在巴基斯坦，2 型糖尿病患者的生活体验：文化和家庭在身体活动中的作用。
Experiences of living with type 2 diabetes in Pakistan: the role of culture and family in physical activity.
机构信息
Institute of Applied Psychology, University of the Punjab, Lahore, Pakistan.
School of Sport and Health Sciences, University of Brighton, Brighton, UK.
出版信息
Int J Equity Health. 2022 Jul 29;21(1):103. doi: 10.1186/s12939-022-01706-4.
BACKGROUND
Diabetes-related guidelines recommend lifestyle changes for people living with type 2 diabetes (PLwD). In South Asian (SA) families, cultural and contextual expectations often influence people's decisions. However, broad explanations provided in the existing literature and theories concerning family involvement can increase the chance of health professionals overlooking the complexities of family roles within SA communities. Previous literature has identified the need to examine the perspectives of PLwD and their family members in Pakistan to shed light on factors perceived to support and hinder recommended physical activity (PA) to manage type 2 diabetes. This study explored (1) the enablers of and barriers to PA in the context of PLwD in Pakistan and (2) family involvement regarding PLwD's engagement with PA.
METHODS
Semi-structured interviews were conducted with 30 PLwD and 17 family members of PLwD who were recruited in metropolitan Lahore (Pakistan) and primarily used state health services available to relatively disadvantaged populations. Interviews were transcribed and analysed using thematic analysis.
RESULTS
Three themes were identified: (1) Going for a walk as a feasible PA; (2) the role of family members in influencing PA; and (3) gender differences and cultural acceptability of an activity. PA enablers for PLwD consist of gender-specific opportunities for activity facilitated by peers and family members. Culturally acceptable opportunities for PA in Pakistan for specific genders and age groups within the socio-cultural context constituted an essential factor. In this study, all women with diabetes described walking as the only acceptable form of PA, whereas some men mentioned other activities such as running, playing cricket, and cycling.
CONCLUSIONS
Medical guidelines must consider patients' daily routines, account for cultural and familial expectations of different genders and age groups, and address social and physical barriers encountered by these different groups to encourage PA among PLwD in SA cultures.
背景
糖尿病相关指南建议 2 型糖尿病患者（PLwD）改变生活方式。在南亚（SA）家庭中，文化和背景期望通常会影响人们的决策。然而，现有文献和理论中关于家庭参与的广泛解释增加了卫生专业人员忽视 SA 社区中家庭角色复杂性的机会。先前的文献已经确定需要研究 PLwD 及其在巴基斯坦的家庭成员的观点，以阐明支持和阻碍推荐体力活动（PA）来管理 2 型糖尿病的因素。本研究探讨了（1）PLwD 在巴基斯坦的 PA 促进因素和障碍因素，以及（2）家庭对 PLwD 参与 PA 的参与情况。
方法
在巴基斯坦的大都市拉合尔（Lahore）招募了 30 名 PLwD 和 17 名 PLwD 的家庭成员进行半结构式访谈，他们主要使用面向相对弱势群体的国家卫生服务。访谈记录被转录并使用主题分析进行分析。
结果
确定了三个主题：（1）散步作为一种可行的 PA；（2）家庭成员在影响 PA 方面的作用；（3）性别差异和活动的文化可接受性。PLwD 的 PA 促进因素包括由同龄人以及家庭成员为特定性别提供的具体活动机会。在巴基斯坦，符合社会文化背景的特定性别和年龄组的文化可接受的 PA 机会是一个重要因素。在本研究中，所有患有糖尿病的女性都将散步描述为唯一可接受的 PA 形式，而一些男性则提到了其他活动，如跑步、板球和骑自行车。
结论
医疗指南必须考虑到患者的日常生活，考虑到不同性别和年龄组的文化和家庭期望，并解决这些不同群体在 PA 中遇到的社会和身体障碍，以鼓励在 SA 文化中 PLwD 进行 PA。
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