| 1. |
- Hjelm, Katarina, 1958-, et al.
(författare)
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Beliefs about health and illness in Swedish and African-born women with gestational diabetes living in Sweden.
- 2012
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Ingår i: Journal of Clinical Nursing. - Molden, MA, USA : Blackwell Publishing. - 0962-1067 .- 1365-2702. ; 21:9-10, s. 1374-1386
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Tidskriftsartikel (refereegranskat)abstract
- Aims. Exploring beliefs about health and illness in women with gestational diabetes born in Sweden and Africa living in Sweden. Further , to study the influence of beliefs on self-care and care seeking. Design: Exploratory descriptive study. Methods. Semi-structured interviews. Consecutive sample of women diagnosed with gestational diabetes, 13 born in Sweden and 10 born in Africa, from a diabetes clinic in Sweden. Qualitative content analysis of data was applied. Results. Beliefs were mainly related to individual and social factors. Health was described as freedom from disease and being healthy. Swedish women perceived heredity and hormonal changes as causing gestational diabetes, avoided work-related stress, had a healthy lifestyle, worried about the baby's health and development of type 2 diabetes, sought information, used more medications and health care and were on sick-leave more often because of pregnancy-related problems than African women, who did not know the cause of gestational diabetes, had a passive self-care attitude and followed prescriptions, often reported being told by staff that gestational diabetes would disappear after delivery and stated more pregnancy-related problems which they treated with rest or watchful waiting. Conclusions. Health/illness beliefs differed and affected self-care and care seeking. Relevance to clinical practice. Individual beliefs and risk awareness must be elicited, and adequate information must be given to prevent negative health effects of gestational diabetes.
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| 2. |
- Hjelm, Katarina, 1958-, et al.
(författare)
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Beliefs about health and illness postpartum in women born in Sweden and the Middle East.
- 2009
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Ingår i: Midwifery. - : Elsevier. - 0266-6138 .- 1532-3099. ; 25:5, s. 564-575
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to explore beliefs about health and illness three months postpartum in women born in Sweden and the Middle East, and to study whether they perceive gestational diabetes mellitus (GDM) as a prediabetic condition. Methods: an explorative study using semi-structured interviews 3 months postpartum. Interviews were held three months after birth. Consecutive sample of women with GDM; 13 born in Sweden and 14 born in the Middle East. The results showed that irrespective of origin, health was focused on well-being and being able to care for the baby. Many Middle Eastern women did not know how long GDM would last or said that they had been informed by staff about its transience. They worried about still having diabetes mellitus, and the disease directed them to self-monitoring of blood glucose and the desire for health-care staff to verify the disease. They showed tendencies to dietary changes. Swedish-born women feared development of type 2 DM and had undertaken active health-related behaviour. In conlusion, beliefs about health and illness differ, change and affect awareness of risk and self-care practice postpartum. Swedish women showed high risk awareness with changes in life style and the desire for more information to avoid developing DM. Middle Eastern women showed increased risk awareness and sought help from staff in checking whether GDM was present in the postpartum period. For clinical practice it is important to recognise that Middle Eastern women, in contrast to Swedish-born women, have not incorporated the message that GDM is a risk marker for future development of DM. Health professionals have a significant role in supporting women and their families undergoing the transition to motherhood, particularly migrants in a new country. Identifying individual beliefs is of utmost importance. Pre-existing baby health clinics can be developed to address mothers' needs as well as the health of the baby.
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| 3. |
- Hjelm, Katarina, 1958-, et al.
(författare)
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Diabetic persons with foot ulcers and their perceptions of hyperbaric oxygen chamber therapy
- 2009
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Ingår i: Journal of Clinical Nursing. - Malden, MA, USA : Blackwell Publishing. - 0962-1067 .- 1365-2702. ; 18:14, s. 1975-1985
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Tidskriftsartikel (refereegranskat)abstract
- To our knowledge there are no patients" evaluations of diabetes care in a high-technology area like the hyperbaric oxygen chamber. The burden on persons with diabetic foot complications might be increased if adjuvant therapy with hyperbaric oxygen therapy (HBOT) within a locked airtight vessel is given. Aim: To elucidate how diabetic patients with limb-threatening foot lesions perceive and evaluate content and organisation of treatment in a multi-place hyperbaric oxygen chamber. Design/participants: An explorative study. Participants were included in the HODFU study, a prospective randomised double-blind study, designed to evaluate whether HBOT heals more chronic foot ulcers than placebo treatment with hyperbaric air. Six females and 13 males, aged 44-83 years (Md 70), with diabetic foot ulcers, participated. Method: Focus-group interviews were held by an external evaluator. Results: Management was perceived as well-functioning with competent staff delivering quick treatment in a positive manner and in good co-operation. HBOT sessions, in groups, were described as unproblematic and pleasant, through sharing experiences with others, although time-consuming and tiring. Recognising the responsible physician and communication with other physicians in the health-care chain was perceived as problematic. Placebo treatment, when given, did not reveal any problems; many perceived HBOT as the last resort and respondents had a negative view of future health and expressed fears of new wounds and amputation. Conclusions and implications: From patients" perspective HBOT in the delivered health-care model was perceived as well-functioning, taking into consideration both technical and relational aspects of care in this high-technology environment. Communication with the patient and between different care givers, with a consistent message given and information about who is responsible and to whom one should turn, wherever treated, is the most crucial aspect of the model. Future fears need to be recognised and group interaction can be encouraged to share the burden of disease.
