from her material. To capture the missing voice, I examined Koch and Kralik’s chronic illness research programmes who researched alongside women and men living with long-term conditions mainly in Australia. I was interested in PAR and their application of that approach to those with long-term conditions as discussed in Chapter 1. In addition to these sources, I explored grey literature including Government publications on diabetes and consulted with experts in the field regarding action research who attended the ALARA (Action Research Congress) in Melbourne in September 2010. Other sources accessed included Diabetes UK and internet search engines including Google Advanced Scholar. Following analysis of the primary data, additional searches were undertaken to help contextualise the emerging findings. I also searched the reference lists at the back of journals and reviewed the content of the diabetes journals such as Diabetes Care, The Diabetes Educator and Patient Education and Counselling to obtain relevant research articles for the inquiry. The table below summarises the searches that I undertook. Table 1: Summary of the terms Search Engines Key Words Number of papers Selected papers reviewed Included in review CINAHL Diabetes 80,088 140 (Type 2 Diabetes) 13 OU one stop search Type 2 Diabetes and Minority groups and UK 10,771 20 4 CINAHL Type 2 Diabetes and depression 19,438 13 11 OU one stop search Type 2 Diabetes and African Caribbean and UK 52 6 4 British Nursing Index Type 2 Diabetes and BME groups and UK 20 4 4 British Nursing Index Type 2 Diabetes and self-management 56 27 21 Scopus Type 2 Diabetes and lay beliefs 82 10 8 Google Scholar Type 2 Diabetes, ethnic minority and CAM 6320 10 7 Google Scholar PAR and chronic illness and women 17,100 30 11 Total 260 83 Inclusion criteria
Medical Management – Metformin, things are different when first diagnosed to now 10-20 years . Health Service – GP Knowledge – Recognises that she needs to keep diabetes under control so test glucose levels on a regular basis, obtain information from balance magazine that she reads and son is a scientist. Self-Management – Changed diet post diagnosis if not got a hypoglycaemic coma, used to be an erratic eater. No longer follows a proper Guyanese diet but eats peas and rice and cassava occasionally. Aware of the co-morbidities of diabetes e.g. heart problems. Made lifestyle changes. Testing sticks expensive, not free, a problem for many hence no testing. Complications – hypertension, degenerative disease affecting all organs in the body Family history - none UK – Came at 23 to join husband and studied to be a teacher. Work – Teacher, head of English Department, enjoyed teaching but became stressed with OFSTED so retired. Emotional issues – Problems with marriage as husband worked overseas so got a divorce Spiritual – A Methodist all her life but still attends Methodist church in UK. Praying helps. Guyana – Good memories, happy growing up in the country side, enjoyed a free life. Guyanese Diaspora – Active in the community, helps out at a club. Feeling Low- Sometimes gets a low unexplained feeling, difficulties managing a long-term condition Voice – Recognises the need for a more holistic service under one roof rather than having to attend podiatry clinics or retinal screening elsewhere. So many things to check – feet, eyes, you have to aware of these things yourself, take control. Doctors are blinkered, only see diabetes, need to be reminded about doing other tests e.g. kidney, liver. Predisposition – Problems with black people with kidneys problems – needs another way to test