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Every A, Cuesta-Briand B, Hansell D, Burich S, Tofilua F, Crawford GB, Collier A. A qualitative study of Samoan cancer patients' experiences. Int J Palliat Nurs 2024; 30:380-388. [PMID: 39028314 DOI: 10.12968/ijpn.2024.30.7.380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2024]
Abstract
METHODS This qualitative interview study was part of a larger study that interviewed19 participants recruited among patients with cancer registered with Samoa Cancer Society, or patients recently discharged from the main tertiary hospital in Samoa. Interview transcripts were reviewed, and the research team identified the key palliative-care-related themes. RESULTS Analysis led to the generation of the following key themes: living with pain; resource constraints; support from family and faith; and interactions with healthcare professionals. Most participants were experiencing unresolved pain as a result of poor health knowledge, lack of access to medications and practical issues, such as financial limitations and lack of transport. Participants also reported a lack of resources, including financial constraints, as a significant barrier to effective healthcare. Sources of support for patients with cancer were most commonly strong family relationships and religious faith. Although it was difficult for the participants to access care from healthcare professionals, they found that honest communication about their condition was comforting. However, they were frustrated if they felt communication was unsatisfactory. CONCLUSION This study provides much needed evidence on the issues that affect the quality of life patients with cancer receiving palliative care and their families in Samoa. It also highlights the intersectionality of these issues and how this compounds the patient experience. Practical recommendations for improving palliative care lie in a few key areas, including a need for improved access to opioids and support for family caregivers. However, from a systemic perspective, the way forward should lie in harnessing the strengths of Samoan culture, including the strong sense of family and the role of religion, to provide support and care for palliative patients.
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Affiliation(s)
- Alice Every
- Aged Care Rehabilitation and Palliative Care Division, Northern Adelaide Local Health Network, Adelaide, Australia
| | - Beatriz Cuesta-Briand
- Rural Clinical School of Western Australia, University of Western Australia, Australia
| | - Dyxon Hansell
- World Health Organization, Samoa; National University of Samoa, Samoa
| | | | | | - Gregory B Crawford
- Aged Care Rehabilitation and Palliative Care Division, Northern Adelaide Local Health Network, Adelaide, Australia
- University of Adelaide, Australia
| | - Aileen Collier
- Aged Care Rehabilitation and Palliative Care Division, Northern Adelaide Local Health Network, Adelaide, Australia
- Flinders University, Adelaide, Australia
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Mousum S, Salwa M, Fatema K, Haque MA. Psychometric Validation of the Translated and Adapted Bengali Version of the HLS-EU-Q16/Q6 for Adults. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2024; 61:469580241248132. [PMID: 38751183 PMCID: PMC11100377 DOI: 10.1177/00469580241248132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 03/23/2024] [Accepted: 04/02/2024] [Indexed: 05/19/2024]
Abstract
Health Literacy (HL) emerges as a critical tool in addressing the escalating burden of noncommunicable diseases (NCDs) and their associated costs. Particularly in Bangladesh, where the inadequacy of HL presents multifaceted challenges, there is an urgent need to address this issue. This study aimed to translate and evaluate the Bengali versions of the European Health Literacy Questionnaire with 16 items (HLS-EU Q16) and its shorter 6-item version (HLS-EU Q6), as there is currently no validated Bengali tool for assessing HL. This article used a subset of data from a Bangladeshi national survey of Primary Healthcare (PHC) facilities. The study included adults seeking Non-Communicable Disease (NCD) services at PHCs. Validity and reliability testing succeeded in a detailed back-to-back translation. The statistics covered were descriptive, Cronbach's internal consistency, confirmatory factor analysis, and the chi-square test. Following the translation and preliminary testing, minor rephrasing and the insertion of Item-Relevant Stimulus Material were performed to ensure cultural equivalency. The Confirmatory Factor Analysis produced a 3-factor structure for the HLS-EU-Q16 that included a second-order general component, confirming the viability of using an HL total score. A 3-factor model based on a priori was determined to be suitable for the factor structure of the HLS-EU-Q6. The model fit indices (Chi-square/df, TLI, AGFI, CFI, GFI, SRMR, RMSEA, and PCLOSE) supported CFA models of both scales. The internal consistency of the translated and adapted instruments was α = .934 and .857, respectively. This study showed that the Bengali version of the HLS-EU-Q16 and HLS-EU-Q6 are psychometrically sound, have clear factor structures, and are equivalent to the original models. However, the HLS-EU_Q16 is recommended over the shorter version considering its better psychometric properties.
