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Gulyani P, Rawat P, Elmi Y, Gupta S, Wan CS. Barriers and facilitators of lifestyle management among adult South Asian migrants living with chronic diseases: A mixed-methods systematic review. Diabetes Metab Syndr 2024; 18:102944. [PMID: 38281447 DOI: 10.1016/j.dsx.2024.102944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 01/05/2024] [Accepted: 01/08/2024] [Indexed: 01/30/2024]
Abstract
BACKGROUND AND AIM South Asian migrants have a higher prevalence of chronic diseases than Caucasians. Despite much literature that has explored challenges in chronic disease management amongst the South Asian population in the past decades, their chronic disease management is still suboptimal. Understanding their determinants of disease management behaviour using the Theoretical Domains Framework will inform the development of a culturally sensitive intervention relevant to consumer-end-users. This study aimed to synthesise qualitative and quantitative studies on chronic disease management among adult South Asian immigrants. METHODS A mixed-methods systematic review was conducted using electronic databases. The Mixed Methods Appraisal Tool assessed the quality of the included studies. Quantitative data were transformed into qualitative data and analysed thematically. Subthemes were mapped in the Theoretical Domains Framework presenting barriers and facilitators under each theme. RESULTS 18293 studies were identified, of which 37 studies were included. The barriers and facilitators identified were categorised into four overarching themes: patient-provider interaction and relationship (e.g., complex language use by health professionals), the impact of migration (e.g., weather conditions had an impact on engagement with physical activity), heritage-based practices (e.g., an obligation to consume energy-dense food in social gatherings), and chronic disease management strategies (e.g., lack understanding of appropriate disease management strategies). CONCLUSION This review provides a comprehensive understanding of the complexity of chronic disease management among South Asian migrants and insights into developing multifaceted interventions to address barriers to chronic disease management, guiding the healthcare professionals in helping overcome South Asians perceived barriers to managing chronic disease in the host countries.
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Affiliation(s)
- Purva Gulyani
- Department of Sport, Exercise and Nutrition Sciences, La Trobe University, Bundoora, Australia; Diet Yumm, Craigieburn, Victoria, Australia.
| | | | - Yusra Elmi
- Diet Yumm, Craigieburn, Victoria, Australia
| | - Sabrina Gupta
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Ching Shan Wan
- Nursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne & Australian Catholic University, Australia; National Health and Medical Research Council Centre of Research Excellence in Wiser Wound Care, Menzies Health Institute Queensland, Griffith University, Australia
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Vakil K, Desse TA, Manias E, Alzubaidi H, Rasmussen B, Holton S, Mc Namara KP. Patient-Centered Care Experiences of First-Generation, South Asian Migrants with Chronic Diseases Living in High-Income, Western Countries: Systematic Review. Patient Prefer Adherence 2023; 17:281-298. [PMID: 36756536 PMCID: PMC9899934 DOI: 10.2147/ppa.s391340] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 12/07/2022] [Indexed: 02/02/2023] Open
Abstract
Background First-generation migrants from South Asia account for a considerable proportion of the immigrant populations in high-income, western countries and are at a high risk of developing complex, chronic diseases such as cardiovascular disease and diabetes. Yet, previous systematic reviews have not synthesized information about the healthcare needs and preferences of such migrants and the best ways for health services to provide them with appropriate, culturally sensitive, patient-centered care. The aim of this study is to systematically review the international evidence about first-generation, South Asian migrants' healthcare experiences from the patients' perspectives. Methods Five databases were searched for qualitative, quantitative, and mixed methods studies published between January 1990 and April 2020. Fourteen thousand, six hundred and forty-four papers were retrieved and screened using pre-determined eligibility criteria. Sixty-one papers were included in this narrative synthesis. Relevant qualitative findings from the included papers were thematically analyzed, and quantitative findings were summarized. Results Five themes emerged from findings: 1) Healthcare services engaged; 2) the language barrier; 3) experiences and perceptions of healthcare advice; 4) the doctor-patient relationship; and 5) the role of patients' families in supporting access and delivery of healthcare. Conclusion The findings indicate that communication barriers reduce the cultural and linguistic appropriateness of healthcare. Potential solutions include employing healthcare staff from the same cultural background, training healthcare professionals in cultural competence, and proactively including first-generation, South Asian migrants in decision-making about their healthcare. Future research should explore South Asian migrants' experiences of multimorbidity management, continuity of care, interdisciplinary collaboration, the formation of treatment plans and goals as little to no data were available about these issues.
