Cynthia Johnson and William Whetstone:
Researching Diabetes Treatment in Trinidad
and Tobago

Cynthia Johnson, associate professor and William Whetstone, professor, School of Nursing, co-authored an article titled, “Assessing Transcultural Attitudes Towards Diabetes in Trinidad,” which was published in the December 2005 issue of the Journal of the National Black Nurses Association.

“According to one physician in Trinidad and Tobago, these islands top the scales when it comes to lifestyle diseases such as diabetes, cancer, stroke and hypertension,” says Johnson. “Most people wait to see what happens instead of being proactive with their health. Another physician attributed the increase of diabetes to a direct result of poor diet, a sedentary lifestyle, too much alcohol and smoking.”

Whetstone used the American Diabetic Association’s (ADA) attitude scale, a method employed by researchers to assess the socioeconomic factors surrounding the proliferation of disease among a sample group. These factors include the need for training and teaching of patients and caretakers; the ADA criteria for maintaining hemoglobin A1C at seven or below to prevent complications such as blindness, amputations, and kidney failure; and the psychosocial impact of diabetes on families. Johnson admits that, “It is difficult to generalize perceptions."

Whetstone presented "Assessing Transcultural Attitudes Towards Diabetes Among French Parisians" at the Third Pan-Pacific Nursing Conference held in Hong Kong last November, where he explored the cultural differences in treatment of the disease between France and the United States. The Trinidad and Tobago study provided statistics on the treatment of the disease, including cultural factors ranging from living situations to traditional medicine.

“This study in Trinidad was a convenience sample from adults in the northeast section of the country, a more urban community than most,” Johnson says. “The majority of the sample provided care for themselves or were cared for by family members, friends, or a public health nurse. Nine participants reported receiving care from more than one of these sources, and more than half were under the care of a physician. Five participants reported using bush medicine.”

Johnson’s research revealed that education for health professionals should focus more on counseling skills to help patients manage their condition rather than merely diagnosis and clinical treatment.

“Based on the findings of our study, education by health professionals who merely provide straightforward information, pamphlets, and videos is ineffective,” she says. “Health education must take into consideration the contextual aspects of the individuals’ culture, lifestyle, motivation, values, and self-determination to engage in the management of their diabetes.

Most nurses believe that giving information, monitoring signs and treatment of symptoms, and complications are adequate in their repertoire of diabetic teaching. Unfortunately, this is not the case.

“Most nursing curricula lack giving in-depth counseling skills to their students for effective health teaching. It is said that in assisting a community in improving its health status, healthcare professionals must learn to understand that community and consider its beliefs and values, so that they can provide appropriate health education methodologies for working with culturally diverse groups.”

-Joanie Harmon

Photo above: William Whetstone, professor, School of Nursing. Photo by Joanie Harmon