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  • 51.
    Hjelm, Katarina
    et al.
    School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Bard, Karin
    School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Apelqvist, Jan
    Department of Endocrinology, Malmö University Hospital, University of Lund, Lund, Sweden.
    Gestational diabetes: prospective interview-study of the developing beliefs about health, illness and health care in migrant women.2012Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 21, nr 21-22, s. 3244-3256Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIMS AND OBJECTIVES: 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 and to study the influence on self-care and care seeking.

    BACKGROUND: With today's extensive global migration, contact with the new society/health care 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.

    DESIGN: A qualitative prospective exploratory study.

    METHODS: Semi-structured interviews, with 14 women (28-44 years), on three occasions: during pregnancy in gestational weeks 34-38 and three and 14 months after delivery.

    RESULTS:   There was 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 professionals, particularly a healthy diet, through regression to dietary habits (more sugar, less fibre) and lifestyle held before being diagnosed with gestational diabetes mellitus three months after delivery, back to a healthy diet/lifestyle and worries 14 months after delivery but then focusing on their own risk, as mothers, of developing type 2 diabetes and being unable to care for the child. Over time, the number of persons perceiving gestational diabetes mellitus as a transient condition decreased. Respondents lacked information about gestational diabetes mellitus, diet and follow-ups.

    CONCLUSION: Beliefs changed over time and influenced health-related behaviour. Beliefs about the seriousness of gestational diabetes mellitus among healthcare staff/care organisation influence the development of patients' beliefs and need to be considered in planning care.

    RELEVANCE TO CLINICAL PRACTICE: Pregnancy should be used as an opportunity to provide complete information about gestational diabetes mellitus and future health risks. This should continue after delivery and wishes for regular follow-ups should be met.

  • 52.
    Hjelm, Katarina
    et al.
    Department of Community Medicine, University of Lund, Sweden.
    Bard, Karin
    Department of Health Science and Social Work, University of Växjö, Sweden.
    Berntorp, Kerstin
    Department of Endocrinology, Malmö University Hospital, Sweden.
    Apelqvist, Jan
    Department of Endocrinology, Malmö University Hospital, Sweden.
    Beliefs about health and illness postpartum in women born in Sweden and the Middle East2009Inngår i: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 25, nr 5, s. 564-575Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: 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.

    DESIGN: an explorative study using semi-structured interviews 3 months postpartum.

    SETTING: in-hospital diabetes specialist clinic in Sweden.

    PARTICIPANTS: interviews three months after birth. Consecutive sample of women with GDM; 13 born in Sweden and 14 born in the Middle East.

    MEASUREMENT AND FINDINGS: 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 (DM), which 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.

    KEY CONCLUSIONS: 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.

    IMPLICATIONS FOR 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 crucial importance. Pre-existing baby health clinics can be developed to address mothers' needs as well as the health of the baby.

  • 53.
    Hjelm, Katarina
    et al.
    Department of Community Medicine, University of Lund, and Department of Health Science and Social Work, University of Växjö, Sweden.
    Bard, Karin
    Department of Health Science and Social Work, University of Växjö, Sweden.
    Nyberg, Per
    Department of Caring Sciences, University of Lund, Sweden.
    Apelqvist, Jan
    Department of Endocrinology, Malmö University Hospital, Lund University, Sweden.
    Management of gestational diabetes from the patient's perspective: a comparison of Swedish and Middle-Eastern born women2007Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 16, nr 1, s. 168-178Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    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.

  • 54.
    Hjelm, Katarina
    et al.
    Department of Community Medicine, University of Lund, and Department of Health Science and Social Work, University of Växjö, Sweden.
    Bard, Karin
    Department of Health Science and Social Work, University of Växjö, Sweden.
    Nyberg, Per
    Department of Neuroscience, University of Lund, Sweden.
    Apelqvist, Jan
    Department of Internal Medicine, Lund University Hospital, Sweden.
    Swedish and Middle-Eastern-born women's beliefs about gestational diabetes2005Inngår i: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 21, nr 1, s. 44-60Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: to compare beliefs about health and illness between women born in Sweden and the Middle East who developed gestational diabetes (GD).

    DESIGN: a qualitative, explorative study using semi-structured interviews.

    SETTING: in-hospital diabetes specialist clinic in Sweden.

    PARTICIPANTS: consecutive sample of women with GD; 13 born in Sweden and 14 born in the Middle East.

    MEASUREMENT AND FINDINGS: all the women described health as freedom from disease, and expressed worries for the baby's health and well-being. Women from the Middle East did not know the cause of GD, discussed the influence of social factors, such as being an immigrant, and supernatural factors, tried to adapt to the disease and thought it would disappear after birth, felt they had more pregnancy-related complications but had not received any treatment. Swedish women attributed GD to inheritance, environment and hormonal change, feared developing Type 2 diabetes, found work-related stress harmful to their health, more often sought help, used medications against pregnancy-related complications, and were more often on sick-leave from work.

