More than 2 million Canadians have diabetes, a condition that can lead to serious complications such as kidney disease, heart disease and nerve damage.
Diagnosis of this condition can be scary; especially for Chinese-speaking patients who may not feel comfortable talking about their diagnosis in English, and may be dealing with cultural lifestyles that differ from the traditional Canadian lifestyle. Educators at The Scarborough Hospital’s (TSH) Diabetes Education Centre have recognized this, and created an education program in which educators speak and provide information in Cantonese, using familiar Chinese references throughout. Patients, who might otherwise feel reserved and inhibited in classes that are conducted in English with Western cultural references, can comfortably ask questions and share concerns regarding their condition in Cantonese with professionals who understand both their condition and their culture.
“Many Chinese patients won’t speak up in a traditional program, because the class is in English and the foods are not what they eat at home,” says Mirander Wah, a registered nurse with the Diabetes Education Centre. “So, instead they stay quiet and don’t get as much out of the classes as the English-speaking patients do.” In part one of the program at TSH, a nurse and dietitian teach participants about what diabetes is and how it can be managed with good food choices, exercise and awareness. They also teach patients about treatments and the use of a glucometer, and provide handouts and samples. The class is structured around more culturally familiar references, which encourages increased involvement and participation, resulting in better support group development for participants.
As with any other class, participants receive homework to be completed for the next week. Patients are asked to record their meals, the foods they eat and their exercise routines. They record their sugar levels before eating and two hours after. Patients can learn to recognize how blood sugar levels can be affected by their food choices and activities.
“Part two is a lot more fun and a more interactive class,” says Mirander. It focuses on prevention of long-term diabetes and complications. Homework results are reviewed and discussed, and patients are encouraged to share their experiences from the past week with any observations they have made about the links between food, exercise and sugar levels.
A pharmacist and a social worker join the education team at this point leading discussions in medication options, foot care and community support. The nurse discusses possible long-term complications of diabetes with the group, and the dietician goes into greater detail regarding diet requirements and food portions, focusing on Chinese foods. This discussion also helps the medical team identify any possible health issues early, so the appropriate assistance can be provided to those patients, reducing the possibility of future complications.
Participation in the program is voluntary and open only to those patients with Type 2 Diabetes referred by their doctor. Once a referral is received, the Centre contacts the patient for registration in the program. The two – three hour classes are held at The Scarborough Hospital General Campus and are covered by OHIP. Although the classes are only offered in Cantonese now, the Diabetes Centre hopes to expand the program and offer classes in Mandarin soon. Mandarin-speaking patients can meet with a nurse and a dietitian on an individual basis by request.