There wasn't a difference between my self assessment and the peer review. I dressed appropriately,…
Turkish people and diabetes
The focus of this research is to find if Turkish people enjoy the benefits of the Disease Management Program, DAMP. Specifically, the article talks about people that have the diabetes mellitus type 2 (DAM), (Moisakos, Anna Christen and Christopher Suffolk 2014). To have a clear Idea and comparison, the data have been compared to another study that concentrated on studying the non-immigrant with diabetes part of the DAMP (Mawkish, Anna Christina and Christopher Suffolk 2014). In Germany they introduced the DAMP to try improve the health care among people with chronic conditions.
Even though the article stated that many studies do not confirm people have better advantages being part of these program, it is a useful tool to help the patients to get more benefits from the health system (Mawkish, Anna Christina and Christopher Suffolk 2014). The study took the sample in Hamburg by interviewing the Turkish people, face to face. The sample is almost evenly distributed by gender and the people have been chosen in two ways. The first method was by the doctor’s offices and the second one by word of mouth. The research stated that In this way they took a more random sample.
The final number from 294 possible candidates, 108 participants were part of the program. The Interviews were managed by well- trained Interviewers that spoke both German and Turkish fluently (Moisakos, Anna Christina and Christopher Suffolk 2014). As stated before, the research took the sample and compared it to the doctoral thesis research by Barbara Ourџ-Thiele (Mawkish, Anna Christina and Christopher Suffolk 2014). The sample size is 702 people interviewed by medical professionals and the questionnaire was composed by 29 items (Mawkish, Anna Christina and Christopher Suffolk 2014).
The result wowed the difference between the two samples. It used two different ways to show all the different variables of the research, one is the process of quality in these 4 factors, the examination of the feet, the referrals to the pathologist , the receipt of documentation sheet and the participation In diabetes training. Instead the second one Is the outcome of quality, they focused on the following 5 factors, the Hob, the Blood Pressure, Body weight, Intake of fruit and vegetables and physical actively (Mawkish, Anna Christina and Christopher Suffolk 2014).
The visit to the GAP and the sit to the topologists are two levels of the structure of this DAMP. The Turkish immigrants sample saw the GAP twice in one year instead the German people sample in 3 months they had the visit. Instead, for the eye doctor, the Turkish sample saw the doctor more often than the non-immigrants sample. For the examination of the feet both people from the two sample had the feet checked regularly. The difference came to the pathologist case, in the non-immigrant sample, 15% were suffering from the diabetic foot, 43% were sent to the specialist.
Instead the Turkish sample was sent to only 15% to the pathologist. In the outcome of quality, the Hob was tested by asking If they were able to recall the status and 41% of Turkish were able to recall compared of 64% to the German sample. Similarly was tested the blood pressure and the lifestyle by asking the people’s eating habits (Moisakos, Anna Christina and Christopher Suffolk 2014). After all these comparisons, I need to make few difference. It is not always truth that bigger sample is more accurate than smaller sample but compared 2 sample of different sizes can be a problem to get some accurate results.
The fact also that non-immigrant sample was not equally strutted in gender like the Turkish sample may not give the accuracy required. Besides this, it is important to talk about the language and education. The fact that Turkish people after many years in Germany still do not have the German language well assimilated is an issue. Also, the education level is really low and that do not help patients to be “empowered” (Mawkish, Anna Christina and Christopher Suffolk 2014) and be able to use fully the health services provided.
Doctors can forget to tell patients important information due to time constrain but also the patients could eave problems to understand completely the doctor’s information. Also, doctors usually use more medical language, that makes everything harder. Link to this language’s aspect, the Turkish sample was taken by German and Turkish interviews. What it comes to mind is the research did not specify if they were German or Turkish. It is important in this case considering that interviewers needed to be well prepared.
The research talked about the intensive training but not specific on what. The language was key here not only on the fluent aspect but also in the meaning and expression aspect. People can talk a language well (the interviewers) but similar to the concept of back translation, the interviewers needed to really understand well what the people respond to them and manage well the data. Due to this, it could happen that some errors could occur if the interviewers and the people did not check reciprocally carefully.
The most important implication in the study is the language that gives consequently a lower health literacy. This is the main aspect that influences people’s poorer health services. Even thought, the results between the Turkish sample and the German sample do not show big difference, there are many aspects that show that Turkish sample do not fully use all the services (Mawkish, Anna Christina and Christopher Suffolk 2014). It is possible like the article mentioned that immigrants go to Turkey often to get medical support.
Still, the amputations is a clear outcome where the health communication is not apply between doctor and patient. If Turkish people have the “foot syndrome” need a visit to the pathologist. If the physician do not send the patient or the patient do not understand the imminent priority, means that the communication failed and amputations are not a good ending for the patients. Factors like the limited language of the Turkish people and time constraint of the doctor to explain clearly everything can bring not good consequences due too poor interaction.
A main question that came to my mind is how is possible than after thirty years Turkish people are not so well integrated in the German society. Integration could be aim by helping people learning German proficiently. The goal is not that Turkish people forget their origins but knowing better German language and society traditions can help them to gain fully of the service the society gives. Education is another important goal. The education level has to increase.
More Turkish health employees could help to overcome to this situation. Probably if the state specifically incentives the Turkey people to study and gain a higher educational level could help the immigrants for new opportunities. New study would be to evaluate the doctor-patient relationship in the German among the Turkey generations part of the DAMP. Both sample will take young adults between 21-30 years old, both genders that has chronic asthma. Take similar sample sizes and evaluate the differences.
What the research would aim to understand how younger generations managed the relationships in the health system and how this lead to different outcomes. I believe that younger Turkish people might have different language level compared to the older generations. After that, it would be interesting understand if there is a difference in health literacy between the older and younger generations in the Turkish population. In this case, if there is not going to be a difference, the state would really need to incentive younger Turkish people to improve their language skills.