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UBC Theses and Dissertations

Diabetic diet management : a native Indian perspective Fuller, Caroline Anne


Maturity-onset diabetes has become a growing health problem among Canadian Native Indians. Although there is a growing body of literature examining the etiology and cultural meanings of diabetes in this population, there is little knowledge of the Native perspective of diabetic diet management among groups in Western Canada. Therefore, the purpose of this study was to examine the problems perceived by Native Indians in managing a diabetic diet. Kleinman's conceptual framework guided the formulation of the research question and methodololgy. In order to elicit and understand the experience of diabetic diet management from the perspective of the Native Indian, the qualitative research method of phenomenology was employed. Data were collected through the use of unstructured tape-recorded interviews that allowed the subjects to describe the phenomenon in their own words according to their own reality. The sample consisted of three men and three women all living on reserve from three Coast Salish bands in the Fraser Valley of British Columbia. Four of the subjects were interviewed twice, the other two were seen three times for a total of fourteen in-depth interviews. Data were collected and analyzed simultaneously over a period of seven months. After being transcribed verbatim, interview data were examined for common themes that emerged and the raw data were coded accordingly. As themes surfaced during the analysis, they were clarified, validated, and/or discounted during subsequent meetings with the informants. In this process, the nature of diabetic diet management was elucidated. The problems experienced by the informants were embedded in the larger phenomenon of diabetes management. How the illness was understood and dealt with in the context of daily living shaped the experience of diet management and the nature of the problems that surfaced. Two central interrelated concepts emerged from the data that explained how the subjects lived with their diets on a daily basis. The first concept entailed the evolving personal understanding of diabetes as it was shaped by the subjective experience of symptoms and the anecdotal stories of the numerous relatives with the same illness. The second concept emerged from the interwoven social environment in which the subjects lived out their daily lives. This was discovered to be both a source of difficulty and a source of strength for the individuals of the study. A variety of implications for nursing surfaced from the findings. For nursing practice, diabetic education and program development need to be planned and implemented in collaboration with Native leaders and clients. Educators must examine how nursing curricula can focus on the client's perspective of the illness experience to better enhance communication and health care delivery. There also remain many unanswered questions regarding the diabetic experience in this cultural group and how it is tied to the social network of such communities.

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