Risk perception in older South Asians with Type 2 Diabetes in the United Kingdom

Citation

Macaden L (2007) Risk perception in older South Asians with Type 2 Diabetes in the United Kingdom. Doctor of Philosophy. Northumbria University, Newcastle upon Tyne..

Abstract
South Asians living in the UK have an increased predisposition to developing Type 2 diabetes. Type 2 diabetes usually occurs later in life and has significant invisible long term risks that can affect an individual's quality of life and longevity but are preventable with life style changes. For people of South Asian origin, their perception of risks associated with Type 2 diabetes is likely to be shaped by a range of different factors, including cultural influences on gender roles, family life, and the significance of food and its preparation. The South Asian population in the United Kingdom is heterogeneous with strong socio cultural and religious beliefs that impact upon an individual's life style. Research on issues related to risk and risk perception have largely been conducted in developed countries. Models on risk perception have also evolved from these settings where people have increased personal autonomy, better resources and access to health care and related information. Risk is socially constructed and is influenced by socio cultural factors, religious beliefs and gender. Health related risks are understood differently by lay people and practitioners. Research available on risk perception among minority ethnic groups and the immigrant population living in a western context is very limited. Risk perception among South Asians with diabetes has not been explored in particular despite the escalating incidence of Type 2 diabetes in this population. This study aimed to explore how risks related to diabetes were perceived by older South Asians with Type 2 diabetes in the United Kingdom and developing a conceptual model on risk perception. A qualitative research design using grounded theory with its theoretical foundations drawn from Symbolic Interactionism was used. Data from two focus group interviews with ethnic health development workers, seven individual interviews with practitioners and twenty interviews with older South Asians with Type 2 diabetes was collected, transcribed and analysed. The process of Cross Language interpretation (Larson 1998) was used with gender and ethnically matched interpreters to collect data from non English speaking participants. Triangulation, audit trail, peer debrief and reflexivity were used to enhance rigour in the research process. Risk perception among older South Asians was interpreted in terms of risk awareness and risk engagement. Risk awareness was influenced by factors from within the cognitive and affective domains that resulted in risk engagement. Risk engagement was proactive if risk awareness was present and the locus of control was internal. Risk awareness involving the affective domain resulted in reactive risk engagement through risk response, ranking of risks, risk repair and creation of safety nets when influenced by external locus of control. The affective domain being predominant in comparison to the cognitive domain poses significant implications in the planning and provision of services to minority ethnic groups. The concept of concordance in diabetes management and the empowerment model that advocates self management towards risk prevention as the cornerstone of diabetes management may be challenging for both South Asians and their practitioners. This model on risk prevention that is largely oriented towards the cognitive domain requiring internal locus of control needs to be carefully evaluated in minority ethnic groups such as South Asians with Type 2 diabetes.

Keywords
aaailable at EThOS: http://ethos.bl.uk/OrderDetails.do?did=1&uin=uk.bl.ethos.530146 Access from Institution: http://nrl.northumbria.ac.uk/578/