Brown Ken, Avis Mark, Hubbard Michelle
Family Medical Centre, 171 Carlton Road,Nottingham, NG3 2FW.
Br J Gen Pract. 2007 Jun;57(539):461-9.
There is evidence that African-Caribbean people with diabetes have poorer outcomes than other individuals with diabetes. It is not fully understood why this happens.
To gain an understanding of how health beliefs influence the way African-Caribbean people with diabetes manage their illness.
Qualitative study using one-to-one interviews.
Inner-city Nottingham during 2003-2004.
A purposive sample of 16 African-Caribbean people with type 2 diabetes. Participants took part in semi-structured in-depth interviews which were audio-taped recorded and transcribed. Transcripts were analysed for emergent themes and validity was checked by an independent researcher and through discussion with a local community group. Data were managed using NVivo software.
Participants were strongly influenced by memories of growing up in the Caribbean, migration to the UK, and friends' and families' accounts of diabetes, as well as their own experiences of the illness. Knowledge and understanding of diabetes was sometimes poor. There was some mistrust in the value of advice and treatment offered by professionals and a preference for natural treatments. Health professionals were generally praised but some interviewees felt that the NHS did not cater properly for black people. Insulin treatments were feared and diet- or tablet-controlled diabetes was seen by some as a mild form that did not warrant serious concern.
These findings have implications for how some people manage their diabetes and how diabetes care is delivered to the African-Caribbean community.
有证据表明,患有糖尿病的非裔加勒比人比其他糖尿病患者的治疗效果更差。目前尚不完全清楚为何会出现这种情况。
了解健康观念如何影响非裔加勒比糖尿病患者管理自身疾病的方式。
采用一对一访谈的定性研究。
2003年至2004年期间的诺丁汉市中心城区。
从16名患有2型糖尿病的非裔加勒比人中进行目的抽样。参与者参加了半结构化的深入访谈,访谈进行了录音并转录。对转录文本进行分析以找出新出现的主题,并由一名独立研究人员以及通过与当地社区团体讨论来检查效度。使用NVivo软件管理数据。
参与者深受在加勒比地区成长的记忆、移民到英国的经历、朋友和家人对糖尿病的描述以及他们自己的患病经历的影响。对糖尿病的知识和理解有时较差。对专业人员提供的建议和治疗的价值存在一些不信任,并且更倾向于自然疗法。健康专业人员总体上受到赞扬,但一些受访者认为国民保健制度没有妥善照顾黑人。人们害怕胰岛素治疗,一些人认为通过饮食或药物控制的糖尿病是一种轻症形式,不值得严重关注。
这些发现对一些人如何管理他们的糖尿病以及如何向非裔加勒比社区提供糖尿病护理具有启示意义。