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Affiliation(s)
- Sabrina Mousum
- Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Marium Salwa
- Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | | | - Md Atiqul Haque
- Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
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Oyama S, Duckham RL, Pomer A, Rivara AC, Kershaw EE, Wood A, Fidow UT, Naseri T, Reupena MS, Viali S, McGarvey ST, Hawley NL. Association between age at menarche and cardiometabolic risk among Samoan adults. Am J Hum Biol 2024; 36:e23982. [PMID: 37668413 PMCID: PMC10845161 DOI: 10.1002/ajhb.23982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 07/19/2023] [Accepted: 08/15/2023] [Indexed: 09/06/2023] Open
Abstract
OBJECTIVES Recent studies suggest that early menarche may increase cardiometabolic morbidity and mortality. Yet few studies have examined this association in the Pacific Islands, where obesity prevalence is among the highest globally. We sought to examine associations between age at menarche and cardiometabolic risk in Samoa. METHODS Participants were from the Soifua Manuia study (n = 285, age 32-72 years) conducted in Samoa from 2017 to 2019. Logistic regressions were conducted to estimate odds of obesity, hypertension, diabetes, dyslipidemia, and metabolic syndrome per one-year increase in age at menarche. Linear regressions were conducted to examine associations between age at menarche and continuous measures of adiposity, blood pressure, insulin resistance, and serum lipids. RESULTS Median age at menarche was 14 years (IQR = 2). After controlling for relevant covariates, each one-year increase in age at menarche was associated with a 15% decrease (OR = 0.85, 95% CI: 0.72-1.01, p = .067) in odds of hypertension, but a 21% increase (OR = 1.21, 95% CI: 1.01-1.45, p = .044) in odds of diabetes and 18% increase (OR = 1.18, 95% CI: 0.98-1.42, p = .081) in odds of high total cholesterol. Each additional year in age at menarche was associated with a 1.60 ± 0.52 kg (p = .002) decrease in lean mass and 1.56 ± 0.51 kg (p = .003) decrease in fat-free mass. CONCLUSIONS Associations between age at menarche and cardiometabolic risk may be population-specific and are likely influenced by both current and historical nutritional and epidemiological contexts. Prospective studies are needed to clarify the role of childhood adiposity and other early life exposures on age at menarche and subsequent cardiometabolic risk.
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Affiliation(s)
- Sakurako Oyama
- Yale School of Medicine, New Haven, Connecticut, USA
- Department of Anthropology, Yale University, New Haven, Connecticut, USA
| | - Rachel L Duckham
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Burwood, Victoria, Australia
- Australian Institute for Musculoskeletal Sciences, Department of Medicine, Western Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Alysa Pomer
- Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Anna C Rivara
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, USA
| | - Erin E Kershaw
- Division of Endocrinology, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Ashlee Wood
- Division of Endocrinology, Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Ulai T Fidow
- Department of Obstetrics & Gynecology, Tupua Tamasese Meaole Hospital, Apia, Samoa
| | | | | | | | - Stephen T McGarvey
- International Health Institute, Department of Epidemiology, Department of Anthropology, Brown University, Providence, Rhode Island, USA
| | - Nicola L Hawley
- Department of Anthropology, Yale University, New Haven, Connecticut, USA
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, USA
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Salahuddin NS, Palutturi S. Developing Concept of Healthy Island: A Systematic Review. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2020.6488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: The archipelago region is a vulnerable area to human health problems. Several problems in the archipelago area including climate change, lack of a holistic management plan, infectious diseases, non-communicable diseases, economic problems, population growth, health facilities, and access to health services. The development of a healthy island concept is a solution to overcoming health problems in the archipelago.
AIM: This article aims to identify the formation of the concept of a healthy island.
METHODS: Article review was conducted using three bibliographic databases. Articles were selected based on the 2010–2020 publication using PRISMA flow diagram 2015.
