Download 2009-05-04-2329-Chinatown_Clinic

Treating Chinese Diabetic Patients
Judi Wong
Drexel University School of Public Health
May 2009
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107
Interactive Main Menu
Introduction
Common medical terminology for diabetes treatment
Frequently used terminology for diabetes symptoms
The Chinese culture and perceptions of type 2 diabetes
The Chinese culture and social impacts of type 2 diabetes
The Chinese culture and type 2 diabetes diet management
The Chinese culture and type 2 diabetes fitness management
The Chinese culture and type 2 diabetes medication
management
Contacts
References & Resources
Note: The Chinese characters used in this module are in simplified form, and the
pronunciation that follows the characters are in hàn yŭ pīn yīn, Mandarin Chinese.
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107
Introduction
At the Chinatown Clinic, we serve a variety of
populations in the community, and to a greater
extent, most of the patients are of Chinese or
Indonesian origin. Many of them suffer from
Type 2 diabetes and thus seek help at our clinic.
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107
Introduction
Our underlying concern: How may medical
students relate to a patient population whose
culture and language are different from the
students’? Though our clinic’s patient
interpreters are instrumental in removing the
language barrier, there are still several cultural
aspects with each population that medical
students (and all health care providers) should
be cognizant of.
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107
Introduction
Thus, this module intends to familiarize
participating medical students (and other
interested parties) with the particulars of the
Chinese culture that play a substantial role in
addressing Type 2 diabetes treatment and health
management.
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107
Introduction
The information contained within this module are
not exhaustive on this particular topic, and
interested medical students are encouraged to
seek more information by themselves, perhaps
using the listed references and resources as a
starting point.
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107
Common medical terminology
for diabetes treatment
• Diabetes 糖 尿 病 (táng niào bìng)
• Insulin 胰 岛 素 (yí dăo sù)
• Glucose “糖” (táng) ; 葡 萄 糖 (pú táo táng) “grape sugar”
• Pancreas 胰 腺 (yí xiàn)
• Blood test 验 血 (yàn xuè [xuĕ])
• Blood sugar 血 糖 (xuè [xuĕ] táng)
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107
Common medical terminology
for diabetes treatment
• Blood pressure
血 压 (xuè [xuĕ] yā)
• High blood pressure
高 血 压 (gāo xuè [xuĕ] yā)
• Low blood pressure
低 血 压 (dī xuè [xuĕ] yā)
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107
Common medical terminology
for diabetes treatment
• Cholesterol 胆 固 醇 (dăn gù chún)
• LDL (low density lipoprotein)
低 密 度 脂 蛋 白 (dī mì dù zhī dàn bái)
• HDL (high density lipoprotein)
高 密 度 脂 蛋 白 (gāo mì dù zhī dàn bái)
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107
Common medical terminology
for diabetes treatment
• Triglycerides 甘 油 三 酯 (gān yóu sān zhĭ)
• Lipids 脂 肪 (zhī fáng) ; 脂 质 (zhī zhì)
• Fat 肥 (féi) ; 油 (yóu) ; 脂 肪 (zhī fáng)
• Saturated fat 饱 和 脂 肪 (băo hé zhī fáng)
• Unsaturated fat 不 饱 和 脂 肪
(bù băo hé zhī fáng)
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107
Common medical terminology
for diabetes treatment
• Breathe 呼 吸 (hū xī)
• Take a deep breath 深 呼 吸 (shēn hū xī) ;
深 吸 气 (shēn xī qì)
• Hold your breath 屏 气 (bĭng qì) ; 屏 吸 (bĭng xī)
• Exhale 退 气 (tuì qì) ; 呼 出 (hū chū)
• Inhale 吸 气 (xī qì) ; 吸 入 (xī rù)
• Hard time breathing/asthma
气 喘 (qì chuăn) ; 哮 喘 (xiāo chuăn)
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107
Frequently used terminology
for diabetes symptoms
• Dizziness 头 晕 (tóu hūn)
• Numbness 麻 (má)
• Fingers 手 指 (shŏu zhĭ)
• Toes 脚 趾 (jiăo zhĭ)
• Eyesight 视 力 (shì lì)
• Failing eyesight 视 力 下 降 (shì lì xìa jiàng) ;
视 力 衰 退 (shì lì shuāi tuì)
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107
The Chinese culture and
perceptions of Type 2 diabetes
Diabetes: The Name Itself
In Chinese, the general term for “diabetes,” 糖 尿 病
(táng niào bìng), can be literally translated as “sugared
urine,” and there is no specific distinction between Type
1 [胰 岛 素 依 赖 性 糖 尿 病 (yí dăo sù yī lài xìng táng
niào bìng)] and Type 2 diabetes. Thus, for the most part,
the disease is referred to by its most prominent
symptom, and not by a technical medical term or a
generalization of the disease etiology.
