title: Diabetes service provision: a qualitative study of the experiences and views of Pakistani and Indian patients with Type 2 diabetes.
abstract: OBJECTIVE
  To explore Pakistani and Indian patients' experiences of, and views about, diabetes services in order to inform the development of culturally sensitive services.
  
  
  METHODS
  Qualitative, interview study involving 23 Pakistani and nine Indian patients with Type 2 diabetes recruited from general practices and the local community in Edinburgh, Scotland. Data collection and analysis occurred concurrently and recruitment continued until no new themes emerged from the interviews.
  
  
  RESULTS
  Respondents expressed gratitude for the availability of free diabetes services in Britain, as they were used to having to pay to access health care on the Indian subcontinent. Most looked to services for the prompt detection and treatment of complications, rather than the provision of advice about managing their condition. As respondents attached importance to receiving physical examinations, they could be disappointed when these were not offered by health-care professionals. They disliked relying on interpreters and identified a need for bilingual professionals with whom they could discuss their diabetes care directly.
  
  
  CONCLUSIONS
  Gratitude for free services in Britain may instil a sense of indebtedness which makes it difficult for Pakistanis and Indians to be critical of their diabetes care. Health-care professionals may need to describe their roles carefully, and explain how different diabetes services fit together, to avoid Pakistani and Indian patients perceiving treatment as unsatisfactory. Whilst linkworker schemes may meet patients' need to receive culturally sensitive information in their first language, work is needed to assess their effectiveness and sustainability.
authors.affiliation: Research Unit in Health, Behaviour and Change, School of Clinical Sciences and Community Health, The University of Edinburgh, Edinburgh, UK. J.Lawton@ed.ac.uk
authors.forename: J
authors.initials: J
authors.lastname: Lawton
authors.forename: N
authors.initials: N
authors.lastname: Ahmad
authors.forename: L
authors.initials: L
authors.lastname: Hanna
authors.forename: M
authors.initials: M
authors.lastname: Douglas
authors.forename: N
authors.initials: N
authors.lastname: Hallowell
mesh_terms: D000328:Adult; D000368:Aged; D001294:Attitude to Health / Q000208:ethnology*; D003695:Delivery of Health Care / Q000592:standards*; D048909:Diabetes Complications / Q000175:diagnosis / Q000208:ethnology / Q000517:prevention & control / Q000523:psychology; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology* / Q000523:psychology / Q000628:therapy; D005006:Ethnicity; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D007194:India / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D019303:Multilingualism; D010154:Pakistan / Q000208:ethnology; D017060:Patient Satisfaction / Q000208:ethnology; D011369:Professional-Patient Relations; D036301:Qualitative Research; D012606:Scotland; D012737:Sex Factors