Gender and the capacity of women with NIDDM to implement medical advice

Abstract

This qualitative study of women with non-insulin dependent diabetes mellitus (NIDDM) examined constructions of their diabetes management and socio-familial relationships as potential sources of support. Semi-structured interview data was collected from 16 women. The transcripts were analysed with the aim of examining the ways in which gender relations structured women's accounts of health-related behaviours. Women talked about themselves as wives, mothers, being pregnant and parenting, and friends of other women in ways that demonstrated how caring for others impeded their capacity to care for themselves. Meeting the food preferences of husbands and dietary requirements of diabetic husbands were dominant themes in women's accounts of marriage, and in various ways women justified their husbands' lack of support. Furthermore, the care of others during pregnancy and parenting was also an obstacle to women caring for themselves. An awareness of the gender politics inherent within social and family contexts is crucial to improving the effectiveness of medical advice for diabetes management.

Keywords

discourse feminism gender marital relationship non-insulin dependent diabetes mellitus qualitative research women's health.

Get full access to this article

View all access options for this article.

References

Goodall TA , Halford WK Self-management of diabetes mellitus: a critical review. Health Psychol 1991; 10: 1-8.

Huse DM , Oster G. , Killen AR , Lacey MJ , Colditz GA The economic costs of non-insulin dependent diabetes mellitus. JAMA 1989; 262: 2708-13.

Janz NK , Becker MH The health belief model: a decade later. Health Education Quarterly 1974; 11: 1-47.

Hampson SE , Glasgow RE , Foster LS Personal models of diabetes among older adults: relationship to self-management and other variables. The Diabetes Educator 1995; 21: 300-7.

Anderson RM Patient empowerment and the traditional medical model. Diabetes Care 1995; 18: 412-4.

Kvam SH , Lyons JS Assessment of coping strategies, social support, and general health status in individuals with diabetes mellitus. Psychological Reports 1991; 68: 623-632.

Wang C-Y. , Fenske MM Self-care of adults with non-insulin dependent diabetes mellitus: Influence of family and friends. The Diabetes Educator 1996; 22: 465-70.

Trostle JA Medical compliance as ideology. Soc Sci Med 1988; 27: 1299-308.

Bell DSH. Exercise for patients with diabetes: benefits, risks, precautions. Postgrad Med 1992; 92: 183-96.

10.

Travis T. Patient perceptions of factors that affect adherence to dietary regimens for Diabetes Mellitus. The Diabetes Educator 1997 ; 23: 152-6.

11.

Wierenga ME Lifestyle modification for weight control to improve diabetes health status. Patient Education and Counselling 1994; 23: 33-40.

12.

Hurley AC , Shea CA Self-efficacy: Strategy for enhancing diabetes self-care. The Diabetes Educator 1992; 18: 146-50.

13.

Kurtz SMS. Adherence to diabetes regimens: empirical status and clinical applications . The Diabetes Educator 1990; 16: 50-6.

14.

McNabb WL

Adherence in diabetes: can we define it and can we measure it?

Diabetes Care 1997; 20: 215-8.

15.

Conrad P. Qualitative research on chronic illness: a commentary on method and conceptual development. Soc Sci Med 1990; 30: 1257-63.

16.

Thompson SC , Pitts JS In sickness and in health: chronic illness, marriage, and spousal caregiving . In: Spacapan S, Oskamp S, eds. Helping and being helped. Naturalistic studies. The Claremont Symposium on Applied Social Psychology . Sage: Newbury Park: CA, 1992.

17.

Belgrave FZ , Lewis DM

The role of social support in compliance and other health behaviours for African Americans with chronic illness. J Health

Soc Policy, 1994; 5: 55-68.

18.

Anderson JM , Wiggins S. , Rajwani R. , Holbrook A. , Blue C. , Ng M. Living with a chronic illness: Chinese-Canadian and Euro-Canadian women with diabetes-Exploring factors that influence management . Soc Sci Med, 1995; 41: 181-95.

19.

Cigoli V. , Binda W. , Marta E. Marital relationships and type II diabetes. Family Systems Medicine, 1994; 12: 295-314.

20.

Shillitoe RW Psychology and diabetes: psychosocial factors in management and control. London: Chapman and Hall, 1988.

21.

Rajaram SS Experience of hypoglycemia among insulin dependent diabetics and its impact on the family. Sociology of Health and Illness, 1997; 19: 281-96.

22.

Hamberg K. , Johansson E. , Lindgren G. , Westman G. The impact of marital relationship on the rehabilitation process in a group of women with long-term musculoskeletal disorders. Scand J Soc Med, 1997; 25: 17-25.

23.

Weedon C. Feminist Practice and Poststructuralist Theory. Basil Blackwell : Oxford, 1987.

24.

Hepworth J. , Mensforth H. Enhancing diabetes management. Final report submitted to the Research and Development Advisory Grants Committee (RADGAC), Grant No. HS378, Commonwealth Department of Human Services, Canberra, Australia, 1998.

25.

van Dijk TA Discourse. A multidisciplinary introduction. Sage : London, 1996.

26.

Potter J. , Wetherell M. Discourse and social psychology: beyond attitudes and behavior. Sage: London, 1987.

27.

Berg BL An introduction to content analysis. In: Qualitative research methods for the social sciences. London: Allyn and Bacon, 1989.

28.

Lincoln Y. , Guba E. Naturalistic inquiry. Sage: Newbury Park, CA, 1985.

29.

Potter J. Discourse analysis: theoretical considerations. In: Richardson TE , ed. Handbook of qualitative methods. London: BPS Publications, 1996.

30.

Kari W. The rationality of caring. Economic and Industrial Democracy , 1984; 2: 185-211.