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英国南亚裔人群中疾病认知与糖尿病自我管理的社会文化背景:一项混合方法研究

Illness beliefs and the sociocultural context of diabetes self-management in British South Asians: a mixed methods study.

作者信息

Patel Neesha R, Chew-Graham Carolyn, Bundy Christine, Kennedy Anne, Blickem Christian, Reeves David

机构信息

Centre for Endocrinology and Diabetes and Manchester Centre for Health Psychology, Institute of Human Development, The University of Manchester, Room S42, Second Floor, Zochonis Building, Brunswick Street, Manchester, M13 9PT, UK.

Primary Care and Health Sciences, and NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) West Midlands, Research Institute, Keele University, Keele, Staffordshire, ST5 5BG, UK.

出版信息

BMC Fam Pract. 2015 May 10;16:58. doi: 10.1186/s12875-015-0269-y.

Abstract

BACKGROUND

British South Asians have a higher incidence of diabetes and poorer health outcomes compared to the general UK population. Beliefs about diabetes are known to play an important role in self-management, yet little is known about the sociocultural context in shaping beliefs. This study aimed to explore the influence of sociocultural context on illness beliefs and diabetes self-management in British South Asians.

METHODS

A mixed methods approach was used. 67 participants recruited using random and purposive sampling, completed a questionnaire measuring illness beliefs, fatalism, health outcomes and demographics; 37 participants completed a social network survey interview and semi-structured interviews. Results were analysed using SPSS and thematic analysis.

RESULTS

Quantitative data found certain social network characteristics (emotional and illness work) were related to perceived concern, emotional distress and health outcomes (p < 0.05). After multivariate analysis, emotional work remained a significant predictor of perceived concern and emotional distress related to diabetes (p < 0.05). Analysis of the qualitative data suggest that fatalistic attitudes and beliefs influences self-management practices and alternative food 'therapies' are used which are often recommended by social networks.

CONCLUSIONS

Diabetes-related illness beliefs and self-management appear to be shaped by the sociocultural context. Better understanding of the contextual determinants of behaviour could facilitate the development of culturally appropriate interventions to modify beliefs and support self-management in this population.

摘要

背景

与英国普通人群相比,英属南亚裔糖尿病发病率更高,健康状况更差。已知对糖尿病的认知在自我管理中起着重要作用,但对于塑造这些认知的社会文化背景却知之甚少。本研究旨在探讨社会文化背景对英属南亚裔疾病认知及糖尿病自我管理的影响。

方法

采用混合方法。通过随机和目的抽样招募了67名参与者,他们完成了一份测量疾病认知、宿命论、健康状况和人口统计学特征的问卷;37名参与者完成了社交网络调查访谈和半结构化访谈。使用SPSS和主题分析法对结果进行分析。

结果

定量数据发现某些社交网络特征(情感和疾病应对)与感知到的担忧、情绪困扰和健康状况相关(p < 0.05)。多变量分析后,情感应对仍然是与糖尿病相关的感知担忧和情绪困扰的重要预测因素(p < 0.05)。定性数据分析表明,宿命论态度和信念影响自我管理行为,且会采用社交网络中常推荐的替代食物“疗法”。

结论

与糖尿病相关的疾病认知和自我管理似乎受到社会文化背景的影响。更好地理解行为的背景决定因素有助于制定符合文化背景的干预措施,以改变认知并支持该人群的自我管理。

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