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107
The Chinese culture and
perceptions of Type 2 diabetes
Diabetes: Etiology, chronicity, and the physician’s role
From the previous note concerning the Chinese term
for diabetes, it can also be derived that many Chinese
patients do not understand much about the etiology of
the disease, and perhaps even less of the concept that
diabetes is a chronic disease. For example, in a study
with Chinese immigrants in the United States, who had
Type 2 diabetes, the participants believed that going to
the doctor would soon cure them of the disease [1].
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107
The Chinese culture and
perceptions of Type 2 diabetes
Diabetes: Suffering from the disease
In the same study [1], one of the participants also
referred to having Type 2 diabetes as “suffering” from
the disease. The investigators noted through their
behavioral model that there is a “cognitive processing,”
or an objective view that many Chinese patients have of
the disease (such as the disease being hereditary), yet,
when expressing their health condition, the patients do
so in an “emotional” manner, such as with the
statement, “I suffer from diabetes.”
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107
The Chinese culture and
perceptions of Type 2 diabetes
Diabetes: Self-incrimination
The investigators found that 100% of the Chinese
immigrants blamed themselves for being a diabetic,
especially citing their dietary habits and lifestyles as the
main culprits. It is an unfortunate point of view when one
takes into account that new immigrants in the United States
usually undergo “major changes in diet, occupation,
exercise,” and most importantly, “psychosocial stress [1]:”
the bottom line is that it is not entirely their fault.
Many Chinese people also adhere to the traditional of “selfdiscipline,” and when a disease sets in, their “managing self
before managing others” attitude becomes shattered [2].
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107
The Chinese culture and
social impacts of Type 2 diabetes
Support from family vs. support from friends:
Traditionally, the Chinese maintain strong family ties
with pride [8], and find support (though usually not
emotional support) from relatives. However, as many
immigrants in the United States who have left their
families behind, Chinese immigrants particularly rely
more often on their friends for advice and as well as for
emotional support. Even with families established here,
Chinese people (especially with women) still do not
confide in with their family members.
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107
The Chinese culture and
social impacts of Type 2 diabetes
Social gatherings:
For many Chinese people, a highlight of the weekend (or
any day) is chance to go out and eat with family and friends,
especially to “dim sum (Cantonese Chinese)” 点 心
(Mandarin Chinese: diăn xīn). The word literally means
“dessert” or “delicacies” and indeed, the foods present in
dim sum are all high in starch, sugar, salt, fat (meat), grease,
and a lot of which are deep fried pastries.
Another term for this type of meal is 饮 茶 (yĭn chá),
“drinking tea,” for tea is consumed as a complement to all
the food. (continued next slide)
http://whatiatetoday.files.wordpress.com/2008/03/dim-sum.jpg
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107
The Chinese culture and
social impacts of Type 2 diabetes
Social gatherings: (continued)
However, dim sum is not healthy for a person with Type 2
diabetes, and for the Chinese patient, it is extremely hard not to
accept an invitation from friends. It is up to the patient to be
able to limit themselves on the amount of food that they
consume, which becomes more difficult if the patient has not
informed relatives or friends that they do have Type 2 diabetes.
Yet, as investigators have found out, “some people may choose
to eat foods that raise blood glucose levels because they feel
socially obligated to do so [1].” This train of though certainly
comes into play with Chinese diabetic patients when they have to
learn how to balance managing their own health and managing
their social ties.
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107
The Chinese culture and
social impacts of Type 2 diabetes
Cooking at home:
For many Chinese women, cooking is a duty that is delegated to
them in the family. However, the catch is that they also must
cook what their husband or family prefers to eat.
