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Disclosure of type 1 diabetes status: a qualitative study in a mixed South Asian population in central England
- Authors:
- PATEL Naina, et al
- Journal article citation:
- Diversity in Health and Care, 8(4), 2011, pp.217-223.
- Publisher:
- Radcliffe Publishing
The findings reported here are drawn from a larger study of insulin therapy among South Asian adults with Type 1 diabetes. This paper focuses on the perceptions of this group of patients about other people’s attitudes to insulin therapy and the impact of these attitudes on their status as individuals who require insulin. The 15 participants were recruited, through specialist care clinics in Leicester. Some of those interviewed described experiencing and observing negative perceptions and views about diabetes and the use of insulin. These perceptions did not deter participants from revealing their diabetes in certain situations. Disclosure was seen as beneficial in terms of work and social occasions at which they would need to inject, and in terms of ensuring that they would receive insulin during hypoglycaemic episodes. However, disclosing diabetes was sometimes problematic in the context of marriage prospects. The authors conclude that the disclosure of diabetes is influenced by the cultural and social contexts in which people live and work. Although the participants generally adopted a pragmatic approach to disclosure, because this facilitated self-care, they were less inclined towards disclosure in relation to marriage prospects. The authors suggest that this may have implications for both the management of diabetes and psychological well-being.
Application of evidence-based fall-prevention strategies to culturally and linguistically diverse older adult populations in Australia
- Authors:
- PAUSENBERGER Eva, HAINES Terry P.
- Journal article citation:
- Diversity in Health and Care, 8(4), 2011, pp.225-237.
- Publisher:
- Radcliffe Publishing
Despite the fact that older people from culturally and linguistically diverse populations will become an increasing percentage of Australia's population, they are underrepresented in studies of fall prevention. This study examined perceptions regarding falls, strategies for preventing falls, barriers to participation in fall-prevention strategies, and responses to a 15-week exercise and education based fall prevention programme among a diverse group of older adults from Cambodian, Croatian, Turkish and Arabic speaking populations living in Melbourne. Pre and post-tests were designed to assess past experience of falling, daily routine, self-perceived risk of falling, self-reported awareness of interventions, strategies believed to prevent falls and barriers to using these. The participants initially had a simplistic approach, feeling that they knew how to prevent falls, and that strategies such as 'being careful' and 'using mobility supports' were the most effective means of preventing them. Following the intervention programme, they recognised the importance of exercise-based interventions, but there was no immediate change in the rate of falls or participation in activities of daily living. The authors conclude that the programme may have changed attitudes towards exercise as an effective means of preventing falls. However further research is needed to determine whether the benefits of interventions developed and tested among homogenous populations translate to these more diverse patient groups.
Using community-based participatory research (CBPR) with ethno-cultural groups as a tool to develop culturally and linguistically appropriate asthma educational material
- Authors:
- POURESLAMI Iraj, et al
- Journal article citation:
- Diversity in Health and Care, 8(4), 2011, pp.203-215.
- Publisher:
- Radcliffe Publishing
Educational interventions for new immigrants are often developed without input from those involved. The authors examined how community-based participatory research could be used in the development of patient-related educational material on order to enhance the self-management of asthma within these communities. Concept development focus groups were used to reveal participants' beliefs, issues, and concerns about asthma and its management. A total of 29 adult asthma patients of Latin American, Chinese, Iranian and Punjabi descent living in the Vancouver area took part in these group sessions. The aim was to gather information for the production of a series of asthma-related educational video clips and pamphlets that were developed in a community's specific language and reflected its cultural beliefs and practices. The focus group methodology was found to be a useful strategy for developing culturally and content relevant educational interventions for members of new immigrant groups that are typically under-represented in research about asthma and related issues in Canada. The information gathered will be used to help understand the relationship between culture, language and the management and care of asthma. The authors encourage the use of participatory research where community events and social gatherings are used as practical communication methods to increase ethno-cultural awareness about the health prevention and management.
