VOLUME 11 NUMBER 2 • JUNE 2014
63
SA JOURNAL OF DIABETES & VASCULAR DISEASE
RESEARCH ARTICLE
to be a general consensus about consuming little to no red meat.
Spouses of two participants who also have diabetes heavily
influenced their eating habits. The participants pointed out that,
for the most part, they enjoy eating sweet and starchy foods, but
try to keep it to a minimum by eating smaller portions.
Nearly all the participants in the focus group did find the health
information they received from various sources as useful; however,
several of the participants found some of the health information to
be quite confusing. One participant talked about the information
that she read on the label of products in the grocery store, ‘I read
a lot in the grocery store, but I’m confused about the sugar alcohol
labelled on some items.’ The same participant went on to say that
she needed clarification on the controversy surrounding SplendaH.
One female participant found her target number for diabetes
and cholesterol to be confusing. The same participant was also
confused about the difference between baby aspirin and regular
aspirin. Another female participant, who acknowledged her caloric
goal, didn’t understand how to count the amount of calories she
consumes per day. One participant expressed frustration with the
fluctuation in his blood glucose levels, ‘I don’t understand why my
blood sugar is fluctuating. I don’t feel I need to pay for my medicine
if it’s not working.’
Identifying medications and understanding prescriptions
The most common method of identifying medication for which the
drug is prescribed was by looking at the name on the medication
bottle followed by pill colour, shape, size and imprint. Looking
at the name on the medication bottle and colour was by far the
most preferred methods of identification. More participants in the
intervention group had a greater preference for the name on the
bottle, while more of the participants in the non-intervention group
had preference for pill colour. One participant identified the use of a
pill box, ‘I don’t like it when themedicine changes,’ said one patient.
‘My doctor wants me to take generics and that messes me up…
sometimes it’s the same colour.’ Another participant identified her
medications by keeping them in separate places around the home.
A few others mentioned that they have been on the medications
for so long that they know what their medication look like. When
asked if there was an alternative way they would prefer to identify
their medication, some preferred drug name on the medication
bottle, colour, shape, size, imprint, asking a pharmacist, reading
the package insert, looking at the actual pill or verifying based on
strength. An overwhelming majority still preferred the name on the
medication bottle and colour.
Continuity of care
The most common deciding factor that made participants visit their
doctor for follow-up care was for an emergency followed by an
appointment scheduled by the primary-care physician. The most
common type of health reason mentioned that made patients
visit their primary-care physician were diabetes, hypertension, eye
problems, arthritis and prescription refills. One patient stated that
he does not visit the primary-care physician by scheduled appoint-
ments, but continuously because of his diabetes. Participants
consistently stated that they see their primary care physician every
three months. There seemed to be a variation in the responses to
the question about how often they visit other healthcare providers
because of a referral by a primary-care doctor. The responses
ranged from every two months to every year. A significant number
of participants stated their physician does not ask about other
medications they are taking. According to one participant, ‘If
I don’t take my medicines to my doctor’s appointment, he/she
doesn’t ask.’
Besides the weather, all of the participants stated that they
have no problem in keeping their scheduled appointments. ‘I’m a
diabetic and it’s important’, said one patient.
Self-monitoring of blood glucose/knowledge of BP and
glucose goal/management of high or low glucose levels
Lack of awareness of target blood glucose and blood pressure
goal was acknowledged by an overwhelming majority of both the
intervention and non-intervention participants. At least two women
spoke of how they came up with their own blood glucose goal, ‘I
didn’t get a number, but I read up on it myself.’ Another woman
said, ‘My doctor didn’t give me a target level. I developed one
for myself.’ A few participants were only aware of their morning
blood glucose level specified by their doctor while others were only
aware of their after-meals value. Others stated that they could not
remember what goal was specified for them. Nearly all participants
stated that they have no problems in checking their blood glucose,
however, a few participants didn’t like the idea of sticking their
finger because it was too painful or that the meter they used
required a lot of blood.
When asked about how they will respond to feeling shaky,
hungry and sweaty or feeling thirsty, tired and weak, nearly all said
that they will first check their blood sugar and then eat a piece of
candy or drink orange juice. A few stated that they would proceed
and eat something or drink orange juice.
Knowledge of nutrition-related goals/weight management
All participants agreed that they benefited from controlling their
blood sugar through eating plenty of vegetables and less meat.
They were aware of foods such as candy that increases their blood
sugar. They were equally aware of foods that decrease their blood
glucose such as vinegar, lemon juice, water, vegetables, broiled
chicken, turkey bacon, and fish. ‘It’s not so much the food you eat,
but what you put on it,’ said one patient.
Discussion
The focus groups did help to identify barriers to self-management
that could be associated with poor health outcomes among
minority patients with diabetes. Differences in gender, age, marital
status and culture did not seem to have an impact on the attitudes
and behaviours toward the topics under discussion. Participants’
understanding and knowledge about diabetes came from various
sources.
The participants’ perceptions about eating habits were quite
diverse, no gender difference was noticed. Nearly all the participants
in the focus group did find the health information they received
from various sources as useful, however, there were several of
the participants who found some of the health information quite
confusing. The limited health literacy seen in this study supports
the results of previous studies that have shown that inadequate or
marginal health literacy can limit a person’s ability to care for their
medical problems.
21,22
The most common method of identifying medication for which
the drug is prescribed was by looking at the name on the medication
bottle followed by pill colour, shape, size, and imprint. Looking at
the name on the medication bottle and colour was by far the most
