Living with diabetes in the 4-fold World of the Coeur d'Alene tribe.

Despite national initiatives, diabetes disproportionately affects Native Americans. Although many studies have focused on the needs of Native Americans for culturally relevant diabetes programs, few have focused on Northwest tribes. This article presents the results of a phenomenological study exploring the experience of Coeur d'Alene tribal members living with type 2 diabetes. The main theme to emerge was perseverance while balancing tensions between burdens and strengths in 4 areas: valuing tribal traditions, being inattentively caring, struggling with disease burdens, and experiencing patient-provider tensions. This article provides new understanding about barriers and supports for diabetes self-management in one Native American tribe.