Aboriginal young people's experiences of type 2 diabetes diagnosis, management and support: A qualitative study in the Kimberley region of Western Australia.
Australian Aboriginal people
culturally competent care
diabetes mellitus, type 2
family
indigenous peoples
rural health
young people
Journal
Health promotion journal of Australia : official journal of Australian Association of Health Promotion Professionals
ISSN: 1036-1073
Titre abrégé: Health Promot J Austr
Pays: Australia
ID NLM: 9710936
Informations de publication
Date de publication:
20 Aug 2024
20 Aug 2024
Historique:
revised:
05
08
2024
received:
22
10
2023
accepted:
08
08
2024
medline:
21
8
2024
pubmed:
21
8
2024
entrez:
21
8
2024
Statut:
aheadofprint
Résumé
In Australia, Aboriginal and Torres Strait Islander young people in remote settings are most-affected by young onset type 2 diabetes (T2D). It is necessary to understand young people's experiences, including factors impacting on self-management, to improve models of care. A phenomenological methodology underpinned this qualitative study in Western Australia's Kimberley region. Two Aboriginal Community Controlled Health Services supported recruitment of seven Aboriginal young people aged 12-24 with T2D, who participated in interviews. A carer and health professional of one young person in each site were also interviewed and relevant medical record data reviewed to assist with triangulation of data. De-identified transcripts were inductively coded and a coding structure developed with oversight by a Kimberley Aboriginal researcher. Young people reported varied experiences and emotions relating to a T2D diagnosis. Most recounted this was upsetting and some reported current negative impact on emotional wellbeing. Challenges with understanding and managing diabetes were highlighted, particularly regarding healthy eating, physical activity and medication. Family are a prominent source of self-management support, with the intergenerational impact of diabetes being evident for each participant. Positive relationships with health professionals, entailing continuity of care, were valued. There are significant emotional and medical challenges for young people with T2D and their families. Recommendations from this work will contribute to the development of local resources and initiatives to improve diabetes-related support. SO WHAT?: Alongside broader efforts to support good health at the societal level, enhanced health education and family-oriented support structures including Aboriginal clinical staff for young people with T2D are needed.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Department of Health and Aged Care, Australian Government
Informations de copyright
© 2024 The Author(s). Health Promotion Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of Australian Health Promotion Association.
Références
Peña AS, Curran JA, Fuery M, George C, Jefferies CA, Lobley K, et al. Screening, assessment and management of type 2 diabetes mellitus in children and adolescents: Australasian Paediatric endocrine group guidelines. Med J Aust. 2020;213(1):30–43.
Kao K, Sabin M. Type 2 diabetes mellitus in children and adolescents. Aust Fam Physician. 2016;45:401–406.
Viner R, White B, Christie D. Type 2 diabetes in adolescents: a severe phenotype posing major clinical challenges and public health burden. Lancet. 2017;389:2256–2260.
Zeitler P, Arslanian S, Fu J, Pinhas‐Hamiel O, Reinehr T, Tandon N, et al. ISPAD clinical practice consensus guidelines 2018: type 2 diabetes mellitus in youth. Pediatr Diabetes. 2018;19(Suppl 27):28–46.
Borus JS, Laffel L. Adherence challenges in the management of type 1 diabetes in adolescents: prevention and intervention. Curr Opin Pediatr. 2010;22(4):405–411.
Warwick S, Atkinson D, Kitaura T, LeLievre M, Marley JV. Young aboriginal people's perspective on access to health care in remote Australia: hearing their voices. Prog Community Health Partnersh. 2019;13(2):171–181.
Sturman DA, Moghaddam B. The neurobiology of adolescence: changes in brain architecture, functional dynamics, and behavioral tendencies. Neurosci Biobehav Rev. 2011;35(8):1704–1712.
Azzopardi P, Brown AD, Zimmet P, Fahy RE, Dent GA, Kelly MJ, et al. Type 2 diabetes in young indigenous Australians in rural and remote areas: diagnosis, screening, management and prevention. Med J Aust. 2012;197(1):32–36.
Zimmet PZ, Magliano DJ, Herman WH, Shaw JE. Diabetes: a 21st century challenge. Lancet Diabetes Endocrinol. 2014;2(1):56–64.
Hjort L, Novakovic B, Grunnet LG, Maple‐Brown L, Damm P, Desoye G, et al. Diabetes in pregnancy and epigenetic mechanisms—how the first 9 months from conception might affect the child's epigenome and later risk of disease. Lancet Diabetes Endocrinol. 2019;7(10):796–806.
Harris SB, Tompkins JW, TeHiwi B. Call to action: a new path for improving diabetes care for indigenous peoples, a global review. Diabetes Res Clin Pract. 2017;123:120–133.
Australian Institute of Health and Welfare. Aboriginal and Torres Strait Islander Health Performance Framework: Health status and outcomes—Diabetes. 2020 [cited 2021 Sept 8]. https://www.indigenoushpf.gov.au/measures/1-09-diabetes
Department of Health Western Australia. Western Australian diabetes standards. Perth: Health Strategy and Networks, Department of Health, Western Australia; 2014.
Titmuss A, Davis EA, O'Donnell V, Wenitong M, Maple‐Brown LJ, Haynes A, et al. Youth‐onset type 2 diabetes among first nations young people in northern Australia: a retrospective, cross‐sectional study. Lancet Diabetes Endocrinol. 2022;10(1):11–13.