Sickle cell in the university curriculum: a survey assessing demand for open-access educational materials in a constructed community of interest
- Authors:
- ROLFE Vivien, FOWLER Mark, DYSON Simon M.
- Journal article citation:
- Diversity in Health and Care, 8(4), 2011, pp.239-249.
- Publisher:
- Radcliffe Publishing
Sickle–cell disease is being increasingly recognised as a major public health issue. It is an important topic in many university curricula across a number of biomedical fields and an exemplar for exploring a number of scientific technologies. However the authors point to a lack of knowledge about sickle cell disease among health professionals that they believe has contributed to tensions in delivering appropriate health care. An internet survey involving 226 respondents from sickle-cell communities of interest (science educators, health professionals and voluntary groups for sickle cell) found greater awareness of educational resources on popular internet sites than on formally constituted academic repositories for open education resources. There was a demonstrate demand for open education resources on the topic providing the quality assurance of such material is addressed. A project developing such sickle-cell resources within a repository of open education resources has been proposed to and funded by the UK's Higher Education Academy (HEA) and Joint Information Systems Committee (JISC). From 2011, 'Sickle Cell Open: Online Topics and Education Resources (SCOOTER)' will develop sickle-cell open education resources, which can be found on its website ( www.sicklecellanaemia.org ).
Hidden lives: the importance of recognising the needs and experiences of older lesbians and gay men within healthcare practice
- Authors:
- FENGE Lee-Ann, HICKS Christina
- Journal article citation:
- Diversity in Health and Care, 8(3), 2011, pp.147-154.
- Publisher:
- Radcliffe Publishing
There is a relative lack of information about older lesbians and gay men living in the UK, a consequent lack of awareness and training around diversity in ageing and the risk of discrimination on grounds of age and sexual orientation by care providers. The authors believe that the provision of respectful, compassionate, accessible healthcare is as important to LGBT people as it is to anyone else. They suggest that healthcare practitioners need a greater understanding of the experiences of older gay men and lesbians if their diverse needs are to be met. This paper discusses the findings of a participative research project involving older (age 50+) lesbians and gay men living in the South-West of England. The Gay and Grey project analysed 91 responses to a quantitative questionnaire and 30 qualitative interviews. Key themes include issues of 'coming out', disclosing identities and concerns about heterosexism in care. These are discussed in terms of the need to adopt a more person-centred approach within healthcare that promotes an emphasis on valuing individual identity and diversity.
Black, minority ethnic and refugee (BMER) communities and the National Dementia Strategy: the London experience
- Author:
- TRUSWELL David
- Journal article citation:
- Diversity in Health and Care, 8(2), June 2011, pp.113-119.
- Publisher:
- Radcliffe Publishing
The National Dementia Strategy (NDS) is a five year plan that sets out initiatives designed to improve awareness and knowledge of the issue, ensure early diagnosis and improve GP training, services in General hospitals and Care homes as well as services aimed at Carers. While recent government policy in health and social care has highlighted the need for local partnerships across sectors to deliver improved healthcare and reduce health inequalities, there has been limited research on dementia in minority ethnic groups. Despite the cosmopolitan mix of the capital's population, black, minority ethnic and refugee (BMER) communities have historically been marginalised from strategic health initiatives. This article highlights the work undertaken by the London Region Dementia Implementation Task Group to support commissioner engagement with BMER communities in planning dementia services, and to help these communities to have more influence on the implementation of the NDS in London. The article ends by describing the potential health access and economic risks of failing to improve the involvement of BMER communities when planning dementia care.
Settling in New Zealand: the well-being of Indian immigrant women as shaped by their children
- Author:
- NAYAR Shoba
- Journal article citation:
- Diversity in Health and Care, 8(2), June 2011, pp.93-101.