    KEY CONCLUSIONS: Swedish women initiated a battle against GD, demanded medical treatment for pregnancy-related complications because of gainful employment and viewed pregnancy as a disease. Women from the Middle East temporarily adapted to the disease and perceived pregnancy and related problems as a natural part of life.

    IMPLICATIONS FOR PRACTICE: it is important to assess individual beliefs, risk awareness and to meet individual needs for information.

  • 55.
    Hjelm, Katarina
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Hälsouniversitetet. Linnaeus University, Växjö, Sweden .
    Beebwa, Esther
    Mbarara University of Science and Technology (MUST), Uganda.
    The influence of beliefs about health and illness on foot care in ugandan persons with diabetic foot ulcers2013Inngår i: Open Nursing Journal, ISSN 1874-4346, E-ISSN 1874-4346, Vol. 7, s. 123-132Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Diabetes mellitus is developing into a pandemic, mainly affecting Sub-Saharan Africa, and the prevalence of complications is increasing. Diabetic foot disorders are a major source of disability and morbidity. Delay in the health care process due to patients' beliefs might have deleterious consequences for life and limb in persons with diabetic foot ulcers. No previous studies of beliefs about health and illness in persons with diabetic foot ulcers living in Africa have been identified. The aim of the study was to explore beliefs about health and illness among Ugandans with diabetic foot ulcers that might affect health-related behaviour including self-care and care seeking. An explorative study was implemented with consecutive sample and semi-structured interviews were held with 14 Ugandan men and women, aged 40-79, with diabetic foot ulcers. The main findings showed that knowledge was limited about causes, management and prevention of diabetic foot ulcers. Foot ulcers were often detected as painful, believed to heal or improve, and led to stress and social isolationbecause of smell and reduced mobility. Most lacked awareness of the importance of complete daily foot care and seldom practised self-care. Health was described as absence of disease and pain. Many feared future health which was related to contact with nurses in the professional sector from whom they sought information, help with blood tests and wound dressings and desired better organised diabetes clinics providing health education and more opening hours. Many have an underutilised potential for self-care and need education urgently, delivered in well-organised clinics aimed to raise awareness of the threat and prevent foot ulcers.

  • 56.
    Hjelm, Katarina
    et al.
    Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Berntorp, Kerstin
    Department of Endocrinology, Skåne University Hospital, Malmö, Sweden.
    Apelqvist, Jan
    Department of Endocrinology, Skåne University Hospital, Malmö, Sweden.
    Beliefs about health and illness in Swedish and African-born women with gestational diabetes living in Sweden2012Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 21, nr 9-10, s. 1374-1386Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIMS: This paper is a report on a study exploring beliefs about health and illness in women with gestational diabetes born in Sweden and Africa living in Sweden. A further aim is to study the influence of beliefs on self-care and care seeking.

    BACKGROUND: Extensive global migration leading to multicultural societies implies challenges to health care. Health/illness beliefs are culturally related and determine health-related behaviour, including self-care, which is crucial in management of gestational diabetes. The risk of developing gestational diabetes is increased in migrants, particularly of African origin, when residing in Western countries. No previous studies, except one, have been found comparing health/illness beliefs in women with gestational diabetes of different origin.

    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. Lower risk awareness in African-born women was related to limited knowledge about the body and gestational diabetes, which was further amplified by healthcare professionals informing them about gestational diabetes being transient.

    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.

  • 57.
    Hjelm, Katarina
    et al.
    Department of Community Medicine, University of Lund, Sweden.
    Berntorp, Kerstin
    Department of Endocrinology, Malmö University Hospital, University of Lund, Sweden.
    Frid, Anders
    Department of Endocrinology, Malmö University Hospital, University of Lund, Sweden.
    Åberg, Anders
    Department of Obstetrics and Gynaecology, Lund University Hospital, University of Lund, Sweden.
    Apelqvist, Jan
    Department of Endocrinology, Malmö University Hospital, University of Lund, Sweden.
    Beliefs about health and illness in women managed for gestational diabetes in two organisations.2008Inngår i: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 24, nr 2, s. 168-182Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: to explore beliefs about health, illness and health care in women with gestational diabetes mellitus (GDM) managed in two different organisations based on diabetology or obstetrics.

    DESIGN: an explorative qualitative study using semi-structured interviews.

    SETTING: clinic A: a specialist diabetes clinic with regular contact with a diabetologist and antenatal care provided by a midwife; clinic B: a specialist maternity clinic providing regular contact with a midwife, a structured programme for self-monitoring of blood glucose and insulin treatment, and a 1-day diabetes class by an obstetrician, a diabetologist, a midwife and a dietician. The clinics were located at two different university hospitals in Sweden.

    PARTICIPANTS: a consecutive sample of Swedish women diagnosed with GDM; 13 managed in clinic A and 10 managed in clinic B.

    MEASUREMENT AND FINDINGS: women described their perceptions of as well-being, being healthy and freedom from disease. All respondents reported a delay in the provision of information about GMD and an information gap about GDM and the management of the condition, from diagnosis until the start of treatment at the specialist clinic. Respondents from clinic A expressed fear about future development of type 2 diabetes. Women from clinic B discussed different causes of GDM, and many claimed that health-care staff informed them that GDM was a transient condition during pregnancy. Respondents from clinic A reported a conflict in their treatment of pregnancy and GDM as two different conditions.

