| 1. |
- Alme, Tomas Nordheim, et al.
(författare)
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Chronic fatigue syndromes: real illnesses that people can recover from
- 2023
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Ingår i: Scandinavian Journal of Primary Health Care. - : TAYLOR & FRANCIS LTD. - 0281-3432 .- 1502-7724. ; 41:4, s. 372-376
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Tidskriftsartikel (refereegranskat)abstract
- The Oslo Chronic Fatigue Consortium consists of researchers and clinicians who question the current narrative that chronic fatigue syndromes, including post-covid conditions, are incurable diseases. Instead, we propose an alternative view, based on research, which offers more hope to patients. Whilst we regard the symptoms of these conditions as real, we propose that they are more likely to reflect the brains response to a range of biological, psychological, and social factors, rather than a specific disease process. Possible causes include persistent activation of the neurobiological stress response, accompanied by associated changes in immunological, hormonal, cognitive and behavioural domains. We further propose that the symptoms are more likely to persist if they are perceived as threatening, and all activities that are perceived to worsen them are avoided. We also question the idea that the best way to cope with the illness is by prolonged rest, social isolation, and sensory deprivation.Instead, we propose that recovery is often possible if patients are helped to adopt a less threatening understanding of their symptoms and are supported in a gradual return to normal activities. Finally, we call for a much more open and constructive dialogue about these conditions. This dialogue should include a wider range of views, including those of patients who have recovered from them.
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| 2. |
- Autio, Hanna, et al.
(författare)
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Historically Based Room Acoustic Analysis and Auralization ofa Church in the 1470s
- 2021
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Ingår i: Applied Sciences. - : MDPI. - 1454-5101 .- 2076-3417. ; 11:4
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Tidskriftsartikel (refereegranskat)abstract
- Worship space acoustics have been established as an important part of a nation’s cultural heritage and area of acoustic research, but more research is needed regarding the region of northern Europe. This paper describes the historical acoustics of an important abbey church in Sweden in the 1470s. A digital historical reconstruction is developed. Liturgical material specific to this location is recorded and auralized within the digital reconstruction, and a room acoustic analysis is performed. The analysis is guided by liturgical practices in the church and the monastic order connected to it. It is found that the historical sound field in the church is characterized by the existence of two distinct acoustical subspaces within it, each corresponding to a location dedicated to the daily services of the monastical congregations. The subspaces show significantly better acoustic conditions for liturgical activities compared to the nave, which is very reverberant under the conditions of daily services. Acoustic transmission from the two subspaces is limited, indicating that the monastic congregations were visually and acoustically separated from the visitors in the nave and each other.
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| 3. |
- Hjelm, Katarina, et al.
(författare)
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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
- 2018
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Ingår i: BMC Women's Health. - : Springer Science and Business Media LLC. - 1472-6874. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- 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 today's extensive global migration, contact with the new society and health system confronts the migrant's 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.
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| 4. |
- Hjelm, Katarina, 1958-, et al.
(författare)
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Beliefs about health and illness in Latin-American migrants with diabetes living in Sweden
- 2013
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Ingår i: Open Nursing Journal. - : Bentham Science Publishers Ltd.. - 1874-4346. ; 7, s. 57-65
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Tidskriftsartikel (refereegranskat)abstract
- The study explored beliefs about health and illness in Latin American migrants diagnosed with diabetes mellitus (DM) living in Sweden, and investigated the influence on health-related behavior including self-care and care-seeking behavior. Migrants are particularly affected in the diabetes pandemia. Beliefs about health and illness determine health-related behaviour and health but no studies have been found on Latin American migrants with DM. An explorative study design with focus-group interviews of nine persons aged 36-77 years from a diabetes clinic was used. Health was described from a pathogenetic or a salutogenetic perspective: 'freedom from disease or feeling of well-being', and being autonomous and able to work. Economic hardship due to expenses for medications and food for DM affected health. Individual factors such as diet, exercise and compliance with advice, and social factors with good social relations and avoidance of stress, often caused by having experienced severe events related to migrational experiences, were considered important for maintaining health and could cause DM. Disturbed relations to others (social factors), punishment by God or Fate (supernatural factors), intake of diuretics and imbalance between warmth and cold (natural factors) were also perceived as causes. A mix of biomedical and traditional explanations and active self-care behaviour with frequent use of herbs was found. It is important to assess the individual's beliefs, and health professionals, particularly nurses, should incorporate discussions of alternative treatments and other components of explanatory models and co-operate with social workers to consider influence of finances and migrational experiences on health.
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| 5. |
- 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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| 6. |
- Hjelm, Katarina G, et al.