- Publisher:
- Radcliffe Publishing
New Zealand is witnessing an increase in Indian female immigrants. Settling in to their new country affects their well-being and the ways in which they engage with society. This stud, drawing on interviews with 25 Indian immigrant women, examined how they created a place for themselves and their families through their choice of, and engagement in, everyday activities. The data were analysed using dimensional analysis, which revealed that as the women settled in New Zealand, their choice of activities and thus their well-being was influenced by a salient condition, namely number and age of children. Results indicated that, within the home, the women focused on enacting cultural traditions to ensure that their children maintained links with their Indian heritage. As the children grew older however, they found themselves shifting towards activities more reflective of New Zealand practices, believing that their children had an embedded understanding of the Indian culture. Therefore, the number and age of children at the time of immigration influenced which activities the women chose to participate in and how they maintained their well-being in New Zealand.
Ethnicity, gender and mental health
- Authors:
- ROBINSON Mark, KEATING Frank, ROBERTSON Steve
- Journal article citation:
- Diversity in Health and Care, 8(2), June 2011, pp.81-92.
- Publisher:
- Radcliffe Publishing
This study investigated specific black and minority ethnic (BME) men's beliefs about mental health and their experiences of mental health services. It considered the complexities of men's gendered identities and the interplay of these with race, ethnicity and cultural influences. Twelve focus groups consisting of men from specific BME groups were held in London and the West Midlands, and the groups included: African-Caribbean, African, Indian, Pakistani, Bangladeshi and Chinese. The findings include BME men's narratives of well-being, which highlight the importance of relational and normative aspects and the influences of gender and ethnicity on aspirations, identity and values. Factors contributing to mental illness relate to gendered and racialised social expectations, economic factors, generational and gender issues, and experiences of services. The authors concluded that a mix of gendered and racialised experiences, including social stigma, the coercive power of institutions, and men's own perceptions of services contributed to cycles of disengagement and isolation for marginalised BME men with mental health problems.
Supporting the independence and well-being of adults through a universal service: diversity, difference and proportionate universalism
- Authors:
- ROY Alastair, NEWBIGGING Karen
- Journal article citation:
- Diversity in Health and Care, 8(2), June 2011, pp.71-80.
- Publisher:
- Radcliffe Publishing
'Help Direct', a new initiative in Lancashire, England, is a new universal service which aims to give people the right information or advice, individual guidance or practical help before a problem becomes a crisis. This paper reports on research investigating the views of relevant people who might use the service. The research had three aims – to explore how potential users understand well-being, to explore the possible contribution of the service to maintaining independence and supporting well-being, and to identify factors that might facilitate and inhibit the use of such a service for different groups. One hundred participants in 11 focus groups were convened in collaboration with community organisations. The paper describes the ways in which different groups conceptualise well-being and help seeking, before examining the implications of delivering a universal service to diverse communities in relation to the concept of proportionate universalism.
'Third-age' workers caring for adults and older people in England: findings from secondary analysis of the National Minimum Data Set for Social Care
- Authors:
- HUSSEIN Shereen, MANTHORPE Jill
- Journal article citation:
- Diversity in Health and Care, 8(2), June 2011, pp.103-112.
- Publisher:
- Radcliffe Publishing
Even though the UK has implemented policies to combat the effects of age discrimination, ageism is still evident in the hiring, retention and career development opportunities of older workers. As such, this paper investigated the current stock of older workers in the adult social care sector in England. Data was drawn from the National Minimum Data Set for Social Care, and included 80,000 samples of workers. The paper examined the changing profile of three closely related third-age cohorts and investigate the similarities and differences between those working in the care sector aged 60 years or older, and two younger age groups, namely 50-54 and 55-59 years. Analysis revealed that workers in the age range 50-75 years constitute nearly 40% of the whole workforce. In particular, the impact of the oldest third-age group, aged 60-75 years, is substantial, contributing to around 12% of the total. The implications of this diversity are explored.