Empowering patients with diabetes: a qualitative primary care study focusing on South Asians in Leicester, UK

Abstract

Educational initiatives aimed at promoting self-management in chronic diseases such as diabetes need to be designed with an awareness of the complexity of social and cultural experiences and attitudes in target communities.

Cultural barriers impeding ethnic minority groups from accessing effective diabetes care services: a systematic review of observational studies

“…A total of 1897 participants with varied ethnicities, of which 15 were stated and two were unspecified (see Table 3), were recruited from three settings (community, primary care and acute sectors). Nine studies included adults with type 2 diabetes (Greenhalgh et al, 2006(Greenhalgh et al, , 2011Fleming et al, 2008;Lawton et al, 2005Lawton et al, , 2007Lloyd et al, 2008;Kohinor et al, 2011;Duthie-Nurse, 1998;Kelleher and Islam, 1994), two studies involved women with gestational diabetes (Narayan and Rea, 1997;Hjelm et al, 2005), one study included children with type 1 diabetes (Povlsen et al, 2005), four studies included participants with both type 1 and type 2 diabetes (Fagerli et al, 2005;Stone et al, 2005;, and five studies did not specify the diabetes type (Brown et al, 2006;Greenhalgh et al, 1998;Naeem, 2003;Sedgwick et al, 2003;Gonzalez, 2008). The characteristics and cultural and linguistic needs of these populations were varied.…”

“…Of the 22 included studies (see online Tables S1S3), 14 studies were of good quality and met 80100% of the quality criteria (scored A) Greenhalgh et al, 1998Greenhalgh et al, , 2006Greenhalgh et al, , 2011Kohinor et al, 2011;Gonzalez, 2008;Lawton et al, 2005Lawton et al, , 2007Stone et al, 2005;Hjelm et al, 2005;Fagerli et al, 2005;Chowdhury et al, 2000). A further 8 studies were of moderate quality and met 5079% of the quality criteria (scored B) (Fleming et al, 2008;Brown et al, 2006;Duthie-Nurse, 1998;Narayan and Rea, 1997;Kelleher and Islam, 1994;Povlsen et al, 2005;Naeem, 2003;Sedgwick et al, 2003).…”

“…A total of 13 studies reported strict adherence to cultural norms (Kelleher and Islam, 1994;Narayan and Rea, 1997;Greenhalgh et al, 1998Greenhalgh et al, , 2006Greenhalgh et al, , 2011Chowdhury et al, 2000;Naeem, 2003;Hjelm et al, 2005;Lawton et al, 2005Lawton et al, , 2006bLawton et al, , 2008Stone et al, 2005;Fleming et al, 2008;Gonzalez, 2008;Kohinor et al, 2011). Participants in ten of these studies were of South Asian origin (Narayan and Rea, 1997;Kelleher and Islam, 1994;Lawton et al, 2005Lawton et al, , 2006bLawton et al, , 2008Stone et al, 2005;Chowdhury et al, 2000;Greenhalgh et al, 1998Greenhalgh et al, , 2006Greenhalgh et al, , 2011Fleming et al, 2008;Naeem, 2003).…”

“…Participants in ten of these studies were of South Asian origin (Narayan and Rea, 1997;Kelleher and Islam, 1994;Lawton et al, 2005Lawton et al, , 2006bLawton et al, , 2008Stone et al, 2005;Chowdhury et al, 2000;Greenhalgh et al, 1998Greenhalgh et al, , 2006Greenhalgh et al, , 2011Fleming et al, 2008;Naeem, 2003). They had strong traditions with regard to food, and their traditional dishes generally had a very high content of fat or deep-fried food despite awareness of the detrimental effects of these on health and wellbeing.…”

“…Religious beliefs (Muslim, Christian, Hindu and Sikh) and practices were reported in 12 studies (Greenhalgh et al, 1998(Greenhalgh et al, , 2011Kelleher and Islam, 1994;DuthieNurse, 1998;Hjelm et al, 2005;Lawton et al, 2005Lawton et al, , 2006aLawton et al, , 2007Lawton et al, , 2008Naeem, 2003;Kohinor et al, 2011;Stone et al, 2005;Gonzalez, 2008;Chowdhury et al, 2000). Eleven of these studies reported that participants, especially Muslims, demonstrated a strict commitment to religious beliefs about food and fasting during Ramadan, and diabetes self-management was a secondary consideration.…”