Ann Mitchell

What does Type 2 diabetes mean for Guyanese women living in the UK

Guyana• on north east coast of South

America

• 83,000 square miles

• Population <1 million

• Highly complex ethnic group with a great diversity of beliefs

• 90% Asian and African

Who are Guyanese people?

Migration to England

• Political crisis in Guyana during 1960’s and 70’s

• Severe shortage of nurses (Behishon et al 1995

• For academic study

Aims of study

• To explore how Guyanese women who migrated to UK, make sense of, experience and manage Type 2 diabetes

• To assist health care practitioners and policy makers to deliver appropriate diabetic services to these women

Rationale for study• Type 2 diabetes is a long term condition with serious

negative consequences

• People from South Asian descent and African Caribbean ethnic groups are particularly at risk (DH 2007)

• By focusing on a specific minority population (Guyanese), rich insightful data can be obtained which have the potential to provide insight into the needs of a broader ethnic population

Justification for study

• This study looks to develop a rich insight into the perspectives of Guyanese migrant women who have been diagnosed with type 2 diabetes

• Aim is to obtaining more valid and better informed insights into their values, thoughts, feelings and behaviours related to their diabetes management

…by asking the key questions:

• Do cultural beliefs and standpoints influence their diabetes management behaviour?

• Do their spiritual assumptions influence their health seeking behaviour?

• Are there any social pressures that influence their help- seeking behaviour?

Background to study• Type 2 diabetes has a long- and well-established

literature both generally and in terms of specific minority groups

• Management by conventional medicine involves compliance with prescribed medication and lifestyle change

• Health beliefs and diverse influences arising from biomedicine and complementary and alternative medicine may dictate whether individuals seek help or not.

Different discourses framing Type 2 diabetes

• Biomedical model

• Alternative health systems – such as Ayurvedic or Chinese Traditional Medicines

• Complementary therapies – such as herbalism

• Cultural challenges – such as a traditional diet, HIV-AIDS

• Spiritual beliefs, such as in obeah

Methodology - Social constructionist approach

• Qualitative study that looks to the meaning of experiences and accepts multiple knowledges

• Small purposeful sample

• Research methods:

• focus groups

• biographical narrative interviews

• diaries

• Analysis – grounded theory approach

Preliminary Findings

• The biomedical model is the commonly preferred choice of treatment in these populations

• However sometimes a combination of complementary and alternative medicine chosen

• Ethnic minority women are held to have an ‘inadequate knowledge’ of this condition

• Cultural standpoint can influence diabetes management

• Spiritual beliefs can also influence management

Conclusions

• Guyanese women are under-researched – there is a need to capture their lost voices rather than treating them as one homogenous group

• Guyanese migrant women are an ageing population and so may require specific health care services

• Cultural and spiritual standpoints are important when services are provided for these women to help them manage their diabetes

References• Anderson R M and Funnell M M (2000) Compliance and Adherence are Dysfunctional

concepts in Diabetes care. The Diabetes Educator. 26. No 44. p.597 – 604.• Awah P H, Unwin N and Phillimore P (2008) Cure or control; complying with

biomedical regime of diabetes in Cameroon. BMC Health Services Research. 8:43. p.1-11.

• BMA (2004) Diabetes Mellitus – An update for Health Care Professionals. BMA publication unit.

• Chacko E (2003) Culture and therapy: complementary strategies for treatment of Type 2 diabetes in urban setting in Kerala, India. Social Science and Medicine. 56, p.1087-1098.

• Department of Health (2007) Working together for better diabetes care. London: DH• Finlay L (2006) Qualitative Research for Allied Health Professionals.Ed. Chichester:

John Wiley