Vision & Eye Research Unit (VERU), School of Medicine, Anglia Ruskin University, Cambridge, UK.
Shri Bhagwan Mahavir Vitreoretinal services, Sankara Nethralaya, Chennai, India.
Ethn Health. 2020 Aug;25(6):843-861. doi: 10.1080/13557858.2018.1455809. Epub 2018 Mar 26.
To determine whether barriers to diabetes awareness and self-help differ in South Asian participants of different demographic characteristics (age, gender, and literacy) with type 2 diabetes living in the United Kingdom. Six focus group discussions (FGDs) were carried out in patients who were categorized according to age (30-60 years, ≥60 years), gender (male, female) and literacy status (literate, illiterate). Data were analysed following the iterative process of thematic analysis techniques. Barriers were demographic-specific. The illiterate groups reported language as the major barrier to improved diabetes awareness and self-help. The literate groups reported that information provided by healthcare providers was general, and not specific to their diet/culture. Major barriers to adherence to the recommended diet for diabetes included: insufficient knowledge/awareness about nutritional content of food (all groups); lack of self-will to resist eating sweets, especially during weddings/festivals (literate older groups/literate younger females/illiterate older males); difficulty cooking separate meals for diabetic and non-diabetic family members (illiterate/literate older females). Other barriers to seeking advice/help ranged from not wanting to disclose their diabetes as it may affect employment/work (literate groups) to fear of being singled out at social gatherings (illiterate groups). General lack of motivation to exercise was reported by all groups. Time constraints and not knowing what/how to exercise was reported by literate younger groups whilst the illiterate older groups reported to not having suitable exercising facilities at local communities. Different barriers were also reported when accessing healthcare; language barriers (illiterate groups), restricted access to doctors' appointments/difficulty attending specific appointment slots offered by General Practitioners (literate females). Different barriers exist to improved awareness about diabetes and self-help in different patient demographics. Lack of culturally appropriate diabetes educational/awareness programs in the community appeared to be a major barrier in most older and illiterate participants while younger participants reported time constraint.
为了确定在英国居住的不同人口统计学特征（年龄、性别和文化程度）的南亚 2 型糖尿病患者中，糖尿病意识和自助障碍是否存在差异。对根据年龄（30-60 岁，≥60 岁）、性别（男性、女性）和文化程度（识字、不识字）分类的患者进行了 6 次焦点小组讨论（FGD）。数据采用主题分析技术的迭代过程进行分析。障碍具有人口统计学特异性。不识字组报告语言是提高糖尿病意识和自助能力的主要障碍。识字组报告说，医疗保健提供者提供的信息通常是一般性的，与他们的饮食/文化无关。遵守糖尿病推荐饮食的主要障碍包括：对食物营养成分的知识/意识不足（所有组）；缺乏抵制吃甜食的意志力，尤其是在婚礼/节日期间（识字的老年组/识字的年轻女性/不识字的老年男性）；为糖尿病和非糖尿病家庭成员烹饪单独的饭菜有困难（不识字/识字的老年女性/识字的年轻女性）。寻求建议/帮助的其他障碍范围从不想透露自己的糖尿病，因为这可能会影响就业/工作（识字组）到害怕在社交聚会上被挑出来（不识字组）。所有组都报告缺乏锻炼的动力。识字的年轻组报告时间限制和不知道如何锻炼，而不识字的老年组报告当地社区没有适合锻炼的设施。在获得医疗保健方面也报告了不同的障碍；语言障碍（不识字组），预约医生的机会有限/难以参加全科医生提供的特定预约时段（识字女性）。不同的患者群体在提高糖尿病意识和自助能力方面存在不同的障碍。社区缺乏文化上适当的糖尿病教育/意识计划，似乎是大多数老年和不识字参与者的主要障碍，而年轻参与者则报告时间限制。
