Understanding family, social and health experience patterns in British Bangladeshi families: are people as diverse as they seem?

Abstract

Aim: An exploratory study of the Cardiff Bangladeshi community in a primary care setting, prior to the development of culturally appropriate diabetes health education. Background: British Bangladeshis are one of the most economically deprived communities in Britain, with high morbidity and mortality rates from chronic illness. Access and use of their services is perceived by Primary Health Care Teams (PHCTs) to be difficult, due to communication and cultural barriers. Methods: One-to-one taperecorded interviews were held in Sylheti, Bengali or English with an age-stratified sample from the community registered with a practice in central Cardiff. The N*DIST package was used to analyse data, with ongoing discussion of emerging themes. The topics explored in these interviews were family structure and decision making within families, meal patterns, health beliefs, experiences of primary care and barriers to engaging with the outside world. Findings: Family structure and social patterns had many similarities with those of the local community, and dietary and health beliefs also followed 'Western' concepts. People were anxious to be healthy, but often did not know about core primary care services. The community places value on the opinion and support of primary care professionals. However, a major cross-cutting theme was difficulty in accessing health care (especially for women), and reasons for this are discussed in the paper. With this information, the PHCT can now consider adapting itself to improve access and communication. We suggest that our methodological approach is both relevant and achievable for those working in primary care settings in our increasingly multi-cultural, ethnically mixed communities, and is not purely the province of sociologists or academics (important learning points have been identified and highlighted).

Patient access to healthcare services and optimisation of self-management for ethnic minority populations living with diabetes: a systematic review

“…In contrast, a study of twelve Bangladeshi patients found that family interpreters were preferred because of the benefits of shared understanding and privacy (Rhodes & Nocon 2003). This may, however, cause difficulties in arranging appointments if a family member, usually a man, is expected to be available for clinic visits with the patient (Hawthorne et al . 2007).…”

“…There is broader evidence that families frequently serve as informal interpreting services in South Asian families (Brooks et al. 2000, Rhodes & Nocon 2003), so act as important intermediaries in self‐management behaviour; this may be particularly the case for elderly patients (Hawthorne et al. 2007).…”

“…These will be used to develop a future intervention and delivery of culturally competent services in local clinical sites. Several components may be suitably incorporated in the intervention including: adequate resourcing of patients’ needs assessments, provision of interpreters (Hawthorne et al. 2007), provider training, community education programmes (Baradaran et al.…”

“…Family, friends and life history play a central role in shaping African and Caribbean understanding of illness (Brown et al 2007) and provide a strong source of knowledge and emotional support for those from South Asian backgrounds (Bissell et al 2004). There is broader evidence that families frequently serve as informal interpreting services in South Asian families (Brooks et al 2000, Rhodes & Nocon 2003, so act as important intermediaries in self-management behaviour; this may be particularly the case for elderly patients (Hawthorne et al 2007).…”

Evidence-based primary health care and local research: a necessary but problematic partnership

“…Members of the Bangladeshi community (Hawthorne et al, 2007) may differ from each other in important respects: length of time living in high-income countries and in Bangladesh; whether English-or Bangladesh-educated; degree of fluency in reading, writing and speaking English; preference for traditional or Westernized lifestyles; religion; and so on.…”