RESULTS: Based on the review article, it was found that twelve programs or concepts were used to overcome various problems in the archipelago which were obstacles to the realization of a healthy island, namely, a healthy diet; health development review; the concept of a climate change and adaptation health vulnerability assessment and planning project by the world health organization; the world health organization assessment; modeling exposure to tetrachlorethylene; conceptual model of the European Health Literacy Project (HLS-EU); community involvement in the Child Healthy Life Program; Pacific Island Health Care project; data analysis of newly registered TB cases; RHRW; approach to Community-Based Participatory Research; and descriptive epidemiology.
CONCLUSION: To solve health problems on the island is not easy, first, we need to elaborate on the health problems and second, we need to determine health project initiative based on community development.
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Cuesta-Briand B, Hansell D, Burich S, Loimata T. Delays in the Pathway to Cancer Diagnosis in Samoa: A Qualitative Study of Patients' Experiences. Asia Pac J Public Health 2021; 33:707-713. [PMID: 34075810 DOI: 10.1177/10105395211019857] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Cancer is a leading cause of death in Samoa, with cancer patients presenting late and experiencing poor outcomes. Barriers to early diagnosis are complex, and cultural factors play an important part. This qualitative study explored the barriers to cancer diagnosis in Samoa through semistructured interviews conducted with 19 Samoan patients. Thematic data analysis was informed by socioecological theory and yielded 4 themes: knowledge and beliefs about cancer; pain as a trigger for health care-seeking behavior; follow-up issues; and communication and trust. Cancer knowledge and attitudes toward pain were strongly influenced by culture and community beliefs. Lack of follow-up resulted in significant delays, and ineffective patient-doctor communication triggered feelings of uncertainty and mistrust in the health care system. Efforts to address knowledge gaps will not be effective unless they are accompanied by broader strategies addressing local health care capacity issues. Adopting a socioecological framework lens within a regional collaborative approach provides a way forward.
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Affiliation(s)
| | | | | | - Terri Loimata
- National University of Samoa, Apia, Samoa.,Samoa Cancer Society, Apia, Samoa
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Elliott LM, Taylor J. Community Perceptions of the Determinants of Diabetes in Peri-Urban Vanuatu. Asia Pac J Public Health 2021; 33:734-739. [PMID: 33797296 DOI: 10.1177/10105395211005924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Health promotion is a core component of the Pacific region's response to noncommunicable diseases (NCDs) prevention and control. However, while health promotion should build on and be informed by contextually specific norms and social discourse, there remains a paucity in research that seeks to understand how people in the Pacific region comprehend chronic conditions and their determinants. Based in peri-urban Vanuatu, this codesigned study utilized an open-ended survey to investigate community perceptions of factors contributing to the development of type 2 diabetes. Results demonstrate a complex picture of diabetes-specific health literacy, with 22 distinct causes identified by 308 respondents. Dietary factors were commonly acknowledged; however, dietary complexity was not well understood. Limited recognition of the role of tobacco and alcohol consumption in disease development was also noted. Overall, findings demonstrate mixed successes in NCD-related health promotion. Moving away from more universalized approaches commonly advocated by donors, this research identifies the need for locally designed and driven health promotion that focuses on more nuanced, culturally sensitive, and contextually grounded messaging.
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Affiliation(s)
- Lana M Elliott
- Queensland University of Technology, Brisbane, Queensland, Australia.,James Cook University, Townsville, Queensland, Australia
| | - John Taylor
- La Trobe University, Melbourne, Victoria, Australia
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Kammholz G, Craven D, Boodoosingh R, Akeli Amaama S, Abraham J, Burkhart S. Exploring Food Literacy Domains in an Adult Samoan Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073587. [PMID: 33808339 PMCID: PMC8036961 DOI: 10.3390/ijerph18073587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/26/2021] [Accepted: 03/27/2021] [Indexed: 11/16/2022]
Abstract
Samoan food systems have undergone a dramatic nutrition transition, with dietary patterns changing concurrently with increased rates of obesity and non-communicable disease. Whilst policy action and environmental interventions play an important role in improving access to and consumption of healthy food, the success of these relies on a greater understanding of individuals’ food knowledge and behaviours. This study aimed to explore these behaviours using the construct of food literacy in an adult Samoan population. A cross-sectional interviewer-administered questionnaire of a convenience sample of 150 adult Samoans (≥20 years) assessed the four domains of food literacy: plan/manage, select, prepare, and eat. Participants generally plan to include healthy food (87%) and budget money for food (87%). The majority know where to find nutrition labels (68%), of which 43% always use them to inform their food choices. Participants were mostly confident with cooking skills, although food storage practices require further investigation. Over 90% agreed or strongly agreed that food impacts health, although understanding of the Pacific Guidelines for Healthy Living was lacking. Understanding the ability of Samoans to plan/manage, select, prepare, and eat food is an important consideration for future interventions aiming to assist this population in navigating the modern-day food system.
