Differences in personal models among Latinos and European Americans: implications for clinical care.

Abstract

OBJECTIVE: To describe and contrast the personal models of type 2 diabetes in European Americans (EAs) and Latinos and to highlight differences that require a reorientation of clinical care. RESEARCH DESIGN AND METHODS: A total of 116 EAs and 76 Latino individuals with type 2 diabetes were interviewed about their personal model of diabetes. Responses to open-ended questions about the perceived cause, nature, seriousness, course, and future course of diabetes and its impact on everyday life were analyzed using an iterative process, and categories of response were established. Responses were examined within ethnic group, and comparisons across ethnic groups were made for clinically significant differences. RESULTS: Disease descriptions about the nature of the disease were categorized as experiential, biomedical, or psychosocial. Disease descriptions varied significantly by ethnicity (chi2 = 35.92, 2 df, P < 0.001), with more Latinos using an experiential model and more EAs using a biomedical model. Significant differences in life changes caused by the disease were found, with EAs reporting changes in exercise and spontaneity and Latinos in fatigue and mood. Individuals with diabetes from both ethnic groups gave comparable assessments about the cause, seriousness, and effectiveness of treatments for the disease. CONCLUSIONS: Clinical practice that attends to the concerns and experiences of individuals with diabetes from diverse ethnic groups is warranted. Broad assessment of personal models in diverse ethnic groups is recommended.