Exploring the Experiences of West African Immigrants Living with Type 2 Diabetes in the UK

Promoting lifestyle changes in patients with prediabetes from African-Caribbean backgrounds in the United Kingdom

OBJECTIVES

Diabetes is a non-communicable disease where the patient's glucose level in the blood is too high. Diabetes is prevalent among ethnic minority groups in the United Kingdom (UK). Type 2 diabetes is a major cause of premature mortality in England. Unfortunately, the lifestyle of these minority groups has become a barrier to diabetes healthcare treatment. The timely intervention of programmes targeting risk factors associated with diabetes may reduce the prevalence of diabetes among these ethnic minority groups. This review critically explores and identifies barriers that hinder specific African-Caribbean groups from accessing diabetes healthcare and how nurses can promote lifestyle changes in patients with prediabetes from African-Caribbean backgrounds.

DESIGN

An extended literature review (ELR). The process consisted of a search of key databases and other nursing and public health journal articles with the keywords defined in this extended review (prediabetes, diabetes, lifestyle of Afro-Caribbean). Thematic analysis is then applied from a socio-cultural theoretical lens to interpret the selected articles for the review.

RESULTS

Three main barriers were identified: (a) the strong adherence to traditional diets, (b) a wrong perception about diet management and (c) 'Western medication' as a key barrier that hinders effective diabetes management in ethnic minorities, including the African-Caribbean in the UK.

CONCLUSION

To address these barriers, it is important for policymakers to prioritise well-tailored interventions for African-Caribbean groups as well as support healthcare providers with the requisite capacity to provide care.

The Role of Finding Out in Type 2 Diabetes Management among West-African Immigrants Living in the UK

Type 2 diabetes (T2DM) prevalence is three times higher among West African Immigrants compared to the general population in the UK. The challenges of managing T2DM among this group have resulted in complications. Reports have highlighted the impact of migration on the health of the immigrant population, and this has contributed to the need to understand the influence of living in West Africa, and getting diagnosed with T2DM, in the management of their condition in the UK. Using a qualitative constructivist grounded theory approach, thirty-four West African immigrants living in the UK were recruited for this study. All participants were interviewed using Semi-structured interviews. After coding transcripts, concepts emerged including noticing symptoms, delayed diagnosis, affordability of health services, beliefs about health, feelings at diagnosis, and emotions experienced at diagnosis all contribute to finding out about diagnosis T2DM. These factors were linked to living in West Africa, among participants, and played significant roles in managing T2DM in the UK. These concepts were discussed under finding out as the overarching concept. Findings from this study highlight important aspects of T2DM diagnosis and how lived experiences, of living in West Africa and the UK, contribute to managing T2DM among West African immigrants. The findings of this study can be valuable for healthcare services supporting West African immigrants living in the UK.

Maintaining cultural identity: A systematic mixed studies review of cultural influences on the self-care of African immigrants living with non-communicable disease

AIM

To understand and identify cultural factors influencing the self-care practices of African immigrants living with chronic illness in countries outside Africa.

BACKGROUND

The influence of cultural factors on self-care is relatively unexplored in African immigrants with non-communicable diseases (NCDs).

DESIGN

Systematic Mixed Studies review.

DATA SOURCES

PubMed, Psych Info, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Anthropology Plus and Sociological Abstract computerized databases. No limit was placed on publication date.

REVIEW METHODS

Results-based convergent design was used. The Mixed Method Appraisal Tool was used to evaluate the studies. Quantitative studies were synthesized narratively while qualitative studies were synthesized using thematic synthesis.

RESULTS

We identified 251 articles and nine fulfilled our inclusion criteria. The studies were published between 2006 and 2019, with six qualitative and three quantitative studies. Studies were conducted in the United States, Australia, Sweden, the Netherlands and the United Kingdom. Most studies examined the influence of culture on self-care of diabetes (n = 6), while the rest focused on hypertension (n = 3). Findings highlight that cultural norms and practices, non-Western approaches to interpreting and managing illness, cultural connotations of health behaviours and structural challenges influencing self-care. Cultural food preferences made adherence to prescribed diets challenging. Family support facilitated self-care. Maintaining cultural identity was both a driver and constraint to engaging in self-care.

CONCLUSION

The complex interplay of cultural and structural factors influences the willingness of Africans who have immigrated to a developed country to follow recommended self-care practices. Considering these cultural norms and structural barriers can help to explain the self-care behaviours of African immigrant populations.

IMPACT

Clinicians and policymakers who account for structural factors and integrate cultural factors into care facilities, treatment protocols and policy can be influential in promoting self-care in African immigrant populations.