Living well: Understanding the experience of diabetes and cardiovascular disease in First Nations peoples

In the past fifty years, rates of Type 2 diabetes and cardiovascular disease (CVD) have escalated in the First Nations population until they have become the most prevalent chronic diseases in that population (Young et al., 1999). The biophysiologic processes of Type 2 diabetes and CVD are well documented. However, the experiences of First Nations Peoples living with these diseases have not been well investigated. Understanding how the First Nations Peoples 'live well' with these diseases may provide some direction to health care providers in assisting prevention efforts. This ethnographic study focused on First Nations People from the Opaskwayak Cree Nation in northern Manitoba. Fifteen participants (eight men, seven women) engaged in semi-structured interviews which were audio recorded, transcribed, and analyzed using an inductive and reflexive process. Analysis focused on culturally embedded attitudes and practices that allowed First Nations participants to 'live well' with Type 2 diabetes and CVD. 'Living well' was defined by the participants as being more than physical adaptation; it encompassed balancing and maintaining the emotional, spiritual, and environmental aspects of their lives. The investigation provided an opportunity for the participants' voices to be heard. By listening to these voices, I was able to identify the factors which enabled the Opaskwayak Cree Nation People to 'live well' with Type 2 diabetes and CVD. Considering these factors led to the development of a holistic model which can be used to guide practice and further research.

For the participants in this study, culturally based spiritual beliefs, supportive families, and mutually respectful relationships with health care providers enabled them to 'live well' with Type 2 diabetes and CVD. This information can assist health care providers and policy makers to develop services that support the First Nations People's ability to 'live well' when faced with chronic illness.