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28 September 2012

A conversation about health literacy with diabetes nurse Sera Tapu-Ta'ala

I had a conversation about health literacy with Sera Tapu-Ta’ala, Diabetes Nurse Specialist at Kenepuru Hospital, Capital & Coast District Health Board.

Language is what connects families and communities. Dialogues and conversations in the respective Pacific languages is the ideal way in which Pacific people share tasks and support each other to manage a family member’s diabetes, or an individual themselves. Language is one key element in health literacy. It is critical to acknowledge that health literacy is a resource of a family and a community.

Sera’s work is predominantly within the Porirua area. She says that her visiting territory in Porirua is like a village. It has its own structure. Sera’s work in Porirua is shaped by the stories that tie its people to each other.

Stories are the Pacific way to share tasks and experiences. The families Sera visits are a resource—for information, teaching and learning, encouraging adherence and achieving goals. Family members are eyes and ears for each other. When Sera cares for someone with diabetes, she is developing the health literacy of the family.

The patients guide the learning
There’s a lot to learn when you have a long-term condition like diabetes. When Sera is working one-to-one with her patients, she asks open-ended questions, and lets her patients guide the learning. Not being ‘the teacher’ and giving them space to tell their stories lets patients do the learning.

When they talk about how impaired and unwell they feel, Sera interprets the tasks of managing diabetes, so that they develop the skills and knowledge to feel better. She writes down goals and targets, and uses diagrams to explain highs and lows. She uses the “teach back” strategy to seek clarity and to ensure an equal understanding and interpretation of a particular situation has been attained. She chooses language carefully. As a fluent Samoan speaker, she always uses the formal Samoan language for the older people, or those who prefer to speak in the Samoan language. People respond when the language you use is appropriate and simplified.

Spreading the word
Pacific churches play an integral part in the lives of most NZ-based Pacific people. Radio programs on the respective Pacific radios also have an important part. Sera now has a monthly slot on the Samoan radio in Wellington and hopes to extend time to other Pacific Radios. She knows that church is where the people are, and the radio is the means to reach them - so that’s where to take the messages.

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