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Affiliation(s)
- Grace Kammholz
- School of Health and Behavioural Sciences ML41, University of the Sunshine Coast, Locked Bag 4, Maroochydore DC, QLD 4558, Australia; (G.K.); (D.C.)
| | - Dana Craven
- School of Health and Behavioural Sciences ML41, University of the Sunshine Coast, Locked Bag 4, Maroochydore DC, QLD 4558, Australia; (G.K.); (D.C.)
- Australian Centre for Pacific Islands Research, University of the Sunshine Coast, Locked Bag 4, Maroochydore DC, QLD 4558, Australia
| | - Ramona Boodoosingh
- Faculty of Health Science, School of Nursing, National University of Samoa, Apia, Western Samoa;
- Correspondence: (R.B.); (S.B.)
| | - Safua Akeli Amaama
- Centre for Samoan Studies, National University of Samoa, Apia, Western Samoa;
| | - Jyothi Abraham
- Faculty of Health Science, School of Nursing, National University of Samoa, Apia, Western Samoa;
| | - Sarah Burkhart
- School of Health and Behavioural Sciences ML41, University of the Sunshine Coast, Locked Bag 4, Maroochydore DC, QLD 4558, Australia; (G.K.); (D.C.)
- Australian Centre for Pacific Islands Research, University of the Sunshine Coast, Locked Bag 4, Maroochydore DC, QLD 4558, Australia
- Correspondence: (R.B.); (S.B.)
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Role of Seaweed in Diets of Samoa and Kiribati: Exploring Key Motivators for Consumption. SUSTAINABILITY 2020. [DOI: 10.3390/su12187356] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Edible seaweeds have significant potential to contribute to sustainable diets that promote health of Pacific Islanders in ecologically, economically, and socially acceptable ways. No studies to date have investigated motivators for and the consumption of edible green seaweed from the genus Caulerpa (sea grapes) in Samoa and Kiribati. An observational, cross-sectional study utilized an interviewer-administered questionnaire to explore consumption behaviors and the role of sea grapes in the current diets of individuals in Samoa and Kiribati. Of the total 145 participants (n = 79, 54.5% Samoa; n = 66, 45.5% Kiribati), half (n = 76, 52%) reported consuming sea grapes. A significantly greater proportion of Samoans (n = 56, 70.9%) reported consumption than I-Kiribati participants (n = 20, 30.3%). A greater proportion of consumers were male (n = 47, 61.8%). Samoan consumers reported consumption of sea grapes with a higher diversity of foods and being related to traditional events or ceremonies. Motivators for consumption varied between countries, with Samoan consumers reporting strong agreement for taste and value for money, and identified sea grapes as nutritious food, as influences on consumption. Easy access was a motivator in Kiribati only. The findings of this study are underpinned by the degree of food security and differences in culture in Samoa and Kiribati. Future public health efforts to integrate traditional fresh food into local food systems will need to work within the existing social parameters in each respective country.
