The influence of culture on diabetes self-management: perspectives of Gujarati Muslim men who reside in northwest England

BACKGROUND: This study was informed by an embodied perspective of culture, in which culture is grounded in the body and self. This contrasts with some contemporary health research and policy which adopts an oversimplified perspective, portraying culture as static and deterministic and being responsible for non-adherent self-management behaviours.

AIM: To present the findings of a study which explored the influence of culture on (type 2) diabetes self-management in Gujarati Muslim men who reside in northwest England.

METHOD: A case-study approach was used, which combined interview and participant observation methods. Data were collected from Gujarati Muslim men about their lived experiences of diabetes self-management. These accounts, along with further narrative data from 'significant other' participants, were analysed over several cycles.

RESULTS: Two central concepts guide the results: embodied culture and dynamic culture. These concepts reflect the subjective and contextual nature of culture and are illustrated in the themes 'past experiences and socio-economic factors', 'social and gendered roles' and 'personal choice and contextual factors'. The findings highlight that the complexity of life means that culture never exists in isolation, but is one of the many factors that a man negotiates to inform his diabetes self-management.

CONCLUSION: We draw attention to the dissonance between the way culture is presented in some government policy and research, and the way it is understood in an embodied approach. The National Service Framework for Diabetes advocates the provision of individualized culturally appropriate care, and in this paper, we make suggestions as to how an embodied approach can be incorporated within the framework.

RELEVANCE TO CLINICAL PRACTICE: Nurses have an integral role in implementing the National Service Framework for Diabetes. This paper contributes to the debate about how nurses can best deliver this framework to a diverse patient population.