Cultural determinants: Addressing barriers to holistic diabetes care

Abstract Background: Cultural beliefs and traditional practices nearly affect all aspects of diabetes care. Therefore, understanding its broader cultural context can serve as important background information for effective care for diabetes. Materials and Methods: We conducted this study to explore the cultural determinants in diabetes care and to propose a broad theoretical framework for cultural assessment in persons with diabetes. Explanatory Model Interview Catalog interviews of 25 diabetes persons were conducted. Results: We found that perception about diabetes is influenced by tradition, customs and ethos. Diabetes does not show early signs and therefore symptoms are usually ignored until they interfere with their day-to-day living. Following dietary advice was the most difficult part of diabetes care due to varied cultural barriers. Due to cultural reasons, diabetes is still not assigned due priority by the family. Health illiteracy and cost of care were important barriers for seeking care. Diabetics taking conventional treatment often used complementary treatment, which may be hazardous. Language was also considered a barrier for effective diabetes care. Females struggle more for receiving appropriate care for their diabetes due to social and cultural factors. Conclusion: Cultural assessment needs to be done at various stages - initial assessment, identification of cultural issues in care, planning for culturally relevant intervention and evaluation. This calls for focused elements relevant to the presenting problem, necessary intervention, and participatory evaluation. Cultural values, beliefs, customs, and family patterns may be used as clues for planning diabetes care. Such interventions are likely to bear significant impact on diabetes care in times to come.