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Porque me tocó a mi ? Mexican American diabetes patients' causal stories and their relationship to treatment behaviors

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  • Hunt, Linda M.
  • Valenzuela, Miguel A.
  • Pugh, Jacqueline A.

Abstract

This paper reports findings from an ethnographic study of self-care behaviors and illness concepts among Mexican-American non-insulin dependent diabetes mellitus (NIDDM) patients. Open-ended interviews were conducted with 49 NIDDM patients from two public hospital outpatient clinics in South Texas. They are self-identified Mexican-Americans who have had NIDDM for at least 1Â yr, and have no major impairment due to NIDDM. Interviews focused on their concepts and experiences in managing their illness and their self-care behaviors. Clinical assessment of their glucose control was also extracted from their medical records. The texts of patient interviews were content analyzed through building and refining thematic matrixes focusing on their causal explanations and treatment behaviors. We found patients' causal explanations of their illness often are driven by an effort to connect the illness in a direct and specific way to their personal history and their past experience with treatments. While most cite biomedically accepted causes such as heredity and diet, they elaborate these concepts into personally relevant constructs by citing Provoking Factors, such as behaviors or events. Their causal models are thus both specific to their personal history and consistent with their experiences with treatment success or failure. Based on these findings, we raise a critique of the Locus of Control Model of treatment behavior prevalent in the diabetes education literature. Our analysis suggests that a sense that one's own behavior is important to the disease onset may reflect patients' evaluation of their experience with treatment outcomes, rather than determining their level of activity in treatment.

Suggested Citation

  • Hunt, Linda M. & Valenzuela, Miguel A. & Pugh, Jacqueline A., 1998. "Porque me tocó a mi ? Mexican American diabetes patients' causal stories and their relationship to treatment behaviors," Social Science & Medicine, Elsevier, vol. 46(8), pages 959-969, April.
  • Handle: RePEc:eee:socmed:v:46:y:1998:i:8:p:959-969
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    Cited by:

    1. Mendenhall, Emily & Shivashankar, Roopa & Tandon, Nikhil & Ali, Mohammed K. & Venkat Narayan, K.M. & Prabhakaran, Dorairaj, 2012. "Stress and diabetes in socioeconomic context: A qualitative study of urban Indians," Social Science & Medicine, Elsevier, vol. 75(12), pages 2522-2529.
    2. Lawton, Julia & Peel, Elizabeth & Parry, Odette & Douglas, Margaret, 2008. "Shifting accountability: A longitudinal qualitative study of diabetes causation accounts," Social Science & Medicine, Elsevier, vol. 67(1), pages 47-56, July.
    3. Weller, Susan C. & Baer, Roberta D. & Garcia de Alba Garcia, Javier & Salcedo Rocha, Ana L., 2012. "Explanatory models of diabetes in the U.S. and Mexico: The patient–provider gap and cultural competence," Social Science & Medicine, Elsevier, vol. 75(6), pages 1088-1096.
    4. Everett, Margaret, 2011. "They say it runs in the family: Diabetes and inheritance in Oaxaca, Mexico," Social Science & Medicine, Elsevier, vol. 72(11), pages 1776-1783, June.
    5. de Alba Garcia, Javier Garcia & Rocha, Ana L. Salcedo & Lopez, Ivette & Baer, Roberta D. & Dressler, William & Weller, Susan C., 2007. ""Diabetes is my companion": Lifestyle and self-management among good and poor control Mexican diabetic patients," Social Science & Medicine, Elsevier, vol. 64(11), pages 2223-2235, June.

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