An ethnographic investigation of self-management of type-2 diabetes mellitus in Chinese people in China and Wales.

The number of Chinese patients with type-2 diabetes in China and Wales has been increasing dramatically, which has been one of the most prominent health challenges in the two countries. Self-management provides an effective strategy to encourage patients with type-2 diabetes and their family carers to be involved in activities such as lifestyle modification, self-testing of blood glucose, and adherence to daily medication treatment to control their condition in daily lives. However, there is limited research that has explored the perspectives and practices of self-management among Chinese patients in China and Wales. The aim of this study was to investigate self-management of type-2 diabetes from the perspectives and practices of Chinese patients with type-2 diabetes and their family carers living in China and Wales.Data were generated through the use of ethnography that entailed semi-structured interviews with a purposive sample of Chinese patients with type-2 diabetes in China (n=13) and their family carers (n=7) and Chinese patients with type-2 diabetes in Wales (n=13) and their family carers (n=7). Data generation also included a review of participants’ own records of self-management, and observation of public diabetes education sessions in China and in Wales. After thematically analysing the data five key themes emerged: symptom perception and emotional responses to being diagnosed with type-2 diabetes, diabetes-related knowledge and information sources, the positive and negative consequences of type-2 diabetes, the practices of self-management, and barriers and facilitators of self-management of type-2 diabetes among Chinese patients and their family carers in China and Wales.The findings indicated that there was limited awareness and knowledge regarding type- 2 diabetes and self-management among Chinese patients and their family carers in both China and Wales. This was mainly attributed to lack of financial support and access to reliable information sources in China and language barriers in Wales. Another important barrier to self-management among Chinese patients in Wales was lack of family support. In addition, this study has also identified the positive and negative influences of Chinese tradition cultural norms on self-management.This study makes a significant contribution to the limited research on the perspectives and practices of self-management among Chinese patients and their family carers in China and Wales. In particular the findings provide an in depth understanding of the Chinese cultural influences on self-management of type-2 diabetes in two different contexts. Recommendations are provided for health care providers, diabetes educators, health policy makers, and research community