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| 4. |
- Hjelm, Katarina, 1958-, et al.
(författare)
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Gestational diabetes : changed health beliefs in migrant women from five Asian countries living in Sweden: a prospective qualitative study
- 2022
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Ingår i: Primary Health Care Research and Development. - : Cambridge University Press. - 1463-4236 .- 1477-1128. ; 23
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim of this study was to explore the temporal development of beliefs about health, illness and health care in migrant women with gestational diabetes (GD) born in Asia residing in Sweden, and the influence on health-related behaviour in terms of self-care and seeking care. Background: Migrant Asian women are a high-risk group for developing GD. Adapting to the culture in the new society and the healthcare system, being diagnosed with GD and becoming a mother is demanding. The question is whether Asian migrants' patterns of beliefs and behaviour change over time, as no previous study has been revealed on this topic. Method: Qualitative prospective exploratory study. Semi-structured interviews were held on three occasions: during pregnancy and three and fourteen months after delivery, with women born in Asia, diagnosed with GD. Data were analysed with qualitative content analysis. Findings: There was a temporal change of beliefs influencing health-related behaviour, showing a rising curve in risk awareness. An increasing number of persons described developing a healthy diet/lifestyle based on initial advice and shifted focus from the child to worries about the woman's health and risk of developing type 2 diabetes and being unable to care for the child/family. Also, the number of women perceiving GD as a transient condition decreased and more believed it would last forever. Beliefs about health care were unchanged, the healthcare model was perceived working well but information about GD and follow-ups was requested even after delivery, and competent staff was expected. Health professionals' beliefs about the seriousness of GD influence patients' beliefs and need to be considered. Migrant women need support with adequate information, based on their individual beliefs, to continue develop a sustainable healthy lifestyle even after giving birth, to promote health and prevent type 2 diabetes.
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| 5. |
- Hjelm, Katarina, 1958-, et al.
(författare)
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Gestational diabetes: prospective interview-study of the developing beliefs about health, illness and health care in migrant women.
- 2012
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Ingår i: Journal of Clinical Nursing. - Hoboken, NJ, USA : Wiley. - 0962-1067 .- 1365-2702. ; 21:21-22, s. 3244-3256
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to explore the development over time of beliefs about health, illness and health care in migrant women with gestational diabetes mellitus born in the Middle East and living in Sweden. Further to study the influence of beliefs on self-care and care seeking behaviour. There is an extensive global migration and contact with the new society and health care confronts the migrant's culture of origin with the culture of the host country. The question is whether the migrants' patterns of beliefs about health, illness and health-related behaviour change over time? A qualitative prospective exploratory study was implemented. Semi-structured interviews were held with 14 women, aged 28-44 years, in gestational weeks 34-38 and three and 14 months after delivery.The results showed a U-shaped development of beliefs, from focusing on worries about the baby's health during pregnancy and trying to comply with advice from health care staff, particularly a healthy diet, through regression to dietary habits (with intake of more sugar and less fibre) and lifestyle held before being diagnosed with gestational diabetes mellitus three months after delivery but then back to a healthy diet and lifestyle and worries focusing on their own risk, as mothers, of developing type 2 diabetes and being unable to care for the child after one year. Over time, the number of persons perceiving gestational diabetes mellitus as a transient condition decreased. Respondents lacked information about the disease, diet and follow-ups. Beliefs changed over time and influenced health-related behaviour. Beliefs about the seriousness of gestational diabetes mellitus among health professionals' influence development of patients' beliefs. Pregnancy should be used as an opportunity to provide complete information about the disease and future health risks. Continous information should be given after delivery and wishes for regular follow-ups should be met.
