Biomedical subjects
T Greenhalgh
Publications and source records attributed to T Greenhalgh.
Health beliefs and folk models of diabetes in British Bangladeshis: a qualitative study.
OBJECTIVE: To explore the experience of diabetes in British Bangladeshis, since successful management of diabetes requires attention not just to observable behaviour but to the underlying attitudes and belief systems which drive that behaviour. DESIGN: Qualitative study of subjects' experience of diabetes using narratives, semi-structured interviews, focus groups, and pile sorting exercises. A new qualitative method, the structured vignette, was developed for validating researchers' understanding of primary level culture. SUBJECTS: 40 British Bangladeshi patients with diabetes, and 10 non-Bangladeshi controls, recruited from primary care. RESULT: Several constructs were detected in relation to body image, cause and nature of diabetes, food classification, and knowledge of complications. In some areas, the similarities between Bangladeshi and non-Bangladeshi subjects were as striking as their differences. There was little evidence of a fatalistic or deterministic attitude to prognosis, and most informants seemed highly motivated to alter their diet and comply with treatment. Structural and material barriers to behaviour change were at least as important as "cultural" ones. CONCLUSION: Bangladeshi culture is neither seamless nor static, but some widely held beliefs and behaviours have been identified. Some of these have a potentially beneficial effect on health and should be used as the starting point for culturally sensitive diabetes education.
Controversies in primary care. Setting prescribing budgets in general practice. Effective prescribing at practice level should be identified and rewarded.
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A primary-care-led diabetes service: strengths, weaknesses, opportunities and threats.
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Genital warts and cervical screening.
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Advertisements for donepezil. More convincing evidence of efficacy needs to be cited.
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Pressure to prescribe.
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Papers that go beyond numbers (qualitative research)
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Papers that summarise other papers (systematic reviews and meta-analyses).
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How to read a paper. Papers that tell you what things cost (economic analyses).
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How to read a paper. Papers that report diagnostic or screening tests.
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How to read a paper. Papers that report drug trials.
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How to read a paper. Statistics for the non-statistician. II: "Significant" relations and their pitfalls.
It is possible to be seriously misled by taking the statistical competence (and/or the intellectual honesty) of authors for granted. Some common errors committed (deliberately or inadvertently) by the authors of papers are given in the final box.
How to read a paper. Statistics for the non-statistician. I: Different types of data need different statistical tests.
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Assessing the methodological quality of published papers.
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