    KEY CONCLUSIONS: beliefs differed and were related to the health-care model chosen. Women with GDM monitored at a specialist maternity clinic believed GDM to be a transient condition during pregnancy only, whereas women monitored at a diabetes specialist clinic expressed fear about a future risk of developing type 2 diabetes.

    IMPLICATIONS FOR PRACTICE: relevant information about GDM should be provided without delay after initial diagnosis and thereafter repeatedly. It is important to recognise the context of information given on GDM, as it will substantially influence the beliefs and attitudes of women towards GDM as a transient condition during pregnancy or as a potential risk factor for diabetes.

  • 58.
    Hjelm, Katarina
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Hälsouniversitetet.
    Berterö, Carina
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Dissimilarities in Social Support as  Described by Swedish- and Foreign-Born Persons Diagnosed with Type 2 Diabetes and Living in Sweden2014Inngår i: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 4, nr 3, s. 211-222Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Diabetes (DM) requires self-care that is demanding and may cause stress. Social support canbuffer effects of stress. No previous study has been found comparing perceptions of foreign-bornpersons with DM, concerning the content of and need for social support with a population of origin.The aim was to compare the meaning of support and its impact on the life situation in Swedishandforeign-born persons diagnosed with type 2 DM living in Sweden. A purposive sample of 74persons; 34 foreign- and 40 Swedish-born, aged 32 - 80 years, diagnosed with type 2 DM, was included.The foreign-born persons were mostly Middle Eastern and Ex-Yugoslavian refugees. Mixedmethods were used and data were collected by qualitative interviews and quantitative data collectedby the Norbeck Social Support Questionnaire (NSSQ). Studying the figures measured byNSSQ, no significant differences were found according to gender but foreign-born men scoredlower than Swedish, especially in emotional support and aid. The main findings showed that respondents,irrespective of origin, described the meaning of the concept of support mainly as informationsupport in learning to manage DM. However, foreign-born persons also focused onmedical support with regular follow-ups while Swedes emphasized the need for emotional support.Foreign- and Swedish-born persons are in general more similar than dissimilar in describingthe meaning, need and impact of support. Irrespective of origin they want to learn to manage theirdisease and thus desire and need regular follow-up and information immediately from being diagnosed.Further studies are needed as the study is based on a limited sample.

  • 59.
    Hjelm, Katarina
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad.
    Berterö, Carina
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad.
    Social support as described by Swedish people diagnosed with type 2 diabetes mellitus2009Inngår i: Primary Health Care Research and Development, ISSN 1463-4236, E-ISSN 1477-1128, Vol. 10, s. 26-37Artikkel i tidsskrift (Fagfellevurdert)
  • 60.
    Hjelm, Katarina G
    et al.
    Department of Community Medicine, University of Lund, Sweden.
    Bard, Karin
    Department of Health Science and Social Work, University of Växjö, Sweden.
    Nyberg, Per
    Department of Neuroscience, University of Lund, Sweden.
    Apelqvist, Jan
    Department of Endocrinology, University of Lund, Malmö , Sweden.
    Beliefs about health and diabetes in men of different ethnic origin2005Inngår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 50, nr 1, s. 47-59Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    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.

  • 61.
    Hjelm, Katarina
    et al.
    School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Mufunda, Esther
    Department of Health Sciences, Zimbabwe Open University, Harare, Zimbabwe.
    Zimbabwean diabetics' beliefs about health and illness: an interview study2010Inngår i: BMC International Health and Human Rights, ISSN 1472-698X, E-ISSN 1472-698X, Vol. 10, s. 7-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Diabetes mellitus (DM) is increasing globally, with the greatest increase in Africa and Asia. In Zimbabwe a threefold increase was shown in the 1990s. Health-related behaviour is important in maintaining health and is determined by individual beliefs about health and illness but has seen little study. The purpose of the study was to explore beliefs about health and illness that might affect self-care practice and health care seeking behaviour in persons diagnosed with DM, living in Zimbabwe.

    METHODS: Exploratory study. Consecutive sample from a diabetes clinic at a central hospital. Semi-structured interviews were held with 21 persons aged 19-65 years. Data were analysed using qualitative content analysis.

    RESULTS: Health was described as freedom from disease and well-being, and individual factors such as compliance with advice received and drugs were considered important to promote health. A mixture of causes of DM, predominantly individual factors such as heredity, overweight and wrong diet in combination with supernatural factors such as fate, punishment from God and witchcraft were mentioned. Most respondents did not recognize the symptoms of DM when falling ill but related the problems to other diseases, e.g. HIV, malaria etc. Limited knowledge about DM and the body was indicated. Poor economy was mentioned as harmful to health and a consequence of DM because the need to buy expensive drugs, food and attend check-ups. Self-care was used to a limited extent but if used, a combination of individual measures, household remedies or herbs and religious acts such as prayers and holy water were frequently used, and in some cases health care professionals were consulted.

