Dissertation
Health in Action: A Culture-Centered Approach to Discourses and Identity with Type 1 Diabetics
Doctor of Philosophy (PhD), Washington State University
01/2019
Handle:
https://hdl.handle.net/2376/16766
Abstract
Type 1 diabetes (T1D) is an autoimmune disease requiring constant attention to complex health behaviors, the avoidance of which can lead to significant acute and chronic health risks, including five to seven times higher mortality rate than that of the general population. Individuals with chronic conditions such as T1D must reconcile the reality of their illness with their identity, and the incidence of depression is nearly twice as high for those with diabetes as compared to the general population and T1Ds are three to four times as likely to commit suicide than the general population. This study uses the theoretical and methodological framework of Dutta’s Culture-Centered Approach (CCA) to engage T1Ds, parents of T1Ds, and healthcare providers in participatory dialog about the experience of living with or caring for T1D. 21 participants from a semi-rural town in Washington state shared through interviews and focus groups about T1D challenges, stigma, identity, and constructions of health. Data were analyzed using thematic analysis and findings were reported. T1Ds experience a series of dialectics in relation to three key themes of the T1D experience: challenges, stigma, and identity. The analysis also applies the CCA framework of structure, culture, and agency to identify systems that both constrain and provide access to resources and discourses that shape subject positions with which T1Ds contend in constructing their own identities and understandings of health and how to pursue it. T1D constructions of health move from diet and exercise, to a broadened view involving mental and emotional health, and finally to a facilitative view that positions health as a means to ends that are more valued than health, thereby using voice to (re)define health and identity and choice to take action on what they most value. Through participation a community of support that includes formal and informal mentoring of youth and young adults has begun.
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Details
- Title
- Health in Action
- Creators
- Joseph M Hewa
- Contributors
- Jeffery C Peterson (Advisor)Pamela J Bettis (Committee Member)Amanda D Boyd (Committee Member)
- Awarding Institution
- Washington State University
- Academic Unit
- Edward R. Murrow College of Communication
- Theses and Dissertations
- Doctor of Philosophy (PhD), Washington State University
- Number of pages
- 222
- Identifiers
- 99900581504301842
- Language
- English
- Resource Type
- Dissertation