Anthropologic study of immigrant patients with T2DM from Morocco to Spain

Abstract

Background: Immigration in Spain has grown exponentially, with Moroccans being the most numerous group. Aims: To determine the profile of Moroccans with type 2 diabetes mellitus (T2DM), to provide diabetes education strategies. Design/setting: Cross-sectional study in 10 rural and urban centres, Catalonia, Spain. Patients and methods: T2DM patients were interviewed using a structured, evaluated interview questionnaire, translated into Arabic. Data obtained underwent descriptive statistical analysis. Results: Forty patients, aged 50±15 years (73% females) were interviewed: 53% were illiterate; 90% lived with family; 67% lived in Catalonia >5 years; 11% used insulin; 12% used oral agents; 66% reported difficulties with diet and 44% with drugs; 54% ate Moroccan and Spanish cuisine. Self-reported causes of T2DM were: stress (38%); unknown (31%); fear (17%); inherited (14%); God (7%). Thirty-three per cent believed diabetes could be cured; 32% did not use prescribed medication; 43% did not attend appointments; 24% used alternative medicines. Language barriers were present in 60% of respondents and 80% preferred watching TV to reading. Sixty-three per cent followed Ramadan fasting. Quality-of-life ratings from 0 to 10 were >5 in 53% of respondents. Using this information, we designed and developed an educational, bilingual (Arabic/Spanish) DVD that included specific diabetes topics, Moroccan and Spanish cuisine, and recommendations for Ramadan. We also updated the carbohydrate food cup to include staple Moroccan foods. Conclusion: Linguistic and sociocultural barriers (eg low participation rates, illiteracy and poor treatment adherence) were observed. To minimise barriers, tailored educational materials were developed.

Patient empowerment in diabetes – past debates and new perceptions

“…For example, we reported in the last edition of European Diabetes Nursing ways in which HCPs were working with migrant groups to educate them on food choices and diabetes. 4 In the UK, the Year of Care study is all about collaboratively devising a strategy or agreeing a way forward for action, or goals to be achieved in diabetes management which are both reasonable and possible. 5 Empowerment therefore must be considered as a route by which we increase our patient's ability to self-manage their diabetes, and it also has an outcome -the increase of self-efficacy in our patients.…”