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Beliefs, family play role in diabetes management of South Asians in UK
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Clinicians treating South Asian adults with diabetes must account for their family support system and cultural beliefs, both of which may influence the way patients manage their disease, according to research in BMC Family Practice.
In a mixed methods study of South Asian adults with diabetes living in the United Kingdom, researchers found that many patients, particularly first-generation immigrants, held fatalistic beliefs about the disease, had to rely on their English-speaking children to help them research the condition, or relied on incorrect information about herbal remedies or proper foods to eat.
“The sociocultural context is important in shaping beliefs about diabetes and self-management behaviors in the British South Asian population,” Neesha Patel, MD, a research associate and health psychologist at the University of Manchester, told Endocrine Today. “Beliefs about diabetes need to be accounted for in routine diabetes care in order to identify barriers to effective self-management.”
Neesha Patel
Patel and colleagues at other institutions analyzed data from 67 participants (mean age, 61 years) recruited using random and purposive sampling. All participants completed a questionnaire measuring illness beliefs, fatalism, health outcomes and demographics; 37 participants completed a social network survey and semi-structured interviews. Researchers used the summary of diabetes self-care activities (SDSCA) scale to measure the frequency of diabetes-related self-management activities.
Analysis of the qualitative study revealed that many patients held fatalistic beliefs about diabetes, in particular first-generation immigrant British South Asians. British-born South Asians, however, were more likely to attribute diabetes control to lifestyle factors, such as diet and exercise.
In addition, some women noted in interviews that their children helped provide information related to diet, in part because they better understood English and knew how to use the Internet.
“Some men also described how their wife or other females in their network, for instance their mother or sisters, provided support with diabetes medications and strongly believed that other people in the family should take responsibility for ensuring people with diabetes take their medication and eat the right foods,” the researchers wrote.
Many study participants also discussed using alternative therapies in conjunction with prescribed medications, including eating karalla (also known as bitter melon), aloe vera or mixtures of various herbs to help regulate glucose levels.
“Education guidelines need to be developed for health care practitioners on how to account for cultural health beliefs in British South Asians using psychological measures, in order to provide culturally sensitive care and inform behavior change interventions,” Patel said.
Further research into diabetes-related beliefs and the role of social networks between other ethnic groups is needed to inform service design for diabetes care, according to Patel.
“Research into the effectiveness of challenging cultural health beliefs in consultation, using psychological techniques and the impact of this on diabetes health outcomes could also potentially be another area for future research,” she said. - by Regina Schaffer
Disclosure: Patel reports receiving honorarium payments from Sanofi and Janssen. Please see the full study for a list of all other authors’ relevant financial disclosures.
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