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Deterrents to participation in diabetes education : perspectives of elderly Sikh Indo-Canadians Sanghera, Rema Rajeeta

Abstract

Diabetes is a chronic disease which affects approximately 5% of all Canadians and contributes to considerable health care costs. At present diabetes can be controlled but not cured. Increased recognition that the provision of diabetes education is essential in diabetes management has led to the development of education programs in many Canadian hospitals. However, participation surveys done in the United States indicate that only 12 to 35% of individuals with diabetes receive education through formal programs. This study seeks to identify factors deterring participation of elderly Sikh Indo-Canadians with NIDDM in education programs. In depth interviews were conducted with the research participants. The Adapted Chain of Response Model was used as the framework to develop questions for the interview guide and to collect, organize and analyze the data. Deterrents identified in previous studies and supported by this study include: older age, low self-confidence, questioning the worth of the program, being on oral medications versus insulin, having one's own ways of self-care, having a family doctor for treating diabetes, financial concerns, time constraints and transportation problems, and an underestimation of the seriousness of NIDDM by doctors. Deterrents unique to the study include: viewing self as healthy, desiring anonymity, reliance on religion, not valuing non-doctors, lacking familial support, perceiving health professionals as lacking cultural sensitivity, lacking awareness of program purpose and existence, and not being referred at time of diagnosis. Family doctors not valuing diabetes education and/or services of health professionals and not encouraging individuals to attend were also identified as deterrents. This study makes recommendations for practice and research which may be useful to diabetes educators, health care organizations and researchers in assisting them to fully understand and address challenges involved in making diabetes education a reality for a greater number of individuals with diabetes.

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