British Indo-Asians with diabetes mellitus : their adherence and use of medicinal plants
This thesis describes investigations of the usage of unconventional therapeutic methods to treat diabetes mellitus, with particular reference to Asian patients. Findings suggest that usage of unconventional therapeutic methods may persist in diabetic patients regardless of their language, religious belief, ethnic and cultural background or psychological states and adherence. The thesis is presented in two parts. Study 1, a preliminary study, was conducted in Thailand. Groups of adults with diabetes mellitus, aged 17 - 70+ years, were studied to assess the extent to which unconventional therapeutic methods were used, and to examine the possibility that such usage is associated with their psychological states and unsatisfactorily feelings toward orthodox medicine. Data collection was achieved through a combination of well-established and well-evaluated questionnaires and a structured interview. A scale to assess attitudes to diabetes was found to be reliable in this sample, but scales to measure diabetes knowledge and treatment satisfaction were not. Study 2 was a study of British Indo-Asians in Foleshill, Coventry, England. The extent to which medicinal plants were used was explored and compared between two different cultural and religious backgrounds of adults with diabetes: (1) born in an Asian country and (2) born in England. The majority of participants were old with low educational background and income. A number of modifications were made to the structured interview used in study 1 to make it more appropriate for this sample. The two studies suggest that usage of medicinal plants is common among diabetics in Thailand and among British Indo-Asian diabetics born in an Asian country. Only a minority of users of medicinal plants in both countries were willing to discuss their usage of medicinal plants with their physicians. This could be because users believed that their physicians might not approve the usage of non-orthodox treatment. In Thailand, usage of medicinal plants was significantly associated with one factor - a lack of basic diabetes knowledge. In the study in England, a typical user was characterised as an Asian female born in an Asian country, who had a low income, used betel-nut, had a preferencef or a doctor's ethnicity, and had low treatment satisfaction and adherence scores.