Purpose: This study explored how English-speaking Mexican-born immigrants with diabetes 2 (T2D) made decisions about diabetes self-management (DSM).
Background: Little is known about the self-care decisions of Mexican-born adults living in America with T2D. This information is needed so that health care professionals (HCPs) might better support patients’ DSM. T2D is a serious, multi-system disease, effecting persons of Mexican heritage almost twice as often as non-Hispanic whites (NHW); with lower insulin sensitivity, rapid prediabetes/T2D onset, and severe outcomes. Ineffectively managed blood glucose (BG) risks serious complications, reduced life quality, and premature death. T2D is primarily self-managed; requiring BG control. HCPs teaching Mexican émigrés encounter culturally-steeped beliefs that affect decision-making, contradict the science model and are not understood by NHW-HCPs.
Methodology/Results: A purposive sample of 12 (10 women/2 men) were recruited in Los Angeles County. Each participated in a 1.5 – 4-hour semi-structured interview conducted mostly in English. A bilingual research assistant/participant-observer clarified questions/interpreted Spanish explanations. Participants were queried about what influenced DSM decisions, self-care and cultural aspects. Constructivist grounded theory informed data analysis through constant comparison; results were confirmed by co-analysis.
Findings indicated that cultural requisites of being proper by practicing expected role/behavioral norms, eating hostess-prepared food, and hiding the socially-stigmatized diagnosis took precedence over positive DSM (+DSM). Food’s smell/taste, had emotive meaning. Presence at frequent socially-required events and desire to “enjoy today” were powerful decisioning forces that interfered with mastering DSM. To meet social requisites and enjoy flavors gave short-term pleasure but raised BG. The progressive nature of T2D was feared; none understood the progressive loss of insulin production. Motivation of love of family/fear of dreaded outcomes significantly impacted decisions. Accepting the T2D diagnosis/responsibility for/outcomes of DSM were key to being in the battle daily toward +DSM. All were Negotiating between short-term pleasure and illusive, long-term BG effects.
Implications: HCPs may help patients understand cultural influences that interfere with/promote +DSM, helping identify ways to negotiate short-term cultural requisites/avoid long-term outcomes may result in safer DSM decision-making. The substantive theory:
Negotiating every-day diabetes self-management decisions about conflicts between culture, personal enjoyment, and long-term outcomes toward mastery of type 2 diabetes by Mexican-born adults.
","abstract_html":"<p>Purpose: This study explored how English-speaking Mexican-born immigrants with diabetes 2 (T2D) made decisions about diabetes self-management (DSM).</p> <p>Background: Little is known about the self-care decisions of Mexican-born adults living in America with T2D. This information is needed so that health care professionals (HCPs) might better support patients’ DSM. T2D is a serious, multi-system disease, effecting persons of Mexican heritage almost twice as often as non-Hispanic whites (NHW); with lower insulin sensitivity, rapid prediabetes/T2D onset, and severe outcomes. Ineffectively managed blood glucose (BG) risks serious complications, reduced life quality, and premature death. T2D is primarily self-managed; requiring BG control. HCPs teaching Mexican émigrés encounter culturally-steeped beliefs that affect decision-making, contradict the science model and are not understood by NHW-HCPs.</p> <p>Methodology/Results: A purposive sample of 12 (10 women/2 men) were recruited in Los Angeles County. Each participated in a 1.5 – 4-hour semi-structured interview conducted mostly in English. A bilingual research assistant/participant-observer clarified questions/interpreted Spanish explanations. Participants were queried about what influenced DSM decisions, self-care and cultural aspects. Constructivist grounded theory informed data analysis through constant comparison; results were confirmed by co-analysis.</p> <p>Findings indicated that cultural requisites of being proper by practicing expected role/behavioral norms, eating hostess-prepared food, and hiding the socially-stigmatized diagnosis took precedence over positive DSM (+DSM). Food’s smell/taste, had emotive meaning. Presence at frequent socially-required events and desire to “enjoy today” were powerful decisioning forces that interfered with mastering DSM. To meet social requisites and enjoy flavors gave short-term pleasure but raised BG. The progressive nature of T2D was feared; none understood the progressive loss of insulin production. Motivation of love of family/fear of dreaded outcomes significantly impacted decisions. Accepting the T2D diagnosis/responsibility for/outcomes of DSM were key to being in the battle daily toward +DSM. All were Negotiating between short-term pleasure and illusive, long-term BG effects.