent with the presence of chronic conditions that can usually be managed, yet still having risk if severe.
authors: College of Public Health, University of Oklahoma Health Sciences Center American Indian Prevention Center, Oklahoma City.
authors: L D
authors: LD
authors: Carson
authors: College of Public Health, University of Oklahoma Health Sciences Center American Indian Prevention Center, Oklahoma City.
authors: J Neil
authors: JN
authors: Henderson
authors: College of Public Health, University of Oklahoma Health Sciences Center American Indian Prevention Center, Oklahoma City.
authors: Kama
authors: K
authors: King
authors: College of Public Health, University of Oklahoma Health Sciences Center American Indian Prevention Center, Oklahoma City.
authors: Keith
authors: K
authors: Kleszynski
authors: College of Public Health, University of Oklahoma Health Sciences Center.
authors: David M
authors: DM
authors: Thompson
authors: College of Public Health, University of Oklahoma Health Sciences Center American Indian Prevention Center, Oklahoma City.
authors: Patricia
authors: P
authors: Mayer
mesh_terms: D000069:Acculturation; D000328:Adult; D001007:Anxiety; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000208:ethnology* / Q000517:prevention & control / Q000523:psychology*; D005239:Fear; D005260:Female; D006801:Humans; D007198:Indians, North American; D007407:Interviews as Topic; D009825:Oklahoma; D010342:Patient Acceptance of Health Care; D010349:Patient Compliance; D011247:Pregnancy; D037841:Pregnant People / Q000523:psychology*; D012648:Self Care
keywords: American Indian women; diabetes; disease anxiety; pregnancy