Adult onset diabetes is one of the five leading causes of death in Jamaica. Patients report that they are not adequately informed about the nature or the management of their illness. Structured questionnaires, in-depth interviews, free listing, pile sorts, and interactional tapings of doctor–patient appointments were methods used to collect data. Differences in doctor and patient explanatory models and cultural concepts concerning etiology, symptoms, treatment, and lifestyle changes such as diet and exercise often result in miscommunication. Broader social factors including social class differences and asymmetrical power relationships between doctor and patients, and economic factors such as costs of medical care and medication, transportation, and food impact on successful patient management of the illness.
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