One patient related the observation that she would like to follow
the doctor’s orders to eat less meat (less fat, oil/grease, and
cholesterol), more vegetables, more fruit, and basically have a
more balanced diet, yet, her husband loves meat and thus she
must cook it. Living on a budget, the patient also does not see
cooking separate meals for herself and her husband as practical,
and does not like to see food wasted. A suggestion could be that
during the day, the patient may pursue balanced meals, leaving
the meat and starch for dinner when she cooks for her husband.
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107
The Chinese culture and
Type 2 diabetes diet management
Foods/terms that are seldom found in the Chinese culture:
#1: Butter 黄 油 (huáng yóu)
Butter is rarely used in the Chinese cuisine [5]. However,
a lot of oil 油 (yóu) is usually used when cooking, so it
might be a good reminder for the patient to use less oil
when cooking, or to eat less greasy foods. Frosting (or
whipped cream) 奶 油 (năi yóu), though, has become
popular in Asian bakeries, featured prominently on
cakes and in frosting buns 奶 油 包 (năi yóu bāo), which
are eaten for breakfast or lunch.
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107
The Chinese culture and
Type 2 diabetes diet management
Foods/terms that are seldom found in the Chinese culture:
#2: Milk 牛 奶 (niú năi)
Milk is not a part of the Chinese palate. It is also a known
fact that a lot of Asian people are lactose intolerant, and
thus, milk is generally not consumed. More often than not,
Chinese people regularly drink soy milk 豆 奖 (dòu jiāng).
Dairy products, such as cheese 起 士 (qĭ shì: a phonetic
translation of “cheese”), are not popular as well, but
frosting 奶 油 (năi yóu), can be found on cakes and in buns.
www.hungrykaren.com/photos/creambun.jpg
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107
The Chinese culture and
Type 2 diabetes diet management
Foods/terms that are seldom found in the Chinese culture:
#3: Carbohydrates 碳 水 化 和 合 物 (tàn shuĭ huà hé wù)
The term for carbohydrates is not commonly used in the
Chinese culture [6]. Usually, the word starch 淀 粉 (diàn fĕn)
is used as a substitute term, but even then, rice is basically
the key word when speaking of carbohydrates.
What Chinese people will recognize as starchy foods would
be [baked] bread 面 包 (miàn bāo), buns 包 (bāo), steamed
buns 蒸 包 (zhēng bāo), tapioca/starch 淀 粉 (diàn fĕn)
products, taro 芋 头 (yù tóu), and of course, rice 米 (mĭ),
including sticky/glutinous rice 糯 米 饭 (nuò mĭ fàn). Corn
starch is also found in the sauces of many dishes.
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107
The Chinese culture and
Type 2 diabetes diet management
Chinese Festivals and Starch:
Festivals are not the same as holidays, so asking a Chinese
patient if they are “able to follow a healthy eating plan
when [you are] on holiday” is not as effective as asking
them if they are “able to follow a healthy eating plan during
festive periods [7].”
The most notable starchy-food filled holidays (not even
mentioning the rice consumed at gatherings) [7]:
- Chinese New Year 新 年 (xīn nián): (late Jan – Feb)
Year cake 年 糕 (nián gāo) made of rice flour.
(continued on next slide)
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107
The Chinese culture and
Type 2 diabetes diet management
Chinese Festivals and Starch: (continued)
- Dragon Boat Festival 端 午 节 (duān wŭ jié):
(late May – June)
粽 字 (zhòng zï) are leaf-wrapped glutinous rice
mounds stuffed with meat, beans, or sweet bean paste.
- Mid-Autumn Festival 中 秋 节 (zhōng qiū jié):
(late Aug – Sept)
Moon cakes 月 饼 (yuè bĭng) are pastries made of
flour stuffed with sweet paste (usually bean paste).
