COVID-19 stressors for Hispanic/Latino patients living with type 2 diabetes: a qualitative study.

Frontiers in clinical diabetes and healthcare Pub Date : 2023-04-28 eCollection Date: 2023-01-01 DOI:10.3389/fcdhc.2023.1070547
Myia S Williams, Edgardo Cigaran, Sabrina Martinez, Jose Marino, Paulina Barbero, Alyson K Myers, Ralph J DiClemente, Nicole Goris, Valeria Correa Gomez, Dilcia Granville, Josephine Guzman, Yael T Harris, Myriam Kline, Martin L Lesser, Amgad N Makaryus, Lawrence M Murray, Samy I McFarlane, Vidhi H Patel, Jennifer Polo, Roman Zeltser, Renee Pekmezaris
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Abstract

Background and aim: During the early stages of the COVID-19 pandemic, nationwide lockdowns caused disruption in the diets, physical activities, and lifestyles of patients with type 2 diabetes. Previous reports on the possible association between race/ethnicity, COVID-19, and mortality have shown that Hispanic/Latino patients with type 2 diabetes who are socioeconomically disadvantaged are disproportionately affected by this novel virus. The aim of this study was to explore stressors associated with changes in diabetes self-management behaviors. Our goal was to highlight the health disparities in these vulnerable racial/ethnic minority communities and underscore the need for effective interventions.

Methods and participants: Participants were enrolled in part of a larger randomized controlled trial to compare diabetes telehealth management (DTM) with comprehensive outpatient management (COM) in terms of critical patient-centered outcomes among Hispanic/Latino patients with type 2 diabetes. We conducted a thematic analysis using patient notes collected from two research nurses between March 2020 and March 2021. Two authors read through the transcripts independently to identify overarching themes. Once the themes had been identified, both authors convened to compare themes and ensure that similar themes were identified within the transcripts. Any discrepancies were discussed by the larger study team until a consensus was reached.

Results: Six themes emerged, each of which can be categorized as either a source or an outcome of stress. Sources of stress associated with the COVID-19 pandemic were (1) fear of contracting COVID-19, (2) disruptions from lockdowns, and (3) financial stressors (e.g., loss of income). Outcomes of COVID-19 stressors were (1) reduced diabetes management (e.g., reduced diabetes monitoring and physical activity), (2) suboptimal mental health outcomes (e.g., anxiety and depression), and (3) outcomes of financial stressors.

Conclusion: The findings indicated that underserved Hispanic/Latino patients with type 2 diabetes encountered a number of stressors that led to the deterioration of diabetes self-management behaviors during the pandemic.

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拉美裔 2 型糖尿病患者的 COVID-19 压力因素:一项定性研究。
背景和目的:在 COVID-19 大流行的早期阶段,全国范围的封锁扰乱了 2 型糖尿病患者的饮食、体育活动和生活方式。之前关于种族/民族、COVID-19 和死亡率之间可能存在关联的报告显示,社会经济条件较差的西班牙裔/拉美裔 2 型糖尿病患者受到这种新型病毒的影响尤为严重。本研究旨在探讨与糖尿病自我管理行为变化相关的压力因素。我们的目标是强调这些弱势种族/少数民族社区的健康差异,并强调有效干预的必要性:参与者是一项大型随机对照试验的一部分,该试验旨在比较糖尿病远程健康管理(DTM)与综合门诊管理(COM)在以患者为中心的关键结果方面对西班牙裔/拉美裔 2 型糖尿病患者的影响。我们利用两名研究护士在 2020 年 3 月至 2021 年 3 月期间收集的患者笔记进行了专题分析。两位作者独立阅读记录誊本,以确定总体主题。确定主题后,两位作者召开会议,对主题进行比较,确保在记录誊本中找到相似的主题。如有任何差异,则由更大的研究团队进行讨论,直至达成共识:出现了六个主题,每个主题都可归类为压力的来源或结果。与 COVID-19 大流行相关的压力来源有:(1) 害怕感染 COVID-19;(2) 封锁造成的干扰;(3) 经济压力(如收入损失)。COVID-19 压力因素的结果是:(1)糖尿病管理减少(如糖尿病监测和体育活动减少);(2)心理健康结果不理想(如焦虑和抑郁);(3)经济压力因素的结果:研究结果表明,服务不足的西班牙裔/拉美裔 2 型糖尿病患者在大流行期间遇到了一系列压力,导致糖尿病自我管理行为恶化。
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