British‐Pakistani women's perspectives of diabetes self‐management: the role of identity

Aims and objectives 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. Design 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. Relevance to clinical practice 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.