Choi Tammie S T, Walker Karen Z, Palermo Claire
Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, Australia.
Health Soc Care Community. 2018 Mar;26(2):e225-e232. doi: 10.1111/hsc.12501. Epub 2017 Sep 19.
The aim of this study was to understand the experience of Chinese migrants living with type 2 diabetes in Australia and explore their culturally specific diabetes management needs, habits and expectations in the Australian context to help shape an Australian Chinese diabetes service. A case study approach was employed across two Australian cities (Melbourne and Sydney), using participant-observations and qualitative interviews. Purposive sampling was used to find diabetes education sessions for observation and facilitators for interviews before snowball technique was used to identify relevant clinicians. Thematic analysis with pattern matching was used for data analysis. A total of 18 participant-observations and 12 interviews were conducted. Chinese migrants appeared to experience multiple barriers in accessing the Australian diabetes care service further complicated by the mismatch between the expectations of Chinese patients and the services available. Chinese patients were observed to be collectivistic-orientated relying on friends for diabetes management. While health professionals appeared to be perceived as a source of reputable health information, they often did not provide ongoing support. When professional support was limited, Chinese patients adopted alternative strategies to address their diabetes, which often involved seeking help and information from peers. Some of this information was non-reputable, potentially resulting in detrimental health outcomes. In conclusion, redesigning diabetes care services in line with the principles of collectivism may more appropriately match the Chinese migrants' expectations and needs, and better support them in their diabetes journey.
本研究的目的是了解在澳大利亚生活的2型糖尿病华裔移民的经历,并探索他们在澳大利亚背景下特定文化的糖尿病管理需求、习惯和期望,以帮助塑造一项面向华裔澳大利亚人的糖尿病服务。采用案例研究方法,在澳大利亚的两个城市(墨尔本和悉尼)开展研究,运用参与观察法和定性访谈。在使用滚雪球技术确定相关临床医生之前,采用目的抽样法寻找用于观察的糖尿病教育课程和用于访谈的主持人。采用带有模式匹配的主题分析法进行数据分析。共进行了18次参与观察和12次访谈。华裔移民在获得澳大利亚糖尿病护理服务方面似乎遇到了多重障碍,而中国患者的期望与现有服务之间的不匹配使这些障碍更加复杂。观察发现,中国患者具有集体主义倾向,依靠朋友进行糖尿病管理。虽然卫生专业人员似乎被视为可靠健康信息的来源,但他们往往不提供持续支持。当专业支持有限时,中国患者会采取替代策略来应对糖尿病,这通常包括向同龄人寻求帮助和信息。其中一些信息不可靠,可能会导致有害的健康后果。总之,按照集体主义原则重新设计糖尿病护理服务可能更符合华裔移民的期望和需求,并在他们的糖尿病治疗过程中更好地支持他们。