Perceptions and meanings of type II diabetes among Mexican American farmworking women

The purpose of this phenomenological study was to explore the perceptions and meanings of type II diabetes among Mexican American farmworking women working in California’s Northern San Joaquin Valley. Perceptions of type II diabetes play a major role in how Mexican American farmworking women feel about diabetes and these perceptions influence diabetes treatment strategies and health care decisions. Yet, little is known about the perceptions and meanings that farmworking women attribute to type II diabetes. A qualitative interdisciplinary research methodology (integrating knowledge from social work and nursing) involving open-ended, in-depth interviews with a nonprobabilistic sample of 17 Mexican American farmworking women was used to gain an understanding of how farmworking women make meaning of type II diabetes. Based on Kleinman’s (1980) explanatory model, salient themes in the areas of illness, causation, treatment and perceptions were identified. The study showed that farmworking women have a predominantly cultural perspective of diabetes. A large majority of women applied cultural beliefs and traditional home remedies to the treatment of diabetes; although many were not opposed to incorporating western medicine into cultural treatment strategies. Causation of diabetes was attributed to a transformation of blood and destabilization of the pancreas as a result of Susto (fright), an ethno-specific illness. Home remedy and dosing strategies were categorized and farmworking women revealed subjective definitions of high blood glucose and heredity that are dissimilar to western biomedicine. Understanding how farmworking women conceptualize and make meaning of type II diabetes and including these important culturally influenced beliefs and treatment strategies into interdisciplinary health care practices and service delivery systems can serve as a basis for modifying current medical theoretical orientations about diabetes education, treatment and maintenance strategies and service provision for this particularly vulnerable population. Additionally, the inclusion of cultural beliefs and treatment strategies can engender trust and facilitate meaningful, reciprocal relationships between patients and health care providers, which are considered essential for developing culturally meaningful, effective treatment, and competent and responsible service provision.