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Lyons G, Dean G, Tongaiaba R, Halavatau S, Nakabuta K, Lonalona M, Susumu G. Macro- and Micronutrients from Traditional Food Plants Could Improve Nutrition and Reduce Non-Communicable Diseases of Islanders on Atolls in the South Pacific. PLANTS 2020; 9:plants9080942. [PMID: 32722347 PMCID: PMC7464995 DOI: 10.3390/plants9080942] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/20/2020] [Accepted: 07/21/2020] [Indexed: 02/07/2023]
Abstract
Pacific Islanders have paid dearly for abandoning traditional diets, with diabetes and other non-communicable diseases (NCD) widespread. Starchy root crops like sweet potato, taro, and cassava are difficult to grow on the potassium-deficient soils of atolls, and high energy, low nutrient imported foods and drinks are popular. Nutritious, leafy food plants adapted to alkaline, salty, coral soils could form part of a food system strategy to reduce NCD rates. This project targeted four atolls south of Tarawa, Kiribati, and was later extended to Tuvalu. Mineral levels in diverse, local leafy food plants were compared to reveal genotype–environment interactions. Food plants varied in ability to accumulate minerals in leaves and in tolerance of mineral-deficient soils. Awareness activities which included agriculture, health, and education officers targeted atoll communities. Agriculture staff grew planting material in nurseries and provided it to farmers. Rejuvenation of abandoned giant swamp taro pits to form diversified nutritious food gardens was encouraged. Factsheets promoted the most suitable species from 24 analyzed, with multiple samples of each. These included Cnidoscolus aconitifolius (chaya), Pseuderanthemum whartonianum (ofenga), Polyscias scutellaria (hedge panax), and Portulaca oleracea (purslane). The promoted plants have been shown in other studies to have anti-NCD effects. Inclusion of the findings in school curricula and practical application in the form of demonstration school food gardens, as well as increased uptake by farmers, are needed. Further research is needed on bioavailability of minerals in plants containing phytates and tannins.
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Affiliation(s)
- Graham Lyons
- School of Agriculture, Food and Wine, University of Adelaide, Waite Campus, Urrbrae, South Australia 5064, Australia
- Correspondence: ; Tel.: +61-8-83136533
| | - Geoff Dean
- Tasmanian Institute of Agriculture, University of Tasmania, Prospect, Tasmania 7250, Australia;
| | - Routan Tongaiaba
- Agriculture and Livestock Division, Ministry of Environment, Lands and Agriculture Development, Tanaea, South Tarawa, Kiribati; (R.T.); (K.N.)
| | | | - Kabuati Nakabuta
- Agriculture and Livestock Division, Ministry of Environment, Lands and Agriculture Development, Tanaea, South Tarawa, Kiribati; (R.T.); (K.N.)
| | - Matio Lonalona
- Department of Agriculture, Ministry of Natural Resources, Energy and Environment, Vaiaku, Funafuti, Tuvalu;
| | - Gibson Susumu
- Gibson Susumu: Sustainable Agriculture Programme, The Pacific Community (SPC), Suva, Fiji;
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Abdullah A, Liew SM, Ng CJ, Ambigapathy S, V Paranthaman PV. Health literacy experiences of multi-ethnic patients and their health-care providers in the management of type 2 diabetes in Malaysia: A qualitative study. Health Expect 2020; 23:1166-1176. [PMID: 32686277 PMCID: PMC7696131 DOI: 10.1111/hex.13095] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 06/06/2020] [Accepted: 06/09/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Patients with type 2 diabetes mellitus (T2DM) require adequate health literacy to understand the disease and learn self-management skills to optimize their health. However, the prevalence of limited health literacy is high in patients with T2DM, especially in Asian countries. OBJECTIVE This study aimed to explore experiences related to health literacy in Asian patients with T2DM. DESIGN This is a qualitative study using in-depth interviews and focus group discussions. A framework analysis was used to analyse the data. SETTING AND PARTICIPANTS articipants (n = 24) were multi-ethnic patients with T2DM (n = 18) and their primary health-care providers (n = 6). This study was conducted in four primary health-care clinics in Malaysia. RESULTS Nine subthemes were identified within the four dimensions of health literacy: accessing, understanding, appraising and applying information. DISCUSSION Motivated patients actively sought information, while others passively received information shared by family members, friends or even strangers. Language and communication skills played important roles in helping patients understand this information. Information appraisal was lacking, with patients just proceeding to apply the information obtained. Patients' use of information was influenced by their self-efficacy, and internal and external barriers. CONCLUSION In conclusion, the experiences of multi-ethnic patients with T2DM regarding health literacy were varied and heavily influenced by their cultures.
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Affiliation(s)
- Adina Abdullah
- Department of Primary Care Medicine, University Malaya Primary Care Research Group (UMPCRG), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Su May Liew
- Department of Primary Care Medicine, University Malaya Primary Care Research Group (UMPCRG), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Chirk Jenn Ng
- Department of Primary Care Medicine, University Malaya Primary Care Research Group (UMPCRG), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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