The long-term goal of this research is to develop effective, culturally appropriate nursing interventions for diabetes among Indian people.
Specific aims of this exploratory, descriptive study are to 1) elicit the representations of diabetes, arthritis, and health-for-age from traditional Mvskoke Creek Indians with and without diabetes, 2) elicit their views of traditional and Western helping systems and of culturally appropriate and inappropriate behavior for Anglo health professionals, 3) assess signs of diabetes and state of health among the Mvskoke, and 4) identify culturally appropriate nursing interventions for diabetes among the Mvskoke. A semi- structured interview based on Leventhal's model of self-regulation in chronic illness and a nursing history and physical assessment guide for diabetics will be developed in English, translated into Mvskoke, and field- tested. 72 same sex pairs of diabetic and non-diabetic respondents from the same families. Mvskoke Indian field interviewers, and assessed by nurse practitioners. A random sample of 25% will be re-interviewed 6 months later to assess stability of illness representations. Data analysis will include individual and group profiles on physical data, interdisciplinary and intercultural review of interview and assessment data to generate categories and relationships, and appropriate descriptive statistics. Prototypical and idiosyncratic narratives of illness identity, causation, duration, and consequences will be developed for such key elements in the population as age cohorts, the well, the ill, and the sexes. All data, project staff, and tribal leaders will be used to generate culturally appropriate nursing interventions for diabetes among the Mvskoke. This research is significant because of the very high prevalence of diabetes among Indians, its interdisciplinary approach, (nursing, anthropology, psychology, and medicine), emphasis on understanding the individual and cultural perspectives of patients so basic to effective intervention, potential for identifying a generalizable method for studying other Indian health problems, and the Mvskokes' profound geographic, economic, and political isolation from health care.
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| Foster, M W; Eisenbraun, A J; Carter, T H (1997) Communal discourse as a supplement to informed consent for genetic research. Nat Genet 17:277-9 |