(författare)
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Beliefs about health and diabetes in men of different ethnic origin
- 2005
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Ingår i: Journal of Advanced Nursing. - Oxon, UK : Blackwell Publishing. - 0309-2402 .- 1365-2648. ; 50:1, s. 47-59
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Tidskriftsartikel (refereegranskat)abstract
- AIM: This paper reports the findings of a study exploring the health and illness beliefs of men with diabetes, who were from different cultural backgrounds and living in Sweden.BACKGROUND: No studies have been reported that have focused on the beliefs about health and illness in men with diabetes mellitus of different ethnic origin. Beliefs may affect self-care and care-seeking behaviour.METHOD: An explorative study design and purposive sampling procedure was used. Focus-group interviews were held with 35 men with diabetes and aged between 39 and 78 years. Fourteen participants were born in Arabic countries, 10 in former Yugoslavia and 11 in Sweden.FINDINGS: Important factors for health were the ability to be occupied/employed and economically independent and, especially among Arabs and former Yugoslavians, sexual functioning. Swedes focused on heredity, lifestyle and management of diabetes, while non-Swedes claimed the influence of supernatural factors and emotional stress related to the role of being an immigrant and migratory experiences as factors related to development of diabetes and having a negative influence on health. Swedes and Arabs described health as "freedom from disease" in contrast to many former Yugoslavians who described health as "wealth and the most important thing in life". Knowledge about diabetes was limited among the men studied, but Arabs showed an active information-seeking behaviour compared with Swedes and former Yugoslavians. Non-Swedish respondents, particularly Arabs, had sought help from health care professionals to a greater extent than Swedes, who were more likely to use self-care measures.CONCLUSION: Being occupied/employed and having knowledge about the body and management of diabetes are important for positive health development. There are dissimilarities in beliefs about health and diabetes that influence self-care behaviour and health care seeking. Men's cultural backgrounds and spiritual beliefs need to be considered in diabetes care.
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| 7. |
- 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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| 8. |
- 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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| 9. |
- Hjelm, Katarina, et al.
(författare)
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Management of gestational diabetes from the patient's perspective--a comparison of Swedish and Middle-Eastern born women.
- 2007
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Ingår i: Journal of Clinical Nursing: Management of gestational diabetes from the patient's perspective--a comparison of Swedish and Middle-Eastern born women.. ; 16:1, s. 168-78
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to evaluate patients' perceptions of a specialized diabetes clinic for management of women with gestational diabetes born in Sweden and the Middle East and its contribution to a decreased level of stress and improved coping capability to promote health in patients receiving care.Method: Semi-structured individual interviews by external evaluators. Participants were females with gestational diabetes, 13 born in Sweden and 14 born in the Middle East.Findings: The present healthcare model was perceived as functioning well. Swedish women were problem focused and information seeking. Frustration and stress were increased due to perceived delay in information concerning gestational diabetes, limited access to telephone service and lack of confidence in staff because they lacked the expected competence. Control of gestational diabetes and pregnancy by different persons led to perceived lack of holistic care. Women from the Middle East felt cared, had been given the necessary information and claimed to follow advice. Adequate information reduced respondents' anxiety and increased their control over the situation.The clinic needs to be further improved by adapting programmes to persons to become problem focused by giving adequate information immediately.
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| 10. |
- Hjelm, Katarina, et al.
(författare)
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Management of gestational diabetes from the patient's perspective - a comparison of Swedish and Middle-Eastern born women.
- 2007
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Ingår i: Journal of Clinical Nursing. - Oxon, UK : Wiley. - 1365-2702 .- 0962-1067. ; 16:1, s. 168-178
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Tidskriftsartikel (refereegranskat)abstract
- Aim. To explore patients' evaluation of a specialized diabetes clinic for management of women with gestational diabetes born in Sweden and the Middle East and its contribution to a decreased level of stress and improved coping capability to promote health in patients receiving care. Background. No studies comparing patients' perceptions of healthcare in women of different origin with gestational diabetes have been found. A perceived clinical problem in specialized diabetes care is of lower activity level in self-care in foreign- than Swedish-born women and the question is whether the healthcare organization is optimal in meeting different individuals' needs. Design. Explorative study. Method. Semi-structured individual interviews by external evaluators. Participants. Consecutive sample. Females with gestational diabetes, 13 born in Sweden and 14 born in the Middle East. Results. The healthcare model was perceived as functioning well. Swedish women were problem focused and information seeking. Frustration and stress were increased due to perceived delay in information concerning gestational diabetes, limited access to telephone service and lack of confidence in staff because they lacked the expected competence. Control of gestational diabetes and pregnancy by different persons led to perceived lack of holistic care. Women from the Middle East felt cared, had been given the necessary information and claimed to follow advice. Adequate information reduced respondents' anxiety and increased their control over the situation. Conclusions. The clinic needs to be further improved by adapting programmes to persons to become problem focused by giving adequate information immediately. Relevance to clinical practice. Cultural differences in coping strategies and attitudes to gestational diabetes need to be considered. Training of staff working with gestational diabetes patients is urgently needed.
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