Abstract
Objective
Our aim in this study was to gain an understanding of the experiences of Aboriginal
and Torres Strait Islander young people aged 10 to 25 years with type 2 diabetes (T2D)
living in Northern and Central Australia.
Methods
In this qualitative study we explored participants’ experiences of T2D using a social
constructionist epistemology and a phenomenologic methodology. Twenty-seven young
people participated in semistructured in-depth interviews from 4 primary health-care
sites.
Results
Three major constructs emerged. Young people experienced a normalisation–shame paradox
in response to their diagnosis (partly related to that “everyone has diabetes,” as
well as the fear that friends “might judge [me]”), had suboptimal levels of understanding
of T2D (“I don’t really know what diabetes is. I just need somebody to explain to
me a bit more”) and experienced multiple barriers inhibiting their T2D management.
These included complex lives (“I have a rheumatic heart disease […] then they told
me that I have diabetes…I have two things”) and the availability of support (“[I]
talk to my mum…I talk to my aunty too…I don’t talk to anyone else”). Successful management
requires support from health professionals and family and includes strengthening social
networks and educational opportunities.
Conclusions
Our findings reinforce the need for alternative support systems tailored to the specific
needs of young Aboriginal and Torres Strait Islander people with T2D. Enhanced models
of care must be codesigned with young people and their communities and include a focus
on shifting norms and expectations about youth T2D to reduce diabetes stigma and broaden
social support and consider the delivery of health information in youth-friendly environments.
Résumé
Objectifs
L’objectif de notre étude était d’acquérir une compréhension des expériences des jeunes
aborigènes et insulaires du détroit de Torrès âgés de 10 à 25 ans et diabétiques de
type 2 (DT2) qui vivent dans le nord et le centre de l’Australie.
Méthodes
Dans cette étude qualitative, l’épistémologie constructiviste sociale et la méthode
phénoménologique nous ont permis d’explorer les expériences des participants concernant
le DT2. Vingt-sept jeunes de 4 établissements en soins de santé primaires ont participé
à des entretiens semi-structurés en profondeur.
Résultats
Trois construits importants étaient apparus. Les jeunes connaissaient un paradoxe
normalisation–honte en réponse à leur diagnostic (qui s’explique en partie par l’affirmation
que « tout le monde a le diabète » et par la crainte que les amis « puissent [me]
juger »), avaient des niveaux de compréhension sous-optimaux du DT2 (« Je ne sais
pas vraiment ce qu’est le diabète. J’ai simplement besoin que quelqu’un m’explique
un peu plus. ») et se heurtaient à de nombreux obstacles qui inhibaient leur prise
en charge du DT2. Parmi ces obstacles figurent la complexité de leur vie (« J’ai un
rhumatisme cardiaque […] puis ils m’ont dit que j’ai le diabète… J’ai deux choses
») et la disponibilité du soutien (« [Je] parle à ma maman… Je parle à ma tantine
aussi… Je ne parle à personne d’autre »). La réussite de la prise en charge exige
le soutien des professionnels de la santé et de la famille et passe par le renforcement
des réseaux sociaux et les possibilités d’éducation.
Conclusions
Nos résultats contribuent à accentuer le besoin d’avoir d’autres réseaux de soutien
adaptés aux besoins particuliers des jeunes aborigènes et insulaires du détroit de
Torrès qui ont le DT2. Des modèles de soins améliorés doivent être conçus en collaboration
avec les jeunes et leurs communautés et principalement axés sur l’évolution des normes
et des attentes au sujet du DT2 chez les jeunes afin de réduire la stigmatisation
liée au diabète, étendre le soutien social et envisager la prestation d’information
en matière de santé dans les environnements adaptés aux jeunes.
Keywords
Mots clés
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Article Info
Publication History
Published online: May 04, 2022
Accepted:
April 26,
2022
Received in revised form:
March 14,
2022
Received:
December 15,
2021
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Canadian Diabetes Association.