title: British-Pakistani women's perspectives of diabetes self-management: the role of identity.
abstract: OBJECTIVE
  To explore the effects of type 2 diabetes on British-Pakistani women's identity and its relationship with self-management.
  
  
  BACKGROUND
  Type 2 diabetes is more prevalent and has worse outcomes among some ethnic minority groups. This may be due to poorer self-management and an inadequate match of health services to patient needs. The influence that type 2 diabetes has on British-Pakistani women's identity and subsequent self-management has received limited attention.
  
  
  METHODS
  An explorative qualitative study.
  
  
  METHODS
  Face-to-face semi-structured English and Urdu language interviews were conducted with a purposively selected heterogeneous sample of 15 British-Pakistani women with type 2 diabetes. Transcripts were analysed thematically.
  
  
  RESULTS
  Four themes emerged: Perceived change in self emphasised how British-Pakistani women underwent a conscious adaptation of identity following diagnosis; Familiarity with ill health reflected women's adjustment to their changed identity over time; Diagnosis improves social support enabled women to accept changes within themselves and Supporting family is a barrier to self-management demonstrated how family roles were an aspect of women's identities that was resilient to change. The over-arching theme Role re-alignment enables successful self-management encapsulated how self-management was a continuous process where achievements needed to be sustained. Inter-generational differences were also noted: first generation women talked about challenges associated with ageing and co-morbidities; second generation women talked about familial and work roles competing with self-management.
  
  
  CONCLUSIONS
  The complex nature of British-Pakistani women's self-identification requires consideration when planning and delivering healthcare.
  
  
  CONCLUSIONS
  Culturally competent practice should recognise how generational status influences self-identity and diabetes self-management in ethnically diverse women. Health professionals should remain mindful of effective self-management occurring alongside, and being influenced by, other aspects of life.
authors.affiliation: School of Psychological Sciences, University of Manchester, Manchester, UK.
authors.forename: Rabiya
authors.initials: R
authors.lastname: Majeed-Ariss
authors.affiliation: School of Healthcare, University of Leeds, Leeds, UK.|York Trials Unit, Alcuin Research Centre, University of York, York, UK.
authors.forename: Cath
authors.initials: C
authors.lastname: Jackson
authors.affiliation: Department of Health Sciences, University of York, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Knapp
authors.affiliation: School of Health Sciences, Faculty of Medicine & Health Sciences, University of East Anglia, Norwich Research Park, UK.
authors.forename: Francine M
authors.initials: FM
authors.lastname: Cheater
mesh_terms: D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology / Q000451:nursing / Q000523:psychology*; D054242:Emigrants and Immigrants; D004739:England; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D010154:Pakistan / Q000208:ethnology; D012648:Self Care; D012944:Social Support; D016387:Women's Health
keywords: Pakistani; ethnic minority; ethnicity; identity; immigrant; race; self-management; type 2 diabetes; women