</p> <p>Implications: HCPs may help patients understand cultural influences that interfere with/promote +DSM, helping identify ways to negotiate short-term cultural requisites/avoid long-term outcomes may result in safer DSM decision-making. The substantive theory:</p> <p>Negotiating every-day diabetes self-management decisions about conflicts between culture, personal enjoyment, and long-term outcomes toward mastery of type 2 diabetes by Mexican-born adults.</p>","abstract_has_math":false,"creators":["Hart-Kepler, Virginia Lynn"],"institution":null,"degree_name":"PhD Nursing","degree_level":"Dissertation: Open Access","degree_discipline":"Nursing","degree_department":null,"school":null,"contributors":[],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2017,"date_issued":"2017-01-01T08:00:00Z","date_published":"2017-01-01T08:00:00Z","updated_at":"2026-07-24T05:41:42Z","subjects":["Decision-making","Diabetes Self-Management","Hispanic/Latinos","Mexican Immigrants","self-care","Type 2 Diabetes","Nursing"],"languages":[],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"https://digital.sandiego.edu/dissertations/88","outbound_label":"Repository record","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:creator","label":"Author","values":["Hart-Kepler, Virginia Lynn"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.available","label":"Dc Date Available","values":["2017-07-17T07:00:00Z"]},{"key":"thesis:degree_discipline","label":"Discipline","values":["Nursing"]},{"key":"thesis:degree_level","label":"Degree Level","values":["Dissertation: Open Access"]},{"key":"thesis:degree_name","label":"Degree Name","values":["PhD Nursing"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["Decision-making","Diabetes Self-Management","Hispanic/Latinos","Mexican Immigrants","self-care","Type 2 Diabetes","Nursing"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["https://digital.sandiego.edu/dissertations/88"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Purpose: This study explored how English-speaking Mexican-born immigrants with diabetes 2 (T2D) made decisions about diabetes self-management (DSM).
Background: Little is known about the self-care decisions of Mexican-born adults living in America with T2D. This information is needed so that health care professionals (HCPs) might better support patients’ DSM. T2D is a serious, multi-system disease, effecting persons of Mexican heritage almost twice as often as non-Hispanic whites (NHW); with lower insulin sensitivity, rapid prediabetes/T2D onset, and severe outcomes. Ineffectively managed blood glucose (BG) risks serious complications, reduced life quality, and premature death. T2D is primarily self-managed; requiring BG control. HCPs teaching Mexican émigrés encounter culturally-steeped beliefs that affect decision-making, contradict the science model and are not understood by NHW-HCPs.
Methodology/Results: A purposive sample of 12 (10 women/2 men) were recruited in Los Angeles County. Each participated in a 1.5 – 4-hour semi-structured interview conducted mostly in English. A bilingual research assistant/participant-observer clarified questions/interpreted Spanish explanations. Participants were queried about what influenced DSM decisions, self-care and cultural aspects. Constructivist grounded theory informed data analysis through constant comparison; results were confirmed by co-analysis.
Findings indicated that cultural requisites of being proper by practicing expected role/behavioral norms, eating hostess-prepared food, and hiding the socially-stigmatized diagnosis took precedence over positive DSM (+DSM). Food’s smell/taste, had emotive meaning. Presence at frequent socially-required events and desire to “enjoy today” were powerful decisioning forces that interfered with mastering DSM. To meet social requisites and enjoy flavors gave short-term pleasure but raised BG. The progressive nature of T2D was feared; none understood the progressive loss of insulin production. Motivation of love of family/fear of dreaded outcomes significantly impacted decisions. Accepting the T2D diagnosis/responsibility for/outcomes of DSM were key to being in the battle daily toward +DSM. All were Negotiating between short-term pleasure and illusive, long-term BG effects.