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Affiliation(s)
- Krishna Vakil
- Deakin Rural Health, School of Medicine, Deakin University, Warrnambool, Victoria, Australia
| | - Tigestu Alemu Desse
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Faculty of Health, Deakin University, Melbourne, Victoria, Australia
| | - Elizabeth Manias
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Faculty of Health, Deakin University, Melbourne, Victoria, Australia
- School of Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Hamzah Alzubaidi
- Deakin Rural Health, School of Medicine, Deakin University, Warrnambool, Victoria, Australia
- College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
| | - Bodil Rasmussen
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research – Western Health Partnership, Institute for Health Transformation Deakin University, Geelong, Victoria, Australia
- The Centre for Quality and Patient Safety Research in the Institute of Health Transformation -Western Health Partnership, Western Health, Melbourne, Victoria, Australia
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Faculty of Health Sciences, University of Southern Denmark and Steno Diabetes Center, Odense M, Denmark
| | - Sara Holton
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research – Western Health Partnership, Institute for Health Transformation Deakin University, Geelong, Victoria, Australia
- The Centre for Quality and Patient Safety Research in the Institute of Health Transformation -Western Health Partnership, Western Health, Melbourne, Victoria, Australia
| | - Kevin P Mc Namara
- Deakin Rural Health, School of Medicine, Deakin University, Warrnambool, Victoria, Australia
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Sari Y, Yusuf S, Haryanto, Kusumawardani LH, Sumeru A, Sutrisna E, Saryono. The cultural beliefs and practices of diabetes self-management in Javanese diabetic patients: An ethnographic study. Heliyon 2022; 8:e08873. [PMID: 35198756 PMCID: PMC8842014 DOI: 10.1016/j.heliyon.2022.e08873] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 11/29/2021] [Accepted: 01/27/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND It is important to assess the cultural beliefs and practices of diabetic patients since such beliefs and practices greatly influence how patients self-manage the disease. However, how cultural beliefs and practices affect self-management in Javanese diabetic patients in Indonesia is still unclear since research about it is very limited. Therefore, the purpose of this study was to explore the cultural beliefs and practices of diabetes self-management in Javanese diabetic patients. METHODS An ethnographic study was conducted between July 2020 and March 2021 in Banyumas Regency, Indonesia. Forty-seven participants were included, consisting of 36 type 2 diabetes mellitus (T2DM) patients as key informants and 11 family members and health providers as general informants. Purposive and snowball sampling methods were used, and data was collected through in-depth interviews, observations, and the writing of field notes. The data were analyzed by thematic analyses using NVivo 12 software. RESULTS Four themes emerged from the data analysis: (1) misconception about diabetes and management, such as the belief of there being dry sugar and wet sugar types of diabetes; the belief that consuming a lot of cold rice does not increase blood glucose; the belief that insulin causes organ damage; the belief that diabetes can be completely cured; and the belief that walking barefoot is good for the body; (2) cultural beliefs and practices regarding treatment regimen, such as use of medicinal plants to lower blood glucose and home remedies to treat foot ulcers; (3) coping influenced by a blend of culture and religion, such as managing stress by submitting to God and being patients in dealing with their disease; (4) cultural influence on diet management, such as facing difficulties managing their diets at cultural events and difficulties managing the habit of eating sweet-tasting food. CONCLUSION This is the first study to show that Javanese culture strongly influences how diabetic patients in Java self-manage their disease. Various aspects of Javanese culture were found to have either beneficial or detrimental effects on diabetic patients' health status. This study provides new insights for nurses in Indonesia and will help them design a culturally sensitive education program for their diabetic patients.
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Affiliation(s)
- Yunita Sari
- Department of Nursing, Faculty of Health Sciences, Universitas Jenderal Soedirman, Purwokerto, Indonesia
| | - Saldy Yusuf
- Faculty of Nursing, Hasanuddin University, Makassar, Indonesia
| | - Haryanto
- Department of Medical Surgical Nursing, STIK Muhammadiyah Pontianak, West Kalimantan, Indonesia
| | - Lita Heni Kusumawardani
- Department of Nursing, Faculty of Health Sciences, Universitas Jenderal Soedirman, Purwokerto, Indonesia
| | - Annas Sumeru
- Department of Nursing, Faculty of Health Sciences, Universitas Jenderal Soedirman, Purwokerto, Indonesia
| | - Eman Sutrisna
- Department of Pharmacology, Faculty of Medicine, Universitas Jenderal Soedirman, Purwokerto, Indonesia
| | - Saryono
- Department of Nursing, Faculty of Health Sciences, Universitas Jenderal Soedirman, Purwokerto, Indonesia
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