Kimberley Aboriginal Health Planning Forum. Type 2 Diabetes in Children (Kimberley Clinical Protocol). 2020. https://kahpf.org.au/clinical-protocols
Manifold A, Atkinson D, Marley JV, Scott L, Cleland G, Edgill P, et al. Complex diabetes screening guidelines for high‐risk adolescent Aboriginal Australians: a barrier to implementation in primary health care (1836–7399 (Electronic)).
Maple‐Brown LJ, Graham S, McKee J, Wicklow B. Walking the path together: incorporating indigenous knowledge in diabetes research. Lancet Diabetes Endocrinol. 2020;8(7):559–560.
Matua GA, Van Der Wal DM. Differentiating between descriptive and interpretive phenomenological research approaches. Nurse Res. 2015;22(6):22–27.
Tuhiwai Smith L. Decolonizing methodologies research and indigenous peoples. 2nd ed. London, UK: Zed Books; 2012.
Australian Bureau of Statistics. Census QuickStats. 2017. ABS Website; 2017 [cited 2021 Sept 5]. https://quickstats.censusdata.abs.gov.au/census_services/getproduct/census/2016/quickstat/51001?opendocument
Anderson C, Bineham N, Lockwood T, Mukhtar A, Waenerberg N. Kimberley health profile. Perth, WA: WA Country Health Service: Planning and Evaluation Unit; 2018.
Moser A, Korstjens I. Series: practical guidance to qualitative research. Part 3: sampling, data collection and analysis. Eur J Gen Pract. 2018;24(1):9–18.
Fugard AJB, Potts HWW. Supporting thinking on sample sizes for thematic analyses: a quantitative tool. Int J Soc Res Methodol. 2015;18(6):669–684.
Weaver E, Freeman N, Mack S, Titmuss A, Dowler J, Corpus S, et al. “I don't really know what diabetes is”: a qualitative study exploring the experiences of aboriginal and Torres Strait islander young people aged 10‐25 years living with type 2 diabetes in northern and central Australia. Can J Diabetes. 2022;46:722–729.
Quirkos 2.4.1. Computer Software. 2020. https://www.quirkos.com
Carman R, Towell‐Barnard A, Shah M, Davis E, Maple‐Brown L, Pearson G, et al. “Sometimes our mob Don't really take it serious until It's serious”: the experiences of Western Australian aboriginal adolescents living with type 2 diabetes, their parents, and their family members. Can J Diabetes. 2023;47:420–427.
Straw S, Spry E, Yanawana L, Matsumoto V, Cox D, Cox E, et al. Understanding lived experiences of aboriginal people with type 2 diabetes living in remote Kimberley communities: diabetes, it don. Aust J Prim Health. 2019;25:486.
Gopalan A, Blatchins MA, Xu KK, Altschuler A, Marshall CJ, Hessler DM, et al. All in the family: a qualitative study of the early experiences of adults with younger onset type 2 diabetes. J Am Board Fam Med. 2022;35(2):341–351.
Wicklow BA, Sellers EAC, Sharma AK, Kroeker K, Nickel NC, Philips‐Beck W, et al. Association of gestational diabetes and type 2 diabetes exposure in utero with the development of type 2 diabetes in first nations and non–first nations offspring. JAMA Pediatr. 2018;172(8):724–731.
Griffiths E, Atkinson D, Friello D, Marley JV. Pregnancy intentions in a group of remote‐dwelling Australian aboriginal women: a qualitative exploration of formation, expression and implications for clinical practice. BMC Public Health. 2019; 19:568.
Murphy HR, Moses RG. Pregnancy outcomes of young women with type 2 diabetes: poor care and inadequate attention to glycemia. Diabetes Care. 2022;45(5):1046–1048.
Wong J, Ross GP, Zoungas S, Craig ME, Davis EA, Donaghue KC, et al. Management of type 2 diabetes in young adults aged 18–30 years: ADS/ADEA/APEG consensus statement. Med J Aust. 2022;216(8):422–429.
Seear KH, Atkinson DN, Henderson‐Yates LM, Lelievre MP, Marley JV. Maboo wirriya, be healthy: community‐directed development of an evidence‐based diabetes prevention program for young aboriginal people in a remote Australian town. Eval Program Plann. 2020;81:101818.
Warwick S, LeLievre M, Seear K, Atkinson D, Marley JV. Above and beyond: fashioning an accessible health service for aboriginal youth in remote Western Australia. Prog Community Health Partnersh. 2021;15:463–473.
Seear KH, Spry EP, Carlin E, Atkinson DN, Marley JV. Aboriginal women's experiences of strengths and challenges of antenatal care in the Kimberley: a qualitative study. Women Birth. 2021;34(6):570–577.
Kimberley Aboriginal Health Planning Forum. Diabetes type II in adults (Kimberley Clinical Protocol). 2020. https://kahpf.org.au/clinical-protocols
Titmuss A, Davis EA, Brown A, Maple‐Brown LJ. Emerging diabetes and metabolic conditions among aboriginal and Torres Strait islander young people. Med J Aust. 2019;210(3):111–113.
Carlin E, Seear KH, Ferrari K, Spry E, Atkinson D, Marley JV. Risk and resilience: a mixed methods investigation of aboriginal Australian women's perinatal mental health screening assessments. Soc Psychiatry Psychiatr Epidemiol. 2020;56(4):547–557.
RHDAustralia (ARF/RHD writing group). The 2020 Australian guideline for prevention, diagnosis and management of acute rheumatic fever and rheumatic heart disease. 3rd ed. Darwin, NT: RHDAustralia; 2020.
Australian Institute of Health and Welfare. Acute rheumatic fever and rheumatic heart disease—in brief. Cat. no. CVD 87. AIHW 2019.