Nutrition and Dietetics, HAN University of Applied Sciences, Nijmegen, The Netherlands.
Department of Public Health, Academic Medical Centre, Amsterdam, The Netherlands.
Eur J Public Health. 2019 Apr 1;29(2):208-213. doi: 10.1093/eurpub/cky186.
Diabetes type 2 is more prevalent in people from ethnic minorities in the Netherlands, and outcomes of care are worse compared with other Dutch people. Dieticians experience difficulties in managing these groups in self-management and adherence to dietary advice. The aim of this study was to explore the views regarding a healthy diet and dietetic care among ethnic minority type 2 diabetes patients.
Semi-structured interviews were held with 12 migrants with diabetes from Turkey, Morocco, Iraq and Curacao, who visited a dietician. Inclusion went on until saturation was reached. The interview guide was based on the Attitudes, Social influence and self-Efficacy (ASE) model and Kleinman's explanatory model of illness. Interviews were held in the language preferred by the respondent. Transcripts were coded and thematically analyzed.
Several respondents expected a more rigorous, directive and technical approach of the dietician. All respondents acknowledged the importance of a healthy diet. What they considered healthy was determined by culturally influenced ideas about health benefits of specific foods. Important hindrances for dietary change were lack of self-efficacy and social support. Social influences were experienced both as supportive and a hindrance.
Migrant diabetic patients' opinions about healthy food are determined by culturally influenced ideas rather than by dietary guidelines. Dutch dietary care is not tailored to the needs of these patients and should take into account migrants' expectations, cultural differences in dietary habits and specifically address the role of family.
荷兰少数民族人群中 2 型糖尿病更为普遍,其治疗效果也比其他荷兰人差。营养师在管理这些人群的自我管理和饮食建议方面存在困难。本研究旨在探讨少数民族 2 型糖尿病患者对健康饮食和饮食护理的看法。
对 12 名来自土耳其、摩洛哥、伊拉克和库拉索岛的患有糖尿病的移民进行了半结构化访谈,他们都曾就诊于营养师。纳入标准为直至达到饱和状态。访谈指南基于态度、社会影响和自我效能(ASE)模型以及 Kleinman 的疾病解释模型。访谈以受访者首选的语言进行。对访谈记录进行编码和主题分析。
一些受访者期望营养师采取更严格、更直接和更专业的方法。所有受访者都承认健康饮食的重要性。他们认为健康的饮食取决于受文化影响的对特定食物健康益处的观念。改变饮食的主要障碍是自我效能感和社会支持的缺乏。社会影响既具有支持性,也具有阻碍性。
移民糖尿病患者对健康食品的看法取决于受文化影响的观念,而不是饮食指南。荷兰的饮食护理不能满足这些患者的需求,应考虑到移民的期望、饮食习惯的文化差异,并特别解决家庭的作用。