Abstract
American Indian (AI) communities experience a disproportionate rate of Type 2 diabetes (T2D) and cumulative exposure to stress. Although this link is well researched among various populations, it has not been examined among AI communities. Path analysis was used to examine a multiple-mediator model to explain how caregiver stress influences self-reported mental and physical health among 100 AI participants with T2D. Caregiver stress was negatively associated with physical and mental health. Physical health was positively associated with family/community connectedness and mental health was positively associated with both family support and connectedness. The relationship between caregiver stress and mental health was partially mediated by family/community connectedness; caregiver stress had no indirect effects on physical health via either hypothesized mediator. Findings demonstrate the importance of integrating individuals’ connection to family and community and its influence on caregiver stress and mental health in intervention programs targeting diabetes management and care among AI communities.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 621-639 |
| Number of pages | 19 |
| Journal | Journal of Family Nursing |
| Volume | 24 |
| Issue number | 4 |
| DOIs | |
| State | Published - Nov 1 2018 |
Bibliographical note
Funding Information:The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This project was supported by the National Institute of Diabetes and Digestive and Kidney Diseases (DK091250, M. Walls, PI).
Funding Information:
The authors gratefully acknowledge the Gathering for Health Community Research Council and Clinical Project Members: Sidnee Kellar, Rose Barber, Robert Miller, Tweed Shuman, Lorraine Smith, Sandy Zeznanski, Patty Subera, Tracy Martin, Geraldine Whiteman, Lisa Perry, Trisha Prentice, Alexis Mason, Charity Prentice-Pemberton, Kathy Dudley, Romona Nelson, Eileen Miller, Geraldine Brun, Murphy Thomas, Mary Sikora-Petersen, GayeAnn Allen, Frances Whitfield, Phillip Chapman, Sr., Hope Williams, Betty Jo Graveen, Daniel Chapman, Jr., Doris Isham, Stan Day, Jane Villebrun, Beverly Steel, Muriel Deegan, Peggy Connor, Michael Connor, Ray E. Villebrun, Sr., Pam Hughes, Cindy McDougall, Melanie McMichael, Robert Thompson, and Sandra Kier. The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This project was supported by the National Institute of Diabetes and Digestive and Kidney Diseases (DK091250, M. Walls, PI).
Publisher Copyright:
© The Author(s) 2018.
Keywords
- American Indians
- Type 2 diabetes
- community
- family
- stress
