TY - JOUR
T1 - "In a situation of rescuing life"
T2 - Meanings given to diabetes symptoms and care-seeking practices among adults in Southeastern Tanzania: A qualitative inquiry
AU - Metta, Emmy
AU - Bailey, Ajay
AU - Kessy, Flora
AU - Geubbels, Eveline
AU - Hutter, Inge
AU - Haisma, Hinke
N1 - Funding Information:
This study is an integral part of the Netherlands Initiative for Capacity Building in Higher Education (NICHE/TZA/005) project, which seeks to address various aspects of health care in the context of the epidemiological transition in Tanzania. NICHE is funded by the Netherlands Organization for International Cooperation in Higher Education (NUFFIC). The authors acknowledge the support received from the Ifakara Health and Demographic Surveillance System (HDSS) team members and the MZIMA project staff during the data collection processes. We thank our study participants who participated in or otherwise contributed to these results. Finally the authors wish to acknowledge Dr. Shubis Kafuruki for his generous assistance in overseen the coherence of the medical aspects in the article. This manuscript is published with permission from Dr. Mwele Malecela, Director-General, National Institute for Medical Research NIMR/HQ/R.8a/VOL.IX/1389 31August, 2012.
Publisher Copyright:
© 2015 Metta et al.; licensee BioMed Central.
PY - 2015/12/12
Y1 - 2015/12/12
N2 - Background: Diabetes mellitus is an emerging public health problem in Tanzania. For the community and the health system to respond adequately to this problem, it is important that we understand the meanings given to its symptoms, and the care-seeking practices of individuals. Methods: To explore collective views on the meanings given to diabetes symptoms, we conducted nine focus group discussions with adult diabetes patients and members of the general community. To gain a better understanding of how the meanings in the community inform the care-seeking practices of individuals, 19 in-depth interviews were conducted with diabetes patients. The data were analyzed using principles of grounded theory and applying cultural schema theory as a deductive framework. Results: In the communities and among the patients, knowledge and awareness of diabetes are limited. Both people with diabetes and community members referred to their prevailing cultural meaning systems and schemas for infectious diseases to interpret and assign meaning to the emerging symptoms. Diabetes patients reported that they had initially used anti-malarial medicines because they believed their symptoms - like headache, fever, and tiredness - were suggestive of malaria. Schemas for body image informed the meaning given to diabetes symptoms similar to those of HIV, like severe weight loss. Confusion among members of the community about the diabetes symptoms instigated tension, causing patients to be mistrusted and stigmatized. The process of meaning-giving and the diagnosis of the diabetes symptoms was challenging for both patients and health care professionals. Diabetes patients reported being initially misdiagnosed and treated for other conditions by medical professionals. The inability to assign meaning to the symptoms and determine their etiologies informed the decision made by some patients to consult traditional healers, and to associate their symptoms with witchcraft causes. Conclusion: The meanings given to diabetes symptoms and the care-seeking practices described in the study are shaped by the prevailing cultural schemas for infectious diseases and their treatments. Efforts to educate people about the symptoms of diabetes and to encourage them to seek out appropriate care should build on the prevailing cultural meaning system and schemas for diseases, health and illness.
AB - Background: Diabetes mellitus is an emerging public health problem in Tanzania. For the community and the health system to respond adequately to this problem, it is important that we understand the meanings given to its symptoms, and the care-seeking practices of individuals. Methods: To explore collective views on the meanings given to diabetes symptoms, we conducted nine focus group discussions with adult diabetes patients and members of the general community. To gain a better understanding of how the meanings in the community inform the care-seeking practices of individuals, 19 in-depth interviews were conducted with diabetes patients. The data were analyzed using principles of grounded theory and applying cultural schema theory as a deductive framework. Results: In the communities and among the patients, knowledge and awareness of diabetes are limited. Both people with diabetes and community members referred to their prevailing cultural meaning systems and schemas for infectious diseases to interpret and assign meaning to the emerging symptoms. Diabetes patients reported that they had initially used anti-malarial medicines because they believed their symptoms - like headache, fever, and tiredness - were suggestive of malaria. Schemas for body image informed the meaning given to diabetes symptoms similar to those of HIV, like severe weight loss. Confusion among members of the community about the diabetes symptoms instigated tension, causing patients to be mistrusted and stigmatized. The process of meaning-giving and the diagnosis of the diabetes symptoms was challenging for both patients and health care professionals. Diabetes patients reported being initially misdiagnosed and treated for other conditions by medical professionals. The inability to assign meaning to the symptoms and determine their etiologies informed the decision made by some patients to consult traditional healers, and to associate their symptoms with witchcraft causes. Conclusion: The meanings given to diabetes symptoms and the care-seeking practices described in the study are shaped by the prevailing cultural schemas for infectious diseases and their treatments. Efforts to educate people about the symptoms of diabetes and to encourage them to seek out appropriate care should build on the prevailing cultural meaning system and schemas for diseases, health and illness.
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U2 - 10.1186/s12889-015-1504-0
DO - 10.1186/s12889-015-1504-0
M3 - Article
AN - SCOPUS:84928729010
SN - 1471-2458
VL - 15
JO - BMC Public Health
JF - BMC Public Health
IS - 1
M1 - 224
ER -