Abstract
IntroductionDiabetes type 2 is more prevalent in ethnic minorities in the Netherlands, and outcomes of health care in general are worse compared to other Dutch patients. The purpose of this study is to explore the experiences of dieticians and the knowledge, skills and attitudes they consider to be important for effective dietetic care in migrant patients.MethodsSemi‐structured interviews were held with 12 dieticians, of various ages, ethnic backgrounds and experience. The interview guide was based on Seeleman's cultural competence model and the Dutch dietetic consultation model. Interviews were transcribed, coded and thematically analysed, revealing 7 main themes.ResultsDieticians were uncertain whether their care fulfilled their migrant patients’ needs. They experienced language differences as a major barrier for retrieving information and tailoring advice to the patient's needs. Furthermore, dieticians feel they lack cultural knowledge. An open and respectful attitude was considered important for effective care. The communication barrier hindered building a trusting relationship; however, few dieticians mentioned a need for communication training. They expressed a need for cultural competence training, specifically to acquire cultural knowledge.ConclusionDieticians struggle with providing dietetic care for migrant diabetes patients due to communication barriers and difficulty in building a trusting relationship. They are conscious of their lack of cultural knowledge, and acknowledge the need for an open and respectful attitude and essential communication skills in order to collect and convey information. They seem unaware of the impact of low (health) literacy. Cultural competence training is needed for effective dietetic care for migrants.
Highlights
Diabetes type 2 is more prevalent in ethnic minorities in the Netherlands, and outcomes of health care in general are worse compared to other Dutch patients
The largest groups originate from Turkey, Morocco, Surinam and the Dutch Antilles.1Type 2 diabetes mellitus is highly prevalent within Europe, and two to four times more prevalent in ethnic minority populations in this region.[2]
This study reveals that dieticians struggle with their care for migrant patients and are not sure whether their care fulfils the migrant patients’ needs
Summary
Diabetes type 2 is more prevalent in ethnic minorities in the Netherlands, and outcomes of health care in general are worse compared to other Dutch patients. Conclusion: Dieticians struggle with providing dietetic care for migrant diabetes patients due to communication barriers and difficulty in building a trusting relationship They are conscious of their lack of cultural knowledge, and acknowledge the need for an open and respectful attitude and essential communication skills in order to collect and convey information. They seem unaware of the impact of low (health) literacy. Amongst ethnic minorities, higher blood glucose and lipid levels are observed and severe complications occur more often[3] compared to native Dutch diabetic patients.[4] These health disparities relate to patients’ poor health literacy[5,6] and lower self-efficacy[7] resulting in poor self-management. Trained professional interpreters are hardly used due to the lack of reimbursement within the Netherlands
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