    CONCLUSIONS: Limited knowledge about DM, based on beliefs about health and illness including biomedical and traditional explanations related to the influence of supernatural forces, e.g. fate, God etc., were found, which affected patients' self-care and care-seeking behaviour. Strained economy was stated to be a factor of the utmost importance affecting the management of DM and thus health. To develop cost-effective and optimal diabetes care in a country with limited resources, not only educational efforts based on individual beliefs are needed but also considering systemic and structural conditions in order to promote health and to prevent costly consequences of DM.

  • 62.
    Hjelm, Katarina
    et al.
    School of Health Science and Social Work, University of Växjö, Sweden.
    Nambozi, G
    Department of Nursing, Mbarara University of Science and Technology (MUST), Uganda.
    Beliefs about health and illness: a comparison between Ugandan men and women living with diabetes mellitus2008Inngår i: International Nursing Review, ISSN 0020-8132, E-ISSN 1466-7657, Vol. 55, nr 4, s. 434-441Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: The diabetes mellitus (DM) pandemic greatly affects developing countries. Self-care is an important part of management, guided by beliefs about health and illness. Dissimilarities in health-related behaviour in men and women have been described but not comparisons of their beliefs about health and illness.

    AIM: To explore beliefs about health and illness that might affect self-care practice and healthcare-seeking behaviour in men and women with DM in Uganda.

    METHODS: This was an exploratory study with a consecutive sample from an outpatient diabetes clinic at a university hospital. Semi-structured interviews were conducted with 15 women and 10 men aged 21-70 years. Data analysis was conducted by qualitative content analysis.

    FINDINGS: Men's and women's beliefs about health and illness indicated limited knowledge about the body and DM. Dissimilar were men's focus on socio-economic factors, particularly affordability of drugs, sexual function and lifestyle, while women valued well-being, support in daily life and household activities and had a higher risk-awareness of DM. Irrespective of gender, limited self-care measures were used, and health professionals were consulted about health problems.

    CONCLUSION: Similarities and dissimilarities were found between men and women in beliefs about health and illness that affect self-care practice and healthcare seeking. Underlying living conditions, with different gender roles, appear to determine the beliefs about health and illness, which are based on individual knowledge. Measures to increase knowledge about DM are urgently needed in Uganda. In diabetes care, it is important to search for individual beliefs and consider gender and living conditions.

  • 63.
    Hultsjo, Sally
    et al.
    Department of Psychiatry, Ryhov County Hospital, Jönköping.
    Berterö, Carina
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Arvidsson, Hans
    Department of Psychology, The University of Gothenburg, Gothenburg, Sweden.
    Hjelm, Katarina
    School of Health and Caring Sciences, Linnaeus University, Växjö.
    Core components in the care of immigrants with psychoses: A Delphi survey of patients, families, and health-care staff2011Inngår i: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 20, nr 3, s. 174-184Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of the present study was to identify core components in the care of immigrants with psychosis in Sweden. Experts (n = 43) from different perspectives (immigrants, families, and health-care staff) were assembled and used to score the importance of statements regarding components in the care for a person with psychosis in three questionnaire rounds. After each round, the opinions were consolidated and compared to identify whether consensus was reached. Consensus was reached about the importance of being treated on equal terms, regardless of country of birth. Staff interest and respect, shown in different ways of understanding, was valued. Consensus could not be reached on approximately half of the statements, of which four tended to be ranked towards unimportant. Those included that staff should have specific cultural knowledge or that the patient should be allowed to decide whether to be cared for by male or female staff. Nor was it regarded as important to identify a persons religious or ethnic background. The results illustrate the importance of fundamental psychiatric nursing, which should enable nurses to identify and meet the basic needs of all patients, regardless of country of origin. Areas for which consensus was not reached illustrate a future challenge for health-care staff to identify situations when cultural clashes could appear. Staff should have strategies to accomplish cultural negotiations to build an effective treatment alliance with the patient, as well as the family, to meet individual needs.

  • 64.
    Hultsjö, S M
    et al.
    Department of Psychiatry, Ryhov County Hospital, Jönköping.
    Hjelm, Katarina
    School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Organizing care for persons with psychotic disorders and risk of or existing diabetes mellitus type 22012Inngår i: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 19, nr 10, s. 891-902Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This literature review aimed to explore previous knowledge about specific care requirements for persons with psychotic disorders and risk of or existing type 2 diabetes. Sixteen qualitative and quantitative studies in the area were identified and summarized. The studies together indicate that mental health nurses play an important role in motivating people to perform diabetes care as they are often known to and trusted by the patients. A holistic approach to the person's health, with close follow-ups by psychiatric care and cooperation with diabetes care, may have benefits for the person with diabetes. Screening for and treating psychotic symptoms is an important task for the mental health nurse, as these symptoms drain energy from the person and prevent diabetes self-care. Lifestyle and diabetes education needs to be practical, adapted to the individual and focused on maintaining a healthy diet, regular exercise, changing smoking habits and preventing diabetes complications. Treatment with antipsychotic drugs increases the need for follow-ups of glycaemic control.

