Religiosity, spirituality, coping, and resilience among African Americans with diabetes

purpose: Diabetes rates between African Americans and other racial groups appear to be widening even though targeted interventions have reported minor successes for symptom self-management practices. Although diabetes self-care activities are burdensome, only a limited number of studies explore the social and cultural contexts of resilience and religion/spirituality especially among African American adults who were formally homeless, but newly housed. The study purposes were to examine the role of religion and spirituality in coping with diabetes and understand the foundations for resilience in self-management practices.

methods: Semi-structured face-to-face interviews were conducted with 42 African American men and women receiving medical and social services from a community clinic in a Northern California Bay Area city.  All interviews were audio-taped and transcribed verbatim. The 1 – 1.5 hour semi-structured interviews were transcribed data and analyzed using ATLAS.ti (version 7.0).

results: Participants religiosity and spirituality strongly influenced diabetes management practices.  Five resilience themes emerged as cornerstones for coping with diabetes.  Another theme associated with self-care practices included maintaining a positive image of God. While participants recognized diabetes as an illness requiring professional treatment, this was discussed in the context of balancing treatment with spiritual practices such as prayer, reading the bible, and communing with others.

implications: The study findings highlight the importance of spiritual and religious beliefs and practices and coping strategies in diabetes self-care activities among populations relearning life management skills.  Future research should focus on determining how providers integrate patients' beliefs and practices into clinical and social service policy interventions.