What drives distress? Rethinking the roles of emotion and diagnosis among people with diabetes in Nairobi, Kenya
Date
2020Author
Mendenhall, Emily
Musau, Abednego
Bosire, Edna
Mutiso, Victoria
Ndetei, David
Melanie, Rock
Type
ArticleLanguage
enMetadata
Show full item recordAbstract
Type 2 diabetes mellitus is a condition that both results from and produces social and psychological suffering. As 'diabetes' increases among low income patients in poorer nations, new challenges arise that drive, co-occur, and result from the condition. In this article, we describe how social suffering produces diabetes by way of addressing the varied social, psychological, and biological factors that drive diabetes and are reflected in diabetes experiences among patients seeking care at a public hospital in Nairobi, Kenya. We recruited a non-probability sample to participate in a cross-sectional study of 100 patients (aged 35-65 years), where half of the participants sought care from a diabetes clinic and half sought care from the primary healthcare clinic. We obtained informed consent in writing, and collected life history narratives, surveys, anthropometrics, and biomarkers. This paper evaluates survey data using frequencies and regression tables. We found that social factors as opposed to disease factors were major drivers of psychological distress among those with and without diabetes. Psychological distress was associated with female gender and feelings of financial and personal insecurity. We also found insulin resistance was common among those undiagnosed with diabetes, suggesting that many seeking primary care for other health conditions did not receive a routine diabetes test (most likely because it is an out-of-pocket cost, or other competing social factors) and therefore delayed their diagnosis and care. Thus, social and economic factors may drive not only emotional distress among people with diabetes but also delayed care seeking, testing, and self-care as a result of cost and other social challenges.
Citation
Mendenhall E, Musau A, Bosire E, Mutiso V, Ndetei D, Rock M. What drives distress? Rethinking the roles of emotion and diagnosis among people with diabetes in Nairobi, Kenya. Anthropol Med. 2020 Sep;27(3):252-267. doi: 10.1080/13648470.2019.1650243. Epub 2019 Dec 6. PMID: 32755267.Publisher
University of Nairobi
Rights
Attribution-NonCommercial-NoDerivs 3.0 United StatesUsage Rights
http://creativecommons.org/licenses/by-nc-nd/3.0/us/Collections
- Faculty of Health Sciences (FHS) [10385]
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