Lisa Hanna

Service providers in Geelong, one of the priority locations for the resettlement of refugees in regional Australia, were interviewed to explore their perceptions of the health and wellbeing needs of refugees, and the capacity of service providers in a regional area to meet these. In all, 22 interviews were conducted with health and human service professionals in a range of organisations offering refugee-specific services, culturally and linguistically diverse (CALD) services in general, and services to the wider community, including refugees. The findings revealed that a more coordinated approach would increase the effectiveness of existing services; however, the various needs of refugees were more than could be met by organisations in the region at current resource levels. More staff and interpreting services were required, as well as professional development for staff who have had limited experience in working with refugees. It should not be assumed that service needs for refugees resettled in regional Australia will be the same as those of refugees resettled in capital cities. Some services provided in Melbourne were not available in Geelong, and there were services not currently provided to refugees that may be critical in facilitating resettlement in regional and rural Australia.

This paper aims to explore frail older women's lived experiences of 'community' and which aspects of 'community' they perceive as beneficial to their well-being. This qualitative project used a mixed methodological approach which integrated aspects of descriptive phenomenology and grounded theory. Ten frail, older women residing in South East Melbourne, Australia participated in in-depth interviews. This research obtained a rich and detailed account of the aspects of 'community' identified by participants as enhancing their well-being. These included: social contact, community dynamics, feelings of support and positive orientation. This paper has increased our understanding of the factors supporting well-being of frail older women. Service providers should actively consider how they can strengthen these factors to improve social connectedness for frail older women by the use of volunteers, developing social networks and increasing availability and quality of community-based activities.

Type 2 diabetes is at least 4 times more common
among British South Asians than in the general
population. South Asians also have a higher
risk of diabetic complications, a situation which
has been linked to low levels of physical activity
observed amongst this group. Little is known
about the factors and considerations which
prohibit and/or facilitate physical activity
amongst South Asians. This qualitative study
explored Pakistani (n 5 23) and Indian (n 5 9)
patients’ perceptions and experiences of undertaking
physical activity as part of their diabetes
care. Although respondents reported an
awareness of the need to undertake physical
activity, few had put this lifestyle advice into
practice. For many, practical considerations,
such as lack of time, were interwoven with
cultural norms and social expectations. Whilst
respondents reported health problems which
could make physical activity difficult, these
were reinforced by their perceptions and
understandings of their diabetes, and its impact
upon their future health. Education may play
a role in physical activity promotion; however,
health promoters may need to work with,
rather than against, cultural norms and individual perceptions. We recommend a realistic
and culturally sensitive approach, which identifies
and capitalizes on the kinds of activities
patients already do in their everyday lives.

Objective(s). To look at food and eating practices from the perspectives of Pakistanis and
Indians with type 2 diabetes, their perceptions of the barriers and facilitators to dietary
change, and the social and cultural factors informing their accounts.
Method. Qualitative, interview study involving 23 Pakistanis and nine Indians with
type 2 diabetes. Respondents were interviewed in their first language (Punjabi or
English) by a bilingual researcher. Data collection and analysis took place
concurrently with issues identified in early interviews being used to inform areas of
investigation in later ones.
Results. Despite considerable diversity in the dietary advice received, respondents offered
similar accounts of their food and eating practices following diagnosis. Most had
continued to consume South Asian foods, especially in the evenings, despite their
perceived concerns that these foods could be ‘dangerous’ and detrimental to their
diabetes control. Respondents described such foods as ‘strength-giving’, and highlighted
a cultural expectation to participate in acts of commensality with family/community
members. Male respondents often reported limited input into food preparation. Many
respondents attempted to balance the perceived risks of eating South Asian foodstuffs
against those of alienating themselves from their culture and community by eating such
foods in smaller amounts. This strategy could lead to a lack of satiation and is not
recommended in current dietary guidelines.
Conclusions. Perceptions that South Asian foodstuffs necessarily comprise ‘risky’ options
need to be tackled amongst patients and possibly their healthcare providers. To enable
Indians and Pakistanis to manage their diabetes and identity simultaneously, guidelines
should promote changes which work with their current food practices and preferences;
specifically through lower fat recipes for commonly consumed dishes. Information and
advice should be targeted at those responsible for food preparation, not just the person
with diabetes. Community initiatives, emphasising the importance of healthy eating, are
also needed.
Keywords: food; diet; identity; type 2 diabetes; Pakistani; Indian

Aims  To explore newly diagnosed Type 2 diabetes patients’ views about Scottish diabetes services at a time when these services are undergoing a major reorganization. To provide recommendations to maximize opportunities brought by the devolvement of services from secondary to primary healthcare settings.Methods  Qualitative panel study with 40 patients newly diagnosed with Type 2 diabetes, recruited from hospital clinics and general practices in Lothian, Scotland. Patients were interviewed three times over 1 year. The study was informed by grounded theory, which involves concurrent data collection and analysis.Results  Patients were generally satisfied with diabetes services irrespective of the types of care received. Most wanted their future care/review to be based in general practice for reasons of convenience and accessibility, although they disliked it when appointments were scheduled for different days. Many said they lacked the knowledge/confidence to know how to manage their diabetes in particular situations, and needed access to healthcare professionals who could answer their questions promptly. Patients expressed a need for primary care professionals who had diabetes expertise, but who had more time and were more accessible than general practitioners. Patients who had encountered practice lead nurses for diabetes spoke particularly positively of these professionals.Conclusions  Nurses with diabetes training are particularly well placed to provide information and support to patients in primary care. Ideally, practices should run ‘one-stop’ diabetes clinics to provide structured care, with easily accessible dietetics, podiatry and retinopathy screening. Newly diagnosed patients may benefit from being made more aware of specific services provided by charitable organizations such as Diabetes UK.