Anthropologic study of immigrant patients with T2DM from Morocco to Spain

Practical implications for therapeutic patient education

Abstract

Abstract

Background: Immigration in Spain has grown exponentially, with Moroccans being the most numerous group.

Aims: To determine the profile of Moroccans with type 2 diabetes mellitus (T2DM), to provide diabetes education strategies.

Design/setting: Cross-sectional study in 10 rural and urban centres, Catalonia, Spain.

Patients and methods: T2DM patients were interviewed using a structured, evaluated interview questionnaire, translated into Arabic. Data obtained underwent descriptive statistical analysis.

Results: Forty patients, aged 50±15 years (73% females) were interviewed: 53% were illiterate; 90% lived with family; 67% lived in Catalonia >5 years; 11% used insulin; 12% used oral agents; 66% reported difficulties with diet and 44% with drugs; 54% ate Moroccan and Spanish cuisine. Self-reported causes of T2DM were: stress (38%); unknown (31%); fear (17%); inherited (14%); God (7%). Thirty-three per cent believed diabetes could be cured; 32% did not use prescribed medication; 43% did not attend appointments; 24% used alternative medicines. Language barriers were present in 60% of respondents and 80% preferred watching TV to reading. Sixty-three per cent followed Ramadan fasting. Quality-of-life ratings from 0 to 10 were >5 in 53% of respondents. Using this information, we designed and developed an educational, bilingual (Arabic/Spanish) DVD that included specific diabetes topics, Moroccan and Spanish cuisine, and recommendations for Ramadan. We also updated the carbohydrate food cup to include staple Moroccan foods.

Conclusion: Linguistic and sociocultural barriers (eg low participation rates, illiteracy and poor treatment adherence) were observed. To minimise barriers, tailored educational materials were developed.