Diabetes Complications & Preventions Program, St. Joseph's Healthcare, Hamilton, Ontario, Canada.
School of Nursing, McMaster University, Hamilton, Ontario, Canada.
Can J Diabetes. 2019 Aug;43(6):445-452. doi: 10.1016/j.jcjd.2019.04.010. Epub 2019 May 18.
Diabetes mellitus is one of the most common chronic diseases worldwide and a leading cause of morbidity and mortality. A high prevalence of type 2 diabetes mellitus has been noted among the South Asian population, in general, and migrant South Asians. Self-management is considered a proponent to the management of diabetes. Although empirical evidence supports such interventions, little is known regarding the cultural congruency of such interventions for diverse cultural and ethnic groups, particularly South Asians. Our purpose was to determine the effectiveness of diabetes self-management education (DSME) and diabetes self-management support (DSMS), interventions on migrant South Asian's glycated hemoglobin (A1C) levels and whether DSME and DSMS interventions are culturally tailored to the migrant South Asian population. In this study, a systematic review, with narrative synthesis, was conducted. Data were extracted on the study, participant, and intervention characteristics and the cultural congruity using Leininger's sunrise model. Four studies meeting the inclusion criteria were included. Overall, most (75%) of the DSME and DSMS interventions were not effective in reducing A1C levels. Specific to cultural congruity of the interventions, all studies delivered the intervention based on the participant's preferred language and incorporated culturally sensitive dietary information primarily by persons of the same cultural and ethnic background. However, little information was presented on the provision and integration of culturally congruent care. Findings highlight the importance of rethinking the way in which South Asians are labelled as a homogenous group and accounting for such differences when adapting and designing culturally tailored DSME and or DSMS interventions in clinical practice.
糖尿病是全球最常见的慢性疾病之一，也是发病率和死亡率的主要原因。一般来说，南亚人群，包括移民南亚人群，2 型糖尿病的患病率较高。自我管理被认为是糖尿病管理的一个支持者。尽管有经验证据支持这些干预措施，但对于不同文化和族裔群体，特别是南亚人，这些干预措施的文化适宜性知之甚少。我们的目的是确定糖尿病自我管理教育（DSME）和糖尿病自我管理支持（DSMS）干预措施对移民南亚人的糖化血红蛋白（A1C）水平的有效性，以及 DSME 和 DSMS 干预措施是否针对移民南亚人群进行了文化调整。在这项研究中，进行了系统评价，并进行了叙述性综合。使用 Leininger 的日出模型提取了有关研究、参与者和干预措施特征以及文化适宜性的数据。有四项符合纳入标准的研究被纳入。总体而言，大多数（75%）DSME 和 DSMS 干预措施在降低 A1C 水平方面没有效果。具体来说，干预措施的文化适宜性方面，所有研究都根据参与者的首选语言提供干预措施，并主要由具有相同文化和种族背景的人提供文化敏感的饮食信息。然而，关于提供和整合文化适宜性护理的信息很少。研究结果强调了重新思考将南亚人标记为同质群体的方式的重要性，并在临床实践中适应和设计文化适宜的 DSME 和或 DSMS 干预措施时考虑到这些差异。
