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Jamaican adults with diabetes mellitus (DM) living in South Florida often believe taking conventional medications can cause harm. In an effort to limit adverse effects of these medicines, they frequently engage in folk care. However, this practice could actually increase risks of DM-associated complications, such as chronic kidney disease. Little is known about what folk care Jamaican adults are integrating into everyday health care. This focused ethnography explored and described how Jamaican adults with DM who live in South Florida use folk care for managing their DM. Knowing what folk care is part of everyday health practices among ethnical and racially diverse populations, such as Jamaican adults in this study, can help inform nephrology nursing practice and support future research.
Key Words:
Diabetes mellitus, self-care, Jamaican, chronic kidney disease, culture.
Diabetes mellitus (DM) is at pandemic levels in the North America and Latin America/Caribbean regions. Adults with DM face many challenges engaging in selfmanagement activities, which may lead to uncontrolled DM. The main feature of uncontrolled DM, hyperglycemia, can cause a cascade of complications affecting multiple body systems, including the kidneys. In fact, DM is the most common reason for chronic kidney disease (CKD). The challenges of controlling hyperglycemia and the associated complications are well documented (Centers for Disease Control and Prevention [CDC], 2020; International Diabetes Federation, 2020). To achieve better control and reduce complications, many adults from Caribbean countries engage in non-conventional treatments.
The latest available data regarding the prevalence of DM related to income in Caribbean countries, such as Jamaica, indicate that DM is more prevalent in higher income groups, while the opposite is seen in the United States, where DM is more prevalent in lower income groups (World Health Organization [WHO], 2021). In 2019, the U.S. prevalence of DM in adults was 14.7% (CDC, 2021), while the prevalence in Florida was 12.5% (American Diabetes Association, 2021). Epidemiology data from 2016 showed that the prevalence of DM was 11% to 17% in Broward County, which is located in South Florida (Florida Diabetes Advisory Council, 2019). Broward County has the largest population of Jamaicans living outside of their native country (United States Census Bureau, 2022). Adults from Caribbean nations, such as Jamaica, are disproportionately affected by DM and the associated complications (WHO, 2021)....