  • 65.
    Hultsjö, Sally
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Berterö, Carina
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Arvidsson, Hans
    School of Health Sciences and Social Work, Växjö University, Sweden.
    Hjelm, Katarina
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Identifying core components in care of foreign-born persons with psychosis and their families: Using the Delphi techniqueManuskript (Annet vitenskapelig)
    Abstract [en]

    The purpose of this study was to let persons involved in psychosis care (foreign-born persons, families and health care staff) identify the core components in care of foreign-born persons with psychosis and their families in Sweden. The results from three previous qualitative studies consisting of perceptions of psychosis care were reformulated and structured into statements in a questionnaire which was delivered to 43 persons involved in psychosis care. The statements were scored in terms of perceived importance in two rounds using the Delphi technique. The results revealed agreement about the importance of general psychiatric care. Individual perceptions on which importance there was no agreement, suggested that staff must seek to understand a person’s individual perceptions to gain insight about ways to build an effective care alliance with foreign born persons with psychosis and their families.

  • 66.
    Hultsjö, Sally
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Berterö, Carina
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Hjelm , Katarina
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Foreign-born and Swedish-born families perceptions of psychosis care2009Inngår i: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 18, nr 1, s. 62-71Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of the study was to describe how foreign-born and Swedish born families living in Sweden perceive psychosis care. Eleven foreign-born and 15 Swedish-born family members were interviewed and the data were analyzed using a phenomenographic approach. The findings showed three main descriptive categories: taking responsibility, access to care, and attitudes to psychosis. The degree of responsibility in the family decreased if there was easy access to care and support from health-care staff. Knowledge of psychosis was considered to be important in order to counteract prejudiced attitudes in the family and the community. Foreign-born families did not want to be treated differently from Swedes and stressed the importance of finding ways to communicate despite communication barriers. Foreign-born families also were affected by their experiences of psychiatric care and different beliefs about psychosis in their home country. The results indicate how important it is that health-care staff members treat families on equal terms. It is necessary to take the time to identify how to communicate in a good manner and to identify families previous experiences of and beliefs about psychosis care in order to help families face prejudice in society and to see beyond the psychosis.

  • 67.
    Hultsjö, Sally
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Berterö, Carina
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Hjelm, Katarina
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Perceptions of psychiatric care among foreign- and Swedish-born people with psychotic disorders2007Inngår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 60, nr 3, s. 279-288Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIM: This paper is a report of a study to explore different perceptions of psychiatric care among foreign- and Swedish-born people with psychotic disorders.

    BACKGROUND: Research from different countries reports a high-incidence of psychosis among migrants. The risk-factors discussed are social disadvantages in the new country. To understand and meet the needs of people from different countries, their perspective of psychiatric care must be illuminated and taken into consideration.

    METHOD: A phenomenographic study was conducted in 2005-2006 using semi-structured interviews with a convenience sample of 12 foreign-born people and 10 Swedish-born people with psychosis.

    FINDINGS: Three categories were identified: personal and family involvement in care; relating to healthcare staff; and managing illness and everyday life. Foreign-born people differed from Swedish-born people in that they struggled to attain an everyday life in Sweden, relied on healthcare staff as experts in making decisions, and had religious beliefs about mental illness. Among Swedish-born people, the need for more support to relatives and help to perform recreational activities was important.

    CONCLUSION: It is important to identify individual perceptions and needs, which may be influenced by cultural origins, when caring for patients with psychosis. Previous experience of care, different ways of relating to staff, and individual needs should be identified and met with respect. Social needs should not be medicalized but taken into consideration when planning care, which illustrates the importance of multi-professional co-operation.

  • 68.
    Hultsjö, Sally
    et al.
    Psychiatric Clinic, County Hospital, Ryhov, Jönköping, Sweden.
    Hjelm, Katarina
    School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Community health-care staff's experiences of support to prevent type 2 diabetes among people with psychosis: an interview study with health staff2012Inngår i: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 21, nr 5, s. 480-489Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of the study was to describe mental health staff experiences of giving support to prevent type 2 diabetes mellitus (DM) among people with psychosis in community psychiatry. A qualitative interview study with a purposeful sample of 12 community health staff was conducted. Data were analysed using qualitative content analysis. The results show how staff reported continuously supporting people with psychosis to adapt to healthy lifestyles, but stated that support is not given until after a person becomes overweight or is diagnosed with type 2 DM. Support was described as a never-ending process of motivation facing many reverses. Individually-adapted support given in practical situations was perceived as most successful. Cooperation between health-care organizations was seen as essential, but inadequate. Limitations in income and social network, and easy access to fast food and alcohol, were seen as obstacles to support. The results indicate that community health staff are in a position to make a considerable impact in motivating and supporting healthy lifestyle changes in practical situations in daily life among people with psychosis. This study raises awareness of how community health staff's support can be useful when developing nursing skills and health-care plans for people with psychosis.

