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Author ORCID Identifier



Open Access Dissertation

Document Type


Degree Name

Doctor of Philosophy (PhD)

Degree Program


Year Degree Awarded


Month Degree Awarded


First Advisor

Cynthia Jacelon

Second Advisor

Genevieve Chandler

Third Advisor

Alexandrina DesChamps

Subject Categories

Other Nursing


The growth of diabetes in the United States is viewed by some as epidemic with a particular concern as related to African American women. African American women experience diabetes disproportionately to other groups with higher risks of complications and premature death. Historically, they have led all women in labor force participation and maintained roles within and outside the home. The purpose of this study was to gain understanding and meaning of the lived experience of African American women with diabetes and maintaining multiple roles using sensitizing concepts of Relational-Cultural theory. Relational-Cultural theory was described as related to use with women and the incorporation of the influence of culture. The literature review used proxy terms for the concepts of connection, disconnection, mutuality and power over related to limited use of theory concepts in the literature. The review yielded few research studies. Interpretive phenomenology following Ricoeur in philosophy and methodology was used. Three composites of the day-to-day experiences of African American women with diabetes and maintaining multiple roles were provided. The concept of connections diverged into two types of connections with multiple themes. Mutuality themes were not a matter of age but what each brings to the other and closeness developed over time. Themes that emerged related to concepts of disconnections and power over were the will to keep negativity out, disappointment in others, shackles on, shackles off, financial stress makes life difficult. Themes of informational support in the neighborhoods, trust is necessary and need for African American nurses related to the role of nurses with enhancing connections and mutuality. Further nursing research is needed related to use of Relational-Cultural theory and African American women with diabetes and maintaining multiple roles to increase a contextual understanding of their lived experience. Incorporation of Relational-Cultural theory into practice and nursing education was also suggested based on two decades of neuroscience evidence about the importance of relationships.


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