Implications: HCPs may help patients understand cultural influences that interfere with/promote +DSM, helping identify ways to negotiate short-term cultural requisites/avoid long-term outcomes may result in safer DSM decision-making. The substantive theory:
Negotiating every-day diabetes self-management decisions about conflicts between culture, personal enjoyment, and long-term outcomes toward mastery of type 2 diabetes by Mexican-born adults.
"]},{"key":"dc:title","label":"Title","values":["Mexican-Born Immigrant Decision-Making About Self-Management of Type 2 Diabetes"]}]}],"canonical_facts":{"dc:creator":["Hart-Kepler, Virginia Lynn"],"dc:date.available":["2017-07-17T07:00:00Z"],"dc:description.abstract":["Purpose: This study explored how English-speaking Mexican-born immigrants with diabetes 2 (T2D) made decisions about diabetes self-management (DSM).
Background: Little is known about the self-care decisions of Mexican-born adults living in America with T2D. This information is needed so that health care professionals (HCPs) might better support patients’ DSM. T2D is a serious, multi-system disease, effecting persons of Mexican heritage almost twice as often as non-Hispanic whites (NHW); with lower insulin sensitivity, rapid prediabetes/T2D onset, and severe outcomes. Ineffectively managed blood glucose (BG) risks serious complications, reduced life quality, and premature death. T2D is primarily self-managed; requiring BG control. HCPs teaching Mexican émigrés encounter culturally-steeped beliefs that affect decision-making, contradict the science model and are not understood by NHW-HCPs.
Methodology/Results: A purposive sample of 12 (10 women/2 men) were recruited in Los Angeles County. Each participated in a 1.5 – 4-hour semi-structured interview conducted mostly in English. A bilingual research assistant/participant-observer clarified questions/interpreted Spanish explanations. Participants were queried about what influenced DSM decisions, self-care and cultural aspects. Constructivist grounded theory informed data analysis through constant comparison; results were confirmed by co-analysis.
Findings indicated that cultural requisites of being proper by practicing expected role/behavioral norms, eating hostess-prepared food, and hiding the socially-stigmatized diagnosis took precedence over positive DSM (+DSM). Food’s smell/taste, had emotive meaning. Presence at frequent socially-required events and desire to “enjoy today” were powerful decisioning forces that interfered with mastering DSM. To meet social requisites and enjoy flavors gave short-term pleasure but raised BG. The progressive nature of T2D was feared; none understood the progressive loss of insulin production. Motivation of love of family/fear of dreaded outcomes significantly impacted decisions. Accepting the T2D diagnosis/responsibility for/outcomes of DSM were key to being in the battle daily toward +DSM. All were Negotiating between short-term pleasure and illusive, long-term BG effects.
Implications: HCPs may help patients understand cultural influences that interfere with/promote +DSM, helping identify ways to negotiate short-term cultural requisites/avoid long-term outcomes may result in safer DSM decision-making. The substantive theory:
Negotiating every-day diabetes self-management decisions about conflicts between culture, personal enjoyment, and long-term outcomes toward mastery of type 2 diabetes by Mexican-born adults.
"],"dc:identifier":["https://digital.sandiego.edu/dissertations/88"],"dc:subject":["Decision-making","Diabetes Self-Management","Hispanic/Latinos","Mexican Immigrants","self-care","Type 2 Diabetes","Nursing"],"dc:title":["Mexican-Born Immigrant Decision-Making About Self-Management of Type 2 Diabetes"],"thesis:degree_discipline":["Nursing"],"thesis:degree_level":["Dissertation: Open Access"],"thesis:degree_name":["PhD Nursing"]},"updated_at":"2026-07-24T05:41:42Z"}