  • 69.
    Hultsjö, Sally
    et al.
    Ryhov County Hospital.
    Hjelm, Katarina
    University of Lund.
    Immigrants in emergency care: Swedish health care staff's experiences2005Inngår i: International Nursing Review, ISSN 0020-8132, E-ISSN 1466-7657, Vol. 52, nr 4, s. 276-285Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: During the past few decades Sweden has developed into a multicultural society. The proportion of patients with different cultural backgrounds increases, which naturally makes new demands on health care staff.

    Aim: To identify whether staff in somatic and psychiatric emergency care experienced problems in the care of migrants, and if so to compare these.

    Method: The study design was explorative. Focus group interviews of 22 women and 13 men working as nurses and assistant nurses at an emergency ward, an ambulance service and a psychiatric intensive care unit were held.

    Findings: The results showed that the main problems experienced in all wards were difficulties related to caring for asylum-seeking refugees. Some dissimilarities were revealed: unexpected behaviours in migrants related to cultural differences described by staff working in the emergency ward; migrants' refusal to eat and drink and their inactive behaviour in the psychiatric ward; and a lot of non-emergency runs by the ambulance staff because of language barriers between the emergency services centre and migrants.

    Conclusion: The main problems experienced by the health care staff were situations in which they were confronted with the need to care for asylum-seeking refugees. Practice implications: These emphasize the importance of support from organizational structures and national policies to develop models for caring for asylum-seeking refugees. Simple routines and facilities to communicate with foreign-language-speaking migrants need to be developed. Health care staff need a deeper understanding of individual needs in the light of migrational and cultural background.

  • 70.
    Hultsjö, Sally
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Omvårdnad.
    Hjelm, Katarina
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Omvårdnad.
    Mötet mellan vårdpersonal och patienter med utländsk bakgrund inom akutsjukvården i Sverige2006Inngår i: Flervetenskapliga perspektiv i migrationsforskning: årsbok 2006 från forskningsprofilen Arbetsmarknad, migration och etniska relationer (AMER) vid Växjö universitet / [ed] Katarina Hjelm, Växjö University Press , 2006, 1, s. 15-29Kapittel i bok, del av antologi (Annet vitenskapelig)
    Abstract [sv]

       

    Under mångkulturåret 2006 publiceras denna bok som är den fjärde årsboken från Växjö universitets forskningsprofil ”Arbetsmarknad, Migration och Etniska relationer (AMER). Forskningsprofilen inrättades år 2001 och får årligen betydande ekonomiskt stöd av Växjö universitet. Avsikten har varit att utveckla en forskningsmiljö omfattande fyra ämnen: historia, nationalekonomi, sociologi och vårdvetenskap. Via tilldelat anslag stöds även forskning inom den nationalekonomiska arbetsmarknadsforskargruppen CAFO och Växjö universitets samarbete med Svenska Emigrantinstitutet. Avsikten med forskningsmiljön är att utveckla och stimulera forskning och forskarutbildning inom området. Syftet är också att utveckla grundutbildningens innehåll och samverkan med det omgivande samhället.

    Bokens innehåll speglar flera vetenskapers syn på frågor inom migrationsområdet och känns extra viktig att publicera under år 2006 som utnämnts till mångkulturåret. Författarna i boken representerar inte enbart olika ämnesdiscipliner utan utgörs också av personer som kommer ifrån olika länder och med varierande erfarenhet och kompetens inom forskning.

    Att flytta till ett nytt land innebär en anpassningsprocess som kan inverka på migrantens hälsa. I boken återfinns tre kapitel som berör detta, två av dessa kommer ifrån ämnet vårdvetenskap och ett ifrån ämnet nationalekonomi. Unika resultat från Björn Albins doktorsavhandling redovisas i avsnittet ”Hälsa bland invandrare i Sverige i ett långtidsperspektiv”. Ny kunskap om erfarenheter av att vårda invandrare inom det svenska hälso-och sjukvårdssystemet har doktoranden Sally Hultsjö och docent Katarina Hjelm skrivit om i kapitlet ”Mötet mellan vårdpersonal och patienter med utländsk bakgrund inom akutsjukvården i Sverige”. Nydisputerade Maria Nilsson redovisar kunskapsläget kring ”Sjukfrånvaron bland invandrare i Sverige – Utvecklingen under perioden 1981-1991”. Faktorer som kan inverka på hälsa och sjukdom har att göra med t ex diskriminering men också med vilken generation av invandrare man tillhör. En junior- och en seniorforskare i ämnet nationalekonomi diskuterar metodologiska aspekter på dessa faktorer: Filosofie doktor Ali Ahmed och professor Jan Ekberg i kapitlet ”Kan diskriminering studeras med experimentella metoder?” och professor Jan Ekberg i avsnittet ”Kan man studera tre generationer invandrare i Sverige?”. En annan faktor av betydelse för anpassningen i det nya landet och levnadsvillkoren där är yrket och två avsnitt inom det sociologiska fältet berör detta: ”Svenska mot modersmål – utvecklingen av två olika lärargrupper” och ”Den gode invandraren bakar inte pizza – Invandrares företagande i svensk forskning och politik” vilka har författats av doktoranderna Anna-Maria Sarstrand respektive Henrik Hultman. Slutligen behöver vi historiska kunskaper för att förstå såväl vår samtid som framtid och boken avslutas med kapitlen ”…en, efter förhållandena utmärkt tillvaro…”- De danska flyktingarna, arbetsmarknadskommissionen och hjälpkommittén för danska flyktingar i Kalmar 1943” och ”Invandrare som önskade stanna. Ungerska lantarbetare i Sverige i slutet av 1940-talet” författade av filosofie doktorerna Malin Thor respektive Attila Lajos.

