Date of Award

Spring 5-20-2021

Degree Type

Dissertation

Degree Name

PhD Health Sciences

Department

Health and Medical Sciences

Advisor

Michelle L. D'Abundo

Committee Member

Genevieve Pinto Zipp

Committee Member

Felicia Hill-Briggs

Keywords

type 2 diabetes, older adults, underserved, person-centered care, patient-centered care, qualitative research

Abstract

Older adults with type 2 diabetes living in medically underserved areas (MUAs) have unique health and social needs that must be taken into consideration when supporting their type 2 diabetes treatment and management care. Effective treatment and management of type 2 diabetes for older adults living in MUAs requires incorporating the preferences, desires, needs, values, and goals of the person at the center of the care into his/her care plan. Shifting care to be conducive to the treatment and management goals and plans co-created with older adults living in MUAs based on their individual physical, psychological, social, and spiritual preferences, values, desires, needs and goals requires health care systems to redesign and restructure their services and roles to be more favorable to elderly adults. Utilizing a basic qualitative research study design, semi-structured, in-depth interviews were conducted to understand the perspectives of older adults living in MUAs regarding health care received in the treatment and management of their type 2 diabetes. Twelve older adults with type 2 diabetes living in MUAs recruited from senior housing facilities in two designated MUAs participated in the study. The constant comparative method was used for qualitative data analysis. NVivo 12 was used to organize the emerging codes. The Donabedian Model of Care was used as a conceptual framework to guide this research study and provided a lens into which the findings of the study were interpreted, summarized, and reported. Six themes emerged from the qualitative analysis: care treatment and management, accessible services for older adults, information sharing and provider communication, attributes of health care providers, social support, and older adults’ diabetes self-management behavioral strategies. This study gave older adults living in MUAs a voice that offered health care providers with a better understanding of what is important to this vulnerable population in treating and managing their type 2 diabetes. This study provided a framework for health care providers striving to deliver type 2 diabetes treatment and management care to older adults living in MUAs that is holistic, respectful and individualized. Incorporating the findings from this study into practice could lead to greater empowerment and more effective treatment and management care of type 2 diabetes for older adults living in MUAs.

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