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A qualitative study of developing beliefs about health, illness and healthcare in migrant African women with gestational diabetes living in Sweden
Uppsala Univ, Sweden.
Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Medicine and Health Sciences.
Lund Univ, Sweden.
2018 (English)In: BMC Women's Health, ISSN 1472-6874, E-ISSN 1472-6874, Vol. 18, article id 34Article in journal (Refereed) Published
Abstract [en]

Background: Gestational diabetes (GDM) is associated with health risks for both mother and child, and is particularly relevant to migrant women and women of African origin. With todays extensive global migration, contact with the new society and health system confronts the migrants culture of origin with the culture of the host country. The question is whether immigrants patterns of beliefs about health, illness, and health-related behaviour change over time, as no previous studies have been found on this topic. The purpose was to explore development over time, during and after pregnancy, of beliefs about health, illness and healthcare in migrant women with GDM born in Africa living in Sweden, and study the influence on self-care and care seeking. Methods: Qualitative prospective study. Semi-structured interviews, with 9 women (23-40 years), on three different occasions: during pregnancy (gestational weeks 34-38), and 3 and 14 months after delivery managed at an in-hospital diabetes specialist clinic in Sweden. Results: Beliefs were rather stable over time and mainly related to individual and social factors. GDM was perceived as a transient condition as health professionals had informed about it, which made them calm. None, except one, expressed worries about relapse and the health of the baby. Instead women worried about being unable to live an ordinary life and being bound to lifestyle changes, particularly diet, developing diabetes and needing insulin injections. Over time knowledge of appropriate diet improved, although no advice was experienced given by the clinic after delivery. The healthcare model was perceived as well functioning with easy access but regular follow-ups were requested as many (decreasing over time) were unsure whether they still had GDM and lacked information about GDM and diet. During pregnancy information was also requested about the healthcare system before/after delivery. Conclusions: Beliefs changed to a limited extent prospectively, indicated low risk awareness, limited knowledge of GDM, irrelevant worries about future health, and being unable to live a normal life, associated with problematic lifestyle changes. Beliefs about the seriousness of GDM in health professionals influenced patients beliefs and health-related behaviour. The healthcare organisation urgently needs to be improved to deliver appropriate and timely information through competent staff.

Place, publisher, year, edition, pages
BIOMED CENTRAL LTD , 2018. Vol. 18, article id 34
Keywords [en]
Beliefs about health/illness/healthcare; Gestational diabetes mellitus; Migrants/Africa; Prospective study; Self-care; Semi-structured interviews
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:liu:diva-145237DOI: 10.1186/s12905-018-0518-zISI: 000424445300001PubMedID: 29402265OAI: oai:DiVA.org:liu-145237DiVA, id: diva2:1184444
Note

Funding Agencies|Faculty of Medicine, Lund University; Swedish Foundation for Healthcare Sciences and Allergy Research (Vardalstiftelsen); Council for Health and Healthcare Research Lund/Malmo; Swedish Diabetes Association (Svenska Diabetesforbundet); research profile AMER (Arbetsmarknad, Migration och Etniska Relationer - Labour Market, Migration and Ethnic Relations), University of Vaxjo, Sweden

Available from: 2018-02-21 Created: 2018-02-21 Last updated: 2018-02-21

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