Living with diabetes and disadvantage: A qualitative, geographical case study

Article


Power, Tamara, Kelly, Ray, Usher, Kim, East, Leah, Travaglia, Jo, Robertson, Hamish, Wong, Ann and Jackson, Debra. 2020. "Living with diabetes and disadvantage: A qualitative, geographical case study." Journal of Clinical Nursing. 29 (13-14), pp. 2710-2722. https://doi.org/10.1111/jocn.15295
Article Title

Living with diabetes and disadvantage: A qualitative, geographical case study

ERA Journal ID14104
Article CategoryArticle
AuthorsPower, Tamara, Kelly, Ray, Usher, Kim, East, Leah, Travaglia, Jo, Robertson, Hamish, Wong, Ann and Jackson, Debra
Journal TitleJournal of Clinical Nursing
Journal Citation29 (13-14), pp. 2710-2722
Number of Pages13
Year2020
PublisherJohn Wiley & Sons
Place of PublicationUnited Kingdom
ISSN0962-1067
1365-2702
Digital Object Identifier (DOI)https://doi.org/10.1111/jocn.15295
Web Address (URL)https://onlinelibrary.wiley.com/doi/10.1111/jocn.15295
Abstract

Aims and objectives
To elucidate the experiences of people living with diabetes, residing in an urban diabetogenic area.

Background
Community-level social and environmental factors have a role to play in the development of type 2 diabetes mellitus. Socio-economic deprivation; high obesity rates; high access to fast foods; and multiculturalism contribute to higher rates of diabetes in some geographical areas. However, there is a lack of research examining people's experiences of living with diabetes in diabetogenic areas. The word diabetogenic implies that the phenomenon of interest contributes to the development of diabetes.

Design
Qualitative, geographical case study approach.

Methods
A convenience sample of 17 people living with diabetes in a diabetogenic, low-socio-economic urban area participated in face-to-face, semi-structured interviews. Interviews were audio-recorded, transcribed and analysed thematically. This paper adheres to the COREQ guidelines.

Findings
Four main themes were identified: 1. Diabetes fatalism: Inevitability and inertia; 2. Living with Inequity: Literacy and intersectionality; 3. Impersonal services: Intimidating and overwhelming; and, 4. Education in the community: Access and anecdotes.

Conclusions
This study has highlighted the need to develop local solutions for local problems. In this geographical area, solutions need to address generally lower health literacy, how the community would prefer to receive diabetes education and the issue of diabetes fatalism.

Relevance to clinical practice
Findings from this study have highlighted a need to re-examine how diabetes education is delivered in communities that are already experiencing multiple disadvantages. There are research and practice connotations for how fatalism is positioned for people at high risk of developing diabetes.

Keywordsaboriginal; diabetes; fatalism; health literacy; low socioeconomic; multicultural issues; qualitative study; type 2 diabetes
ANZSRC Field of Research 2020420503. Community and primary care
Public NotesFiles associated with this item cannot be displayed due to copyright restrictions.
Byline AffiliationsUniversity of Technology Sydney
University of New England
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