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107
The Chinese culture and
Type 2 diabetes diet management
Frequently used food reference terms:
• Wheat 全 麦 (chuán mài)
• Oatmeal 麦 片 (mài piàn)
• Grain/oats 大 麦 (dà mài) ; 小 麦 (xiăo mài)
• Rice 米 (mĭ)
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107
The Chinese culture and
Type 2 diabetes diet management
Frequently used food reference terms:
• Fiber/cellulose 纤 维 素 (xiān wéi sù)
• Carbohydrates 碳 水 化 和 合 物
(tàn shuĭ huà hé wù)
• Starch 淀 粉 (diàn fĕn)
[this term is usually used in place of the word
carbohydrates]
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107
The Chinese culture and
Type 2 diabetes diet management
Frequently used food reference terms:
• Vegetables 素 菜 (sù cài) ; 青 菜 (qīng cài)
• Meat 肉 (ròu)
• Milk 牛 奶 (niú năi)
• Soy milk 豆 奖 (dòu jiāng)
• Diary 乳 汁 品 (rŭ zhī pĭn)
• Eggs 蛋 (dàn)
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107
The Chinese culture and
Type 2 diabetes diet management
Frequently used food reference terms:
• Fat 肥 (féi)
• Oil/grease 油 (yóu)
• Protein 蛋 白 质 (dàn bái zhĭ)
• Vitamins 维 生 素 (wéi shēng sù)
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107
The Chinese culture and
Type 2 diabetes diet management
Frequently used food reference terms:
• Sugar 糖 (táng)
• Sweet 甜 (tián)
• Salt 盐 (yán)
• Salty 咸 (xián)
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107
The Chinese culture and
Type 2 diabetes fitness management
The task of daily exercising:
Many of the Chinese patients at the Chinatown Clinic
have occupations that require them to work more than
eight hours or have shifts that begin at odd hours.
Thus, a daily exercise regimen may be difficult to fit
into their schedule. Some may take a brisk walk or run,
or do some stretching in the mornings before work,
though many probably opt out of the practice.
Their work schedule may also impact other aspects of
diabetes health management, such as in the intake of
meals, which may occur at irregular hours for patients
that must work long hours or have multiple jobs.
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107
The Chinese culture and
Type 2 diabetes fitness management
Individual vs. organized exercise:
Chinese people tend to exercise on their own (with the
exception of Tai Chi groups one might see gathered in
parks). Advocating exercise to a Chinese patient would
emphasize finding their own time and place to exercise,
versus searching for a group or gym to exercise with [2].
In an intervention study done in Hong Kong, participants
did not change their exercise habits even when the diabetes
management program incorporated promoted “use of
organized exercise” as one of the options for exercise
(baseline: 2.0% ; post-test: 1.6%) [2].
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107
The Chinese culture and
Type 2 diabetes medication management
Western and Traditional Chinese Medicine (TCM):
For many Chinese immigrants, traditional Chinese herbal
medicine continues to play a large part in the treatment of
general ailments, even when they do have prescription
medicine on-hand from physicians here in the United
States. In the clinic, many patients have revealed that they
request these herbal medicines from relatives still residing in
Asia.
Western medicines are perceived to act more quickly than
the herbal medicines, with the latter acting slower to restore
“balance” in the body [8]. Thus, the two can be seen as
complements in the treatment of diseases.
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107
The Chinese culture and
Type 2 diabetes medication management
Western and Traditional Chinese Medicine (TCM):
However, in the literature, there is not enough evidence to
show that there are large positive benefits, or large negative
side-effects, with a Western-Chinese herbal medications
cocktail in the treatment of Type 2 diabetes [3,4]. As Wong,
Lau, Prabaharan, and Pirotta (2008) wrote, “there is little or
no information regarding the potential benefits or risks of
this combined Western/Chinese herbal medicine approach
[3].”
Yet, it would be just a good note to jot down in a patient’s
record if a patient does take herbal medicine.
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107
The Chinese culture and
Type 2 diabetes medication management
The physician’s role:
As mentioned in “The Chinese culture and perceptions of
Type 2 diabetes” section, the Chinese rely heavily on “the
doctor” for guidance in managing their disease, hoping that
the doctor will cure them [1]. Thus, Chinese patients will
usually follow the doctor’s directions with strict adherence
[8] (unless work or other personal matters present an
obstruction in the daily medication schedule) by simply
memorizing what the doctor says to them [6].
It then becomes the physician’s responsibility to emphasize
to the patient that it is not only the medication regimen that
assists in managing this chronic disease, but also the
underlying factors of daily exercise and appropriate diet
prescribed.
