Bridging the Social Support Needs Gap For African American Women with Lupus Through the Chronic Disease Self-Management Program Open Access

Dunlop-Thomas, Charmayne Marie (2013)

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Purpose: Lupus, as a chronic disease with heterogeneous phenotypes of varying disease severity, has led to a higher burden of disease associated with women of color. Low cost high-impact interventions that inform and encourage effective disease self-management are needed. The Chronic Disease Self-Management Program (CDSMP), as a low cost evidence-based intervention, is beneficial and acceptable to the socioeconomically disadvantaged targeted cohort of African American (AA) women with lupus in this study. This program is designed to improve self-management skills and enhance social relationships. This study seeks to understand the social support needs of AA women with lupus and the ways in which the CDSMP addresses these needs. The theoretical perspectives hypothesize that social relationships contribute to overall health.

Methods: Participants were recruited from a public hospital's lupus clinic. A triangulation approach was utilized with qualitative data from forty-five participants who completed the CDSMP, and the two CDSMP leaders. Data was collected from focus groups, questionnaires, and semi-structured leader interviews.

Data Analysis: Focus group transcripts were analyzed using thematic analysis. A thematic code dictionary was developed, informed by the qualitative data and the study's theoretical perspectives, including Cohen's definitions of social relationships and resources. Focus group data were analyzed utilizing ATLAS.ti and SPSS. Other data were clustered based on social support relevance defined by the code dictionary.

Results: Six key social support themes emerged that depicted the emotion- and problem-focused supportive channels of the CDSMP. The program promoted healthy behaviors directly and indirectly addressing issues leading to more productive and rewarding social interactions. Participants reported feeling empowered to be more proactive in their medical care. The avoidance and reduction of stress effects were indicated as major components for active self-care, referred to as "self-love" by the participants.

Summary: This qualitative study provided a greater understanding of the role of social support in this cohort of AA women with lupus. The person-environment relationships were shown to have a significant role in the ability to cope with stress and self-manage their chronic disease. The CDSMP offered the psychological resources to enhance resilience and coping capacities, healthy behaviors, and overall well-being.

Table of Contents

Chapter 1: Introduction

Chapter 2: Review of Literature

Chapter 3: Methods

Chapter 4: Results

Chapter 5: Discussion




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