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Can Fam Physician. 2017 Feb;63(2):e137-e144.

Provider- and patient-related determinants of diabetes self-management among recent immigrants: Implications for systemic change.

Author information

1
Consultant in Research and Evaluation and Adjunct Professor at the Dalla Lana School of Public Health at the University of Toronto in Ontario. i.hyman@utoronto.ca.
2
Senior Research Scientist at Access Alliance Multicultural Health and Community Services in Toronto.
3
Data Analyst at the Institute for Clinical Evaluative Sciences in Toronto.
4
Associate Professor in the School of Nutrition at Ryerson University in Toronto.
5
Full Professor in the Faculty of Nursing at the University of Montreal in Quebec.

Abstract

OBJECTIVE:

To examine provider- and patient-related factors associated with diabetes self-management among recent immigrants.

DESIGN:

Demographic and experiential data were collected using an international survey instrument and adapted to the Canadian context. The final questionnaire was pretested and translated into 4 languages: Mandarin, Tamil, Bengali, and Urdu.

SETTING:

Toronto, Ont.

PARTICIPANTS:

A total of 130 recent immigrants with a self-reported diagnosis of type 2 diabetes mellitus who had resided in Canada for 10 years or less.

MAIN OUTCOME MEASURES:

Diabetes self-management practices (based on a composite of 5 diabetes self-management practices, and participants achieved a score for each adopted practice); and the quality of the provider-patient interaction (measured with a 5-point Likert-type scale that consisted of questions addressing participants' perceptions of discrimination and equitable care).

RESULTS:

A total of 130 participants in this study were recent immigrants to Canada from 4 countries of origin-Sri Lanka, Bangladesh, Pakistan, and China. Two factors were significant in predicting diabetes self-management among recent immigrants: financial barriers, specifically, not having enough money to manage diabetes expenses (P = .0233), and the quality of the provider-patient relationship (P = .0016). Participants who did not have enough money to manage diabetes were 9% less likely to engage in self-management practices; and participants who rated the quality of their interactions with providers as poor were 16% less likely to engage in self-management practices.

CONCLUSION:

Financial barriers can undermine effective diabetes self-management among recent immigrants. Ensuring that patients feel comfortable and respected and that they are treated in culturally sensitive ways is also critical to good diabetes self-management.

PMID:
28209706
PMCID:
PMC5395412
[Indexed for MEDLINE]
Free PMC Article

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