Format

Send to

Choose Destination
See comment in PubMed Commons below
Cultur Divers Ethnic Minor Psychol. 2010 Oct;16(4):461-7. doi: 10.1037/a0020089.

Patient and health care provider views of depressive symptoms and diabetes in American Samoa.

Author information

1
Centers for Behavioral and Preventive Medicine, Alpert Medical School, Brown University, Providence, RI, USA. rfheld@gmail.com

Abstract

High Type 2 diabetes prevalence, associated with recent cultural changes in diet and physical activity, characterizes the U.S. territory of American Samoa. Comorbid diabetes and depression rates are high worldwide and contribute to negative diabetes outcomes; these rates have not been assessed in American Samoa. In this study, 6 focus groups were conducted with 39 American Samoan adults with diabetes; questions on perceptions of diabetes and depressive symptoms were included. Thirteen health care staff interviews were conducted to gain insight into diabetes care in American Samoa. Focus groups and health care staff interviews were translated, transcribed, and entered into NVivo 8 to facilitate analysis. Thematic analysis showed that diabetes patients saw depressive symptoms as directly contributing to high blood sugar. However, these symptoms were rarely mentioned spontaneously, and providers reported they seldom assess them in patients. Many patients and health care staff believed the best ways to respond to feelings of depression involved relaxing, leaving difficult situations, or eating. Staff also discussed cultural stigma associated with depression and the importance of establishing rapport before discussing it. Health care providers in American Samoa need training to increase their awareness of depressive symptoms' negative impact on diabetes management in patients who screen positive for depression. All providers must approach the subject in a supportive context after establishing rapport. This information will be used for cultural translation of a community health worker and primary care-coordinated intervention for adults with diabetes in American Samoa, with the goal of creating an effective and sustainable intervention.

PMID:
21058808
PMCID:
PMC3050566
DOI:
10.1037/a0020089
[Indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for American Psychological Association Icon for PubMed Central
    Loading ...
    Support Center