    Som redaktör är det särskilt glädjande att konstatera att de flesta av årsbokens kapitel är författade av doktorander eller tidigare doktorander inom forskningsprofilen AMER.

    Förhoppningen med boken är att de flervetenskapliga perspektiven skall bidraga till en ökad förståelse för mångkulturella spörsmål!

    Växjö i september 2006

  • 71.
    Katarina, Hjelm
    et al.
    Department of Community Medicine, University of Lund, Lund, Sweden.
    Magnus, Löndahl
    Department of Endocrinology and Diabetes, Lund University Hospital, Lund, Sweden.
    Per, Katzman
    Department of Endocrinology and Diabetes, Lund University Hospital, Lund, Sweden.
    Jan, Apelqvist
    Department of Endocrinology, Malmö University Hospital, Malmö, Sweden.
    Diabetic persons with foot ulcers and their perceptions of hyperbaric oxygen chamber therapy.2009Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 18, nr 14, s. 1975-1985Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    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.

    BACKGROUND: 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.

    DESIGN: Explorative study.

    PARTICIPANTS: 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 (median 70), with diabetic foot ulcers, participated.

    METHOD: Focus-group interviews 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 RELEVANCE TO CLINICAL PRACTICE: 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.

  • 72.
    Lindqvist, Gunilla
    et al.
    Linnaeus University, Växjö, Sweden .
    Albin, Björn
    Linnaeus University, Växjö, Sweden .
    Heikkilä, Kristiina
    Linnaeus University, Växjö, Sweden .
    Hjelm, Katarina
    Linnaeus University, Växjö, Sweden .
    Conceptions of daily life in women living with a man suffering from chronic obstructive pulmonary disease2013Inngår i: Primary Health Care Research and Development, ISSN 1463-4236, E-ISSN 1477-1128, Vol. 14, nr 1, s. 40-51Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim

    To describe conceptions of daily life in women living with a man suffering from chronic obstructive pulmonary disease (COPD) in different stages.

    Background

    The spouse is often the primary caregiver to someone with COPD, and thus also affected by the consequences of the disease. No previous studies have been found focusing on conceptions of daily life in women living with a man suffering from COPD in different stages.

    Methods

    A phenomenographic study was conducted. Data were collected in 2008–2009 through semi-structured interviews with 21 women living with men suffering from COPD in different stages.

    Findings

    Four main descriptive categories were found: unchanged life situation where no support was needed; socially restricted life and changed roles; changes in health; and changes in the couple's relationship where support was needed. The categories are described in relation to the woman herself, in relation to the man, and in relation to others. No support was needed from society or health care when the men had mild COPD and the women experienced no change in their daily life. As the disease progressed, the women's responsibilities increased and their role changed from being a spouse to being an informal carer. Social contacts became limited, and they began to feel isolated. The women prioritized their spouse's health and well-being and compromised their own health. They experienced lack of support from health professionals and from the municipality.

  • 73.
    Lindqvist, Gunilla
    et al.
    Linnaeus University, Växjö, Sweden .
    Heikkilä, Kristiina
    Linnaeus University, Växjö, Sweden .
    Albin, Björn
    Linnaeus University, Växjö, Sweden .
    Hjelm, Katarina
    Linnaeus University, Växjö, Sweden .
    Conceptions of daily life in men living with a woman suffering from chronic obstructive pulmonary disease2013Inngår i: Primary Health Care Research and Development, ISSN 1463-4236, E-ISSN 1477-1128, Vol. 14, nr 2, s. 140-150Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIM: To describe conceptions of daily life in men living with a woman suffering from chronic obstructive pulmonary disease (COPD) in different stages of the disease.

    BACKGROUND: A chronic disease like COPD affects not only the person living with the illness, but also the spouse. Significant tasks and demands are placed on husbands. COPD has for a long time been considered more a man's disease than a woman's disease, but according to new evidence COPD is a vast problem in women, which requires support from their spouses. The literature review did not reveal any previous studies concerning conceptions of daily life in men living with women suffering from COPD in different stages.

    METHODS: A phenomenographic study was conducted. Data were collected from October 2008 to October 2009 through semi-structured interviews with 19 men living with a woman suffering from COPD.

