Self-care behaviors can be challenging for people with diabetes. Daily activities such as blood glucose monitoring, exercise, medication, and food choices can be burdensome. Helping people with diabetes to learn and apply the knowledge, skills, and coping strategies for managing diabetes is crucial to reduce risk for complications. A person-centered approach is central for collaboration and effective communication to improve individual engagement. Given the growing epidemic of diabetes and its complications in African American (AA) populations, understanding religious beliefs and practices and their cultural influence is critical (Powers et al., 2015).
According to the Centers for Disease Control and Prevention (CDC), 29 million people in the United States have been diagnosed with diabetes (2018), and AAs are 1.7 times more likely to have diabetes and twice as likely to die from the disease compared with their white counterparts (American Diabetes Association, 2017). The complications associated with diabetes, such as blindness, kidney disease, and lower limb amputation, are much higher in this population than in non-Hispanic whites (CDC). Diabetes management and education play a significant role in reducing the risk for these complications and have been recognized as the foundation for effective diabetes self-care.
Spiritual beliefs and practices are prominent features in the AA community (Watkins et al., 2013) and these beliefs are very important when faced with chronic disease, illness, and death. According to Sherman (2015), AA spirituality is an acknowledgment of a nonmaterial force that pervades all affairs, human and nonhuman. God is perceived as central to providing strength to deal with the daily challenge of diabetes. A firm belief in God, prayer, meditation, and support from the church is a source of strength and comfort. For some AAs, spiritual beliefs are vital to understanding and coping with illness. Spirituality and religious beliefs also contribute to explaining whether or not one perceives diabetes to be a threatening illness (Scollan-Koliopoulos et al., 2012). Although some AA people with diabetes find spirituality to be helpful in diabetes management, spiritual faith might lead others with chronic illness to "leave it in God's hands" for healing; therefore, reducing or eliminating responsibility for self-care (Sherman).
The traditional approach of "telling" patients what to do can foster a lack of trust. Thus, AAs may appear to be "noncompliant" with the recommendations of their providers. Anderson and Funnell (2010) encourage an empowerment approach to diabetes self-management that encourages patients to reflect on their experience of living with diabetes. With this self-reflection, AAs are more likely to feel psychologically safe, warm, collaborative, and respected, which is essential for improving self-directed positive change in diabetes management. If AA patients do not feel trust in their healthcare providers, they may turn to their church leaders who they feel are more suitable to encourage, influence, and guide them through faith-based interventions.
The high prevalence of diabetes and other chronic diseases among AAs, and lack of trust in traditional healthcare, have led many AA churches to offer health ministries, health fairs, health education, and social support (Sherman, 2015). AA religious beliefs and practices, which include prayer meetings, meditation, church attendance, Bible study, and fellowshipping with each other, serve as essential resources in diabetes self-management (Sherman). The church is a fitting location to encourage diabetes awareness and promotion of education programs. Home healthcare agencies seeking community partners should collaborate with the health ministry teams of local churches to develop preventive and treatment-focused educational programs that incorporate spirituality and faith-based interventions.
The U.S. population is becoming more ethnically diverse and healthcare providers increasingly provide care for patients whose spiritual and cultural beliefs differ from their own (Scollan-Koliopoulos et al., 2012). Listening to hopes, fears, and beliefs can empower providers to help their patients facing chronic illness. It is imperative to acknowledge, respect, and explore the importance of patients' religious beliefs. This could, in turn, improve the level of trust AA patients have toward their healthcare providers. It is important to empower patients by providing them with the knowledge and skills to make informed decisions about their health. To meet the specific needs of the AA populations, diabetes self-management education should be tailored with culturally specific educational materials.
Tips for Home Care Clinicians
* Acknowledge, respect, and explore the patient's religious beliefs
* Recognize that spirituality is an important part of life for many AAs
* Seek out faith-based diabetes support groups through local churches
* Partner with local churches to provide diabetes education
* Remind patients that Scripture tells us the body is the Temple of the Lord, and thus should be well care for
* Remind patients that Scripture tells us faith without works is dead; monitoring blood glucose, taking medications, and exercising are faith-based practices for optimal health
CDC Launches Online Antibiotic Stewardship Course
The US Centers for Disease Control and Prevention (CDC) yesterday launched a new online antibiotic stewardship course.
The interactive web-based activity is designed to help clinicians optimize antibiotic use to combat antibiotic resistance and improve healthcare quality and patient safety. The course will provide an overview of antibiotic resistance and explain the benefits of antibiotic stewardship across the healthcare spectrum. It will also discuss the risks and benefits of antibiotics, with a specific focus on the microbiome, adverse drug events, and Clostridium difficile infections. The first module will focus on outpatient antibiotic stewardship, and the following modules will focus on stewardship in acute care hospitals and long-term care facilities.
The CDC says the goal of the course is to help healthcare professionals deliver effective and consistent message about antibiotic use and antibiotic resistance to patients, and to provide guidance for how to apply antibiotic stewardship principles to the most common conditions that lead to inappropriate use.
Go to: https://www.train.org/cdctrain/course/1075730/compilation
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