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| 6. |
- Hjelm, Katarina, 1958-, et al.
(författare)
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Migrant Middle Eastern women with gestational diabetes seven years after delivery - positive long-term development of beliefs about health and illness shown in follow-up interviews
- 2021
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Ingår i: Primary Health Care Research and Development. - : Cambridge University Press. - 1463-4236 .- 1477-1128. ; 22
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Tidskriftsartikel (refereegranskat)abstract
- Aim: No previous studies have been found focusing on the long-term development of beliefs about health, illness and healthcare in migrant women with gestational diabetes mellitus (GDM). The aim of this study was to explore this and the influence on health-related behaviour (i.e. self-care and care seeking) in migrant women from the Middle East living in Sweden seven years after delivery.Background: GDM is increasing, particularly in migrant women. The risk of adverse outcomes of GDM for health can be improved by interventions reducing blood glucose and lifestyle modifications which medicalise the woman's pregnancy due to intensive follow-up and demanding self-care. The reactions might have an enduring impact on the women's long-term psychological and physical health and adoption of preventive health behaviours.Method: Qualitative exploratory study. Semi-structured follow-up interviews 7 years after delivery with women previously interviewed in gestational weeks 34-38 and 3 and 14 months after delivery. Data analysed with qualitative content analysis.Findings: Health meant freedom from illness, feeling well and living long to be able to care for the children. The present situation was described either positively, changing to a healthier lifestyle, or negatively, with worries about being affected by type 2 diabetes. Beliefs changed among the majority of women, leading to a healthier lifestyle, and they looked positively back at the time when diagnosed and their reactions to it. With few exceptions, they were confident of being aware of future health risks and felt responsible for their own and their children's health/lifestyle. None except those diagnosed with type 2 diabetes had been in contact with healthcare since the last follow-up a year after delivery. Yet, they still would like and need a healthcare model delivering more information, particularly on developing a healthy lifestyle for children, and with regular check-ups also after the first year after delivery.
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| 7. |
- Hjelm, Katarina, 1958-, et al.
(författare)
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Migrants with diabetes believe diabetic foot ulcers being unavoidable and impossible to prevent.
- 2015
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Ingår i: 50th annual meeting of the EUROPEAN DIABETES EPIDEMIOLOGY GROUP.25-28 April 2015. Les Fontaines, Gouvieux-Chantilly, France.Study group of the European Association for the Study of Diabetes (EASD). - Paris, France. : EUROPEAN DIABETES EPIDEMIOLOGY GROUP - EDEG.
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Konferensbidrag (refereegranskat)abstract
- Background: Since type 2 diabetes is developing into a pandemic, particularly affecting migrants in industrializing countries, the prevalence of diabetes complications is expected to increase. Diabetic foot disorders are the predominant source of complications and are serious and costly but highly preventable particularly by self-care. Health-related behavior, including self care and health care seeking, is guided by beliefs about health/illness but has not previously been studied in different migrant groups. We aim to describe beliefs about health/illness in foreign-born persons with diabetic foot ulcers that might affect self-care and health care seeking and to study whether there are dissimilarities related to origin. ‘Material and methods: Qualitative descriptive study. Semi-structured interviews with 26 persons, aged 38-86 years, whereof 13 born in European and 13 in non European countries, all except one in the Middle East, being residents in Sweden between 7-60 years (Md 18 yrs).Results: Most believed foot ulcers being unavoidable and problematic to detect, and mainly caused by internal factors such as diabetes, sometimes combined with external factors as inappropriate foot wear, hot water, or bare foot walking. Perceived health had deteriorated after onset of the foot problems due to immobility and pain. Middle Easterners differed as they discussed the importance to adapt to the will of Allah, leading to even poorer quality of life and view of future health. They described more foot problems and perceived religion (Muslim) with washing rituals of the feet being of importance for health. They were less often regularly monitored than European migrants. Economy affected health, more so in Europeans, due to expenses for medications and shoes. Many described limited activity in self-care, few had searched help for their foot problems and if so solely among professionals and had limited knowledge about the influence of glycaemic control on diabetes/foot status.Conclusions: Foreign-born persons perceived foot ulcers being impossible to prevent, experienced problems with detection, and had limited knowledge about self-care. Dissimilarities in beliefs related to origin were found that negatively affected self-care of the feet why it is important to assess individual beliefs and plan care and education accordingly.
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