ann mitchell what does type 2 diabetes mean for guyanese women living in the uk
Post on 21-Dec-2015
215 views
TRANSCRIPT
Ann Mitchell
What does Type 2 diabetes mean for Guyanese women living in the UK
Guyana• on north east coast of South
America
• 83,000 square miles
• Population <1 million
• Highly complex ethnic group with a great diversity of beliefs
• 90% Asian and African
Who are Guyanese people?
Migration to England
• Political crisis in Guyana during 1960’s and 70’s
• Severe shortage of nurses (Behishon et al 1995
• For academic study
Aims of study
• To explore how Guyanese women who migrated to UK, make sense of, experience and manage Type 2 diabetes
• To assist health care practitioners and policy makers to deliver appropriate diabetic services to these women
Rationale for study• Type 2 diabetes is a long term condition with serious
negative consequences
• People from South Asian descent and African Caribbean ethnic groups are particularly at risk (DH 2007)
• By focusing on a specific minority population (Guyanese), rich insightful data can be obtained which have the potential to provide insight into the needs of a broader ethnic population
Justification for study
• This study looks to develop a rich insight into the perspectives of Guyanese migrant women who have been diagnosed with type 2 diabetes
• Aim is to obtaining more valid and better informed insights into their values, thoughts, feelings and behaviours related to their diabetes management
…by asking the key questions:
• Do cultural beliefs and standpoints influence their diabetes management behaviour?
• Do their spiritual assumptions influence their health seeking behaviour?
• Are there any social pressures that influence their help- seeking behaviour?
Background to study• Type 2 diabetes has a long- and well-established
literature both generally and in terms of specific minority groups
• Management by conventional medicine involves compliance with prescribed medication and lifestyle change
• Health beliefs and diverse influences arising from biomedicine and complementary and alternative medicine may dictate whether individuals seek help or not.
Different discourses framing Type 2 diabetes
• Biomedical model
• Alternative health systems – such as Ayurvedic or Chinese Traditional Medicines
• Complementary therapies – such as herbalism
• Cultural challenges – such as a traditional diet, HIV-AIDS
• Spiritual beliefs, such as in obeah
Methodology - Social constructionist approach
• Qualitative study that looks to the meaning of experiences and accepts multiple knowledges
• Small purposeful sample
• Research methods:
• focus groups
• biographical narrative interviews
• diaries
• Analysis – grounded theory approach
Preliminary Findings
• The biomedical model is the commonly preferred choice of treatment in these populations
• However sometimes a combination of complementary and alternative medicine chosen
• Ethnic minority women are held to have an ‘inadequate knowledge’ of this condition
• Cultural standpoint can influence diabetes management
• Spiritual beliefs can also influence management
Conclusions
• Guyanese women are under-researched – there is a need to capture their lost voices rather than treating them as one homogenous group
• Guyanese migrant women are an ageing population and so may require specific health care services
• Cultural and spiritual standpoints are important when services are provided for these women to help them manage their diabetes
References• Anderson R M and Funnell M M (2000) Compliance and Adherence are Dysfunctional
concepts in Diabetes care. The Diabetes Educator. 26. No 44. p.597 – 604.• Awah P H, Unwin N and Phillimore P (2008) Cure or control; complying with
biomedical regime of diabetes in Cameroon. BMC Health Services Research. 8:43. p.1-11.
• BMA (2004) Diabetes Mellitus – An update for Health Care Professionals. BMA publication unit.
• Chacko E (2003) Culture and therapy: complementary strategies for treatment of Type 2 diabetes in urban setting in Kerala, India. Social Science and Medicine. 56, p.1087-1098.
• Department of Health (2007) Working together for better diabetes care. London: DH• Finlay L (2006) Qualitative Research for Allied Health Professionals.Ed. Chichester:
John Wiley