Adherence to diabetes self-care behaviors in English- and Spanish-speaking Hispanic men

Luis O Rustveld¹, Valory N Pavlik¹, Maria L Jibaja-Weiss^1,2, Kimberly N Kline³, J Travis Gossey¹, Robert J Volk¹

¹Baylor College of Medicine, Department of Family and Community Medicine, Houston, TX, USA; ²Outreach and Health Disparities, Dan L. Duncan Cancer Center, Houston, TX, USA; ³Department of Communication, University of Texas at San Antonio, San Antonio, TX, USA

Abstract: We conducted a qualitative study to elicit attitudes, attributions, and self-efficacy related to diabetes self-care in both English- and Spanish-speaking Hispanic men. Transcripts from six focus groups (three in English and three in Spanish) were reviewed by the authors to extract principal and secondary themes. Participants could describe their medication and lifestyle regimens and were aware of whether they were adherent or nonadherent to physician recommendations. Lack of skills on how to incorporate diet and regular physical activity into daily living, lack of will power, and reluctance to change culturally rooted behaviors emerged as significant barriers to diabetes self-management. Medication adherence is for some men the principal diabetes self-care behavior. Nonadherence appeared to fit two profiles: 1) intentional, and 2) nonintentional. In both instances low self-efficacy emerged as a significant influence on attainment and maintenance of diabetes self-care goals. Participants also expressed a strong sense of fatalism regarding the course of their disease, and seemed to have little motivation to attempt long-term dietary control. Educational and counseling messages should stress that a diagnosis of diabetes is not a death sentence, and full functional capacity can be maintained with good control.

Keywords: type 2 diabetes, self-care, glycemic control, adherence