Assessing Stress and Stress Reduction with Tai Chi among Elderly Hispanics with Diabetes

Background. Persons with type 2 diabetes (T2D) experience psychosocial stress more frequently than the general population, and are more susceptible to depression and poor adherence to their self-care regimen. Stress increases glycemia and interferes with self-care practices (e.g., glucose monitoring, exercising, healthy eating). Stress management approaches (e.g., relaxation, meditation) can reduce glycemia and insulin resistance, and improve quality of life. Limited research examines the use of stress management approaches in minority groups with T2D. Tai Chi is a low-impact physical activity and meditation that reduces stress and glycemia, and improves overall health and insulin resistance in patients with T2D. This pilot study explores explanatory models of diabetes and stress, and perceived sources of stress among elderly Hispanics with T2D, with particular emphasis on the cultural factors influencing the receptivity to physical activity and stress management practices including Tai Chi. Methods. Using purposive/convenience sampling, 30 adults self-identified as Hispanics, 50 years or older with diagnosed T2D will be recruited from the Pilsen and Southeast Chicago communities. Participants should be naive to stress reduction training, and be cognitively intact. Four focus groups stratified by gender (2 male, 2 female) will be conducted. Sessions will follow a standard protocol, will be audio-taped and information stored in electronic format. Qualitative software Atlas ti will be used for data analysis. Confirmatory analysis will be used to rank and weight the categories and themes identified. Results. Results of the focus groups will be used to adapt a diabetes self-management program incorporating Tai Chi as a stress reduction strategy. Conclusions. Incorporating stress reduction as part of self-management practices for Hispanic elderly with T2D may serve to improve their diabetes outcomes and quality of life. Cultural adaptation of successful stress management approaches such as Tai Chi is warranted.