Kofahl C, von dem Knesebeck O, Hollmann J, Mnich E
Institut für Medizinische Soziologie, Sozialmedizin und Gesundheitsökonomie (IMSG), Universitätsklinikum Hamburg Eppendorf.
Gesundheitswesen. 2013 Dec;75(12):803-11. doi: 10.1055/s-0033-1334936. Epub 2013 Mar 19.
Only few findings are available for the large group of type 2 diabetics whose origin is not German. This article investigates 1) the degree of diabetes-knowledge among diabetics of Turkish origin, and 2) factors that influence this knowledge and the competencies with handling the disease.
In cooperation with 15 medical practices 294 diabetics of Turkish origin were interviewed in person by Turkish-speaking interviewers. There is no established concept for this population to measure their health literacy, therefore we adopted some questions from other tests and added our own items. Besides diabetes knowledge tests with closed and open questions the interviewees had to undertake a reading test and a screening test on German language skills. Socio-demographics and the attendance at diabetes trainings were gathered as well, and analysed in principal component analyses and multiple regressions.
On average, the respondents had lived in Germany for 32 years, but 40% of them do not speak German. 25% never went to school and 21% cannot read or write (Turkish). Even though 60% took part in a diabetes training course, it appears that knowledge about the disease is scarce: only 15% could sufficiently explain their diabetes disease with their own words. A dimensional analysis helps to differentiate "theoretical" and "behavioural relevant" knowledge about diabetes. Theoretical knowledge is strongly associated with education, German language skills and attending a training course, whereas competencies that are relevant to the behaviour only are associated with participation in diabetes training courses. The educational effects remain on a rather low level and cannot compensate the fact that theoretical knowledge about diabetes depends on education. Hence, the overall (too) low level of knowledge on health and diabetes is only marginally improved.
Education, attending a diabetes training course and language skills are the main factors for explaining poor knowledge about diabetes. A tailor-made training course--considering people's educational background--for the large group of people of Turkish origin could lead to improvements. Moreover, the neglected potential of self-help groups should be developed, as only one person of the reviewed population reported to search for support here.
对于非德国裔的2型糖尿病患者这一庞大群体,目前仅有少量研究结果。本文调查了:1)土耳其裔糖尿病患者的糖尿病知识水平;2)影响该知识水平以及疾病应对能力的因素。
与15家医疗诊所合作,由会说土耳其语的访谈者对294名土耳其裔糖尿病患者进行了面对面访谈。对于这一人群,尚无成熟的健康素养衡量概念,因此我们借鉴了其他测试中的一些问题,并添加了我们自己的项目。除了有封闭式和开放式问题的糖尿病知识测试外,受访者还必须参加一项阅读测试和一项德语语言技能筛查测试。同时收集了社会人口统计学信息以及参加糖尿病培训的情况,并通过主成分分析和多元回归进行分析。
受访者平均在德国生活了32年,但其中40%不会说德语。25%从未上过学,21%不会读写(土耳其语)。尽管60%参加了糖尿病培训课程,但对该疾病的了解似乎仍然匮乏:只有15%能够用自己的语言充分解释自己的糖尿病病情。维度分析有助于区分关于糖尿病的“理论”知识和“行为相关”知识。理论知识与教育程度、德语语言技能和参加培训课程密切相关,而仅与行为相关的能力则与参加糖尿病培训课程有关。教育效果仍处于较低水平,无法弥补糖尿病理论知识依赖于教育程度这一事实。因此,健康和糖尿病方面的总体(仍然)较低知识水平仅略有改善。
教育程度、参加糖尿病培训课程和语言技能是解释糖尿病知识匮乏的主要因素。为大量土耳其裔人群量身定制的培训课程——考虑到人们的教育背景——可能会带来改善。此外,应挖掘自助小组被忽视的潜力,因为在所调查的人群中只有一人表示在此寻求支持。