Informing services through patient perspectives of living with type 2 diabetes mellitus in Belize
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Date
2020-12
Authors
Allen, Lindsay Patrichia
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Abstract
Type 2 diabetes mellitus (T2DM) is the leading cause of death in Belize, and its prevalence is rapidly increasing. The purpose of this study is to understand the everyday realities of people living with T2DM in Belize (e.g., barriers to care, strengths, health practices), how these affect diabetes self-management (DSM), and implications for health care. Data generation methods include interviews with T2DM patients, discussions with key informants, field notes, and participatory observation which took place in February and March of 2020.
Principal findings were categorized into three main themes. The first is that patients experience numerous difficulties, including a tiered health care system privileging those with more resources, communication barriers with health care providers, and major gaps in prevention, education, and social supports. Secondly, many Belizeans with T2DM engage in spiritual practices that provide for mental strength, stress relief, lifestyle guidance, overcoming addictions, overcoming denial, and building determination toward health promoting, life-affirming attitudes and actions. Further, geographies can empower DSM. Home is a domain where personal power is most focused. A community domain that is conducive to active living is crucial. People use a plethora of local plant medicines instead of, alongside of, or to complement pharmaceuticals for DSM without disclosure to HCPs.
Plant medicine usage and cultural-spiritual healing is pervasive in this population; therefore, health care can optimize T2DM outcomes through open dialogue and collaboration with patients, herbal doctors, traditional Indigenous medicine practitioners, community leaders, and faith leaders. Integrating these understandings will be key for moving forward to improve DSM education and support, as well as culturally safe care.
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Keywords
Type 2 Diabetes, Belize, South America, Cultural safety, Spiritual health, Mental health, Chronic disease, Garifuna, Creole, Grounded theory, Plant medicine, Barriers to care, Diabetes self-management, Spirituality/religiosity, Patient-provider communication, Traditional Indigenous medicine