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Title: Non-compliance and diabetes self-care activities : a case study of Asian and Caucasians.
Author: Meetoo, Danny.
ISNI:       0000 0001 3391 7307
Awarding Body: Manchester Metropolitan University
Current Institution: Manchester Metropolitan University
Date of Award: 2002
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The global prediction of diabetes mellitus as forecasted by the World Health Organisation (WHO) is sombre. Accordingly, by the year 2025 the number of adults likely to be affected by diabetes has been predicted to rise to approximately 300 million. As a non-communicable disease diabetes has a tendency to indiscriminately affect individuals of any age (irrespective of gender) and culture. Diabetes Mellitus does not fully respond to medical treatment, either in the form of subcutaneous insulin or oral anti-diabetic agents, or even when a combination of both insulin and tablets are prescribed. Instead, management needs to be further supplemented by diabetes self-care activities, a guise currently presented as 'self-care' and 'empowerment', in an attempt to retard or prevent· complications associated with diabetes. This cross-cultural qualitative case study therefore sought to explore the notion of non-compliance, which is a moral, analytical and prescriptive category often attached to the career profile of diabetic patients. A multi-method approach to data collection was adopted. This comprised of a semi-structured interview expounding on the multiplex aspects of care needed to be considered during diabetes self-care activities, a 35-item questionnaire which examined the diabetes self-care activities of participants over the preceding seven days and a 7-day health diary exploring the trajectory of diabetes management. A purposeful sample 25 Asians and 24 indigenous Caucasians agreed to participate in this study. Most were recruited from the local diabetic clinic by the Diabetic Specialist Nurse (DSN). A small percentage of the Asians became involved through a snowball effect. Except for the five English speaking Asians, data from the remaining twenty Asians were collected by three paid Asian interpreters. Their methodological implications were noted. The findings revealed that some variations in certain key aspects of diabetes self-care activities were apparent in both groups. Often 'non-compliance' was based on rational decisions made by the participants using practical everyday reasoning. 'Non-compliance' further appeared to have been compounded by ineffective communication. The economic status of many precluded them from purchasing blood glucose monitors while linguistic shortcomings prevented others from reading diabetic related booklets and/or pamphlets. Participants also tended to question the value of many of the self-care activities referred in this study as 'magical rites'. Further there was a tendency to disclose the diagnosis of diabetes to significant others. Two theories are also offered as a way of understanding non-compliance during the management of diabetes mellitus. The first relates to the use of magic as a closed system of logic enabling diabetic individuals to handle uncertainty while the second refers to the notion of stigma and tainted personality. Finally, this cross-cultural case study concludes by offering a number of recommendations likely to improve diabetes self-care activities.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available