Multiple Lenses to Unearth Hidden Voices: Living with Diabetic Foot Ulceration in an Afro-Caribbean Community.

Abstract

(1) Background: This study was conducted in the small island developing state of Barbados, which has dubiously earned the title of "amputation capital of the world", to understand perspectives of persons living with diabetic foot ulceration. (2) Methods: An exploratory multi-lens approach was used (focus groups; dyads; and triads) to gather indigenous Afro-Caribbean perspectives of living with diabetic foot ulceration that may be obscured by using a single method. (3) Results: Findings in this group highlighted the necessity of creating culturally sensitive education tools, as well as understanding how mistrust of local health systems may play a role in decisions to delay seeking health services despite ease of access with no cost at point of care. Problematic historical relationships with health systems among Afro-Caribbean people, for whom oral traditions motivate preference for traditional medicines instead of Western/colonial treatments from North America or Europe, may be deeply entrenched in this population and contribute to health beliefs and behaviors. (4) Conclusions: This paper addresses the gap in the literature regarding the use of qualitative methodologies to explore the beliefs of Afro-Caribbean people within their native context to inform design of culturally responsive self-education programs.