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107
Contacts
Vincent Zarro, M.D., Ph.D.
Assistant Dean, Special Student Services &
Community Experience
Associate Professor of Medicine
Drexel University, Bellet Building
1233 Race Street, Philadelphia, PA 19107
Tel: (215) 762-4920
Email: [email protected]
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107
Contacts
Barbara Hogan, Ph.D.
Associate Professor of Human Services
Acting Dean, School of Graduate Studies
Chestnut Hill College
9601 Germantown Ave., Philadelphia, PA 19118
Tel: (215) 248-7120
Email: [email protected]
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107
Contacts
Regina “Jean” N. Linehan, R.N., M.S., C.D.E.
Director, Diabetes Education Center
University of Pennsylvania Health System
Pennsylvania Hospital
Ayer Building, First Floor
800 Spruce Street, Philadelphia, PA 19107
Tel: (215) 829-5725
Email: [email protected]
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107
Contacts
Chinatown Clinic
Holy Redeemer Chinese Catholic Church
915 Vine Street (corner of Vine St. and 10th St.)
Philadelphia, PA 19107
Email: [email protected]
Hours: Every Wednesday evening beginning at
5:00 pm
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107
References and Resources
[1] Jayne, R.L., & Rankin, S.H. (2001). “Application of Leventhal’s
Self-Regulation Model to Chinese immigrants with Type 2
diabetes.” Journal of Nursing Scholarship, 33(1): 53-59.
[2] Chan, S.C.C., Siu, A.M.H., Poon, P.K.K. & Chan, C.C.H. (2005).
“Chronic disease self-management program [CDSMP] for
Chinese patients: a preliminary multi-baseline study.” International
Journal of Rehabilitation Research, 28: 351-354.
[3] Wong, A.K.Y., Lau, P.M.Y., Prabaharan, V., & Pirotta, M. (2008).
“Letters to the Editor: Chinese herb usage among Chinese
Australians with Type 2 diabetes.” Australian Family Physician,
37(10): 791.
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107
References and Resources
[4] Liu, J.P., Zhang, M., Wang, W.Y., & Grimsgaard, S. (2004).
“Chinese herbal medicines for Type 2 diabetes mellitus.” Cochrane
Database Syst Rev., (3): CD003642.
[5] Xu, Y., Savage, C., Toobert, D., Pan, W., & Whitmer, K. (2008).
“Adaptation and testing of instruments to measure diabetes selfmanagement in people with Type 2 diabetes in mainland China.”
Journal of Transcultural Nursing, 19(3): 234-242.
[6] Chan, Y.M., & Molassiotis, A. (1999). “The relationship between
diabetes knowledge and compliance among Chinese with noninsulin dependent diabetes mellitus in Hong Kong.” Journal of
Advanced Nursing, 30(2): 431-438.
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107
References and Resources
[7] Wu, S.F.V., Courtney, M., Edwards, H., McDowell, J.,
Shortridge-Baggett, L.M., & Chang, P. (2008).
“Development and validation of the Chinese version
of the Diabetes Management Self-Efficacy Scale
[DMSES].” International Journal of Nursing Studies, 45:
534-542.
[8] Xu, Y., Toobert, D., Savage, C., Pan, W., & Whitmer, K.
(2008). “Factors influencing diabetes self-management
in Chinese people with Type 2 diabetes.” Research in
Nursing and Health, 31: 613-625.
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107
References and Resources
[9] nciku at website http://www.nciku.com/
- a reliable English-Chinese and Chinese-English online
translation engine
[10] California Pacific Medical Center: “Health information:
Learning about your health” at website
http://www.cpmc.org/learning/chinese.html
- a good source for diabetes information and material in Chinese
and various other languages
[11] The Government of the Hong Kong Special Administrative
Region: “Centre for Food Safety: Food Safety Focus” at website
http://www.cfs.gov.hk/english/multimedia/multimedia_pub/m
ultimedia_pub_fsf_29_02.html
- a helpful website containing information in English as well as a
Chinese food pyramid
∙ © 2009 Chinatown Clinic ∙
Holy Redeemer Chinese Catholic Church ∙ 915 Vine Street ∙ Philadelphia, PA 19107