Family Harmony: Reconciling Individual and Collective Responsibility in the Care of Type 2 Diabetes Mellitus in Korean Middle-Aged Americans

Type 2 Diabetes Mellitus (DM) has disproportionately affected Korean American immigrants (KAI) in the United States. Biomedical, more individualistic, management models have focused primarily on individual responsibility for the prevention of costly complications. Traditionally, collectivism has been an important attribute of the KAI community. We conducted a qualitative study to explore the individual and collective values within the context of family while caring for DM in middle-aged (40-64 years) KAI. The following themes emerged from individual in-depth interviews: (1) Personal accountability for family harmony: I do it on my own; (2) Preserving appearance of family harmony at all costs: personal sacrifice for the good of the whole; and (3) Family harmony through mutuality: we take care of each other. The process of reconciliation of the individual and collective ethic requires one to find coping strategies, while considering social roles, gender and intergenerational interactions, in order to maintain harmony in KAI families.