    FINDINGS: Two main descriptive categories were found: (1) unchanged life situation where no support was needed; (2) changed life situation related to severity of COPD, where support was needed. The categories were described from the perspective 'ME and my spouse'. Even in their caregiving situation, the men continued with their own life and activities and did not put themselves in second place. No support was needed from healthcare or municipality when the women had mild COPD, but this changed when the COPD progressed. The men felt that daily life was burdened, restricted and the partner relationship was affected, even if the disease had not reached the final stage. The COPD forced them gradually into a caregiving role, and their daily life changed. They become more of a caregiver than a spouse. The men experienced lack of knowledge and support, and they felt that health professionals and municipality did not care about them.

  • 74.
    Mufunda, Esther
    et al.
    School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Albin, Björn
    School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Hjelm, Katarina
    School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Differences in health and illness beliefs in zimbabwean men and women with diabetes2012Inngår i: Open Nursing Journal, ISSN 1874-4346, E-ISSN 1874-4346, Vol. 6, s. 117-125Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This study explored beliefs about health and illness that might affect self-care and health-seeking behaviours in Zimbabwean men and women with diabetes. Gender differences were indicated in a previous study but their extent has not been studied. The present study used a qualitative descriptive design with semi-structured interviews to gain a deeper understanding of the phenomena. The sample consisted of 21 participants, 11 females aged 19-61 years (Median 44 years) and 10 males aged 22-65 years (Median 52 years). Qualitative content analysis was used. Health was described as freedom from diseases and enjoying well-being. Both males and females displayed limited knowledge about diabetes and dissimilarities in health-seeking behaviours. Women, in contrast to men, were more active in self-care and used various measures besides drugs as they related to a higher extent the cause of diabetes to supernatural factors like gods and witches. They sought information from self-help groups and help from outside the professional health sector like healers in the folk sector. Prolonged economic disruption also had negative effects towards maintenance of healthy life-styles as both men and women struggled to get money for food and drugs. Thus, the study highlighted that knowledge about diabetes and its management are important for self-care. There is therefore need to develop acceptable and affordable gender- sensitive diabetes care programmes that enhance patient participation, empowerment and promotion of health.

  • 75.
    Mufunda, Esther
    et al.
    Department of Health Sciences, Zimbabwe Open University, Harare, Zimbabwe.
    Ernersson, Åsa
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Hjelm, Katarina
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Limited knowledge of diabetes in patients attending an outpatient diabetes clinic at a referral hospital in Zimbabwe: a cross-sectional study2018Inngår i: Pan African Medical Journal, ISSN 1937-8688, E-ISSN 1937-8688, Vol. 29, artikkel-id 144Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Diabetes mellitus (DM) has increased globally, with a significant increase noted in African communities. Self-care health-related behavior is determined by beliefs about health and illness which are based on the person?s knowledge of diabetes. The present study aimed to assess patients diabetes awareness and level of diabetes knowledge in Zimbabwean adults with diabetes attending an outpatient diabetes clinic at a main referral hospital.

  • 76.
    Mufunda, Esther
    et al.
    Linnaeus University, Växjö, Sweden.
    Wikby, Kerstin
    Linnaeus University, Växjö, Sweden.
    Albin, Björn
    Linnaeus University, Växjö, Sweden.
    Hjelm, Katarina
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Hälsouniversitetet. Linnaeus University, Växjö, Sweden.
    Level and determinants of diabetes knowledge in patients with diabetes in Zimbabwe: a cross-sectional study2012Inngår i: Pan African Medical Journal, ISSN 1937-8688, E-ISSN 1937-8688, Vol. 13, s. 78-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    INTRODUCTION:

    A previous study of beliefs about health and illness in Zimbabweans with diabetes mellitus indicated limited knowledge about diabetes and the body, affecting self-care and health-care seeking behaviour. The aim of this study was to assess the level of diabetes knowledge in Zimbabwean adults with diabetes mellitus, to determine the main gaps in knowledge and identify the socio-demographic and diabetes-related determinants that predict diabetes awareness and self-care practices.

    METHODS:

    A cross-sectional descriptive study was performed using a standardized self-report Diabetes Knowledge Test questionnaire (DKT) of 58 respondents, 32 women and 26 men. Results were analysed with descriptive and analytic statistical methods.

    RESULTS:

    The majority of the respondents scored average knowledge on all three sub-scales: general knowledge, insulin use and total knowledge, with an overall score of 63.1 ± 14, 2%. Major knowledge gaps were in areas related to diet, insulin use and glycaemic control. No significant differences in mean scores were detected in the diabetes knowledge sub-scales when comparisons were made of mean knowledge scores in relation to socio-demographic and diabetes-related characteristics. However, diabetes-related complications were significantly associated with lower total and general diabetes knowledge, and female gender was an independent determinant of low general knowledge.

    CONCLUSION:

    Knowledge gaps were evident in areas regarding insulin use, diet and glycaemic control. Low diabetes knowledge was associated with female gender and could be a risk factor for development of diabetes-related complications. Knowledge gaps need to be addressed in diabetes education to prevent development of diabetes-related complications.

  • 77.
    Noor Abdulhadi, Nadia M.
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Al-Shafaee, Mohammed Ali
    Sultan Qaboos University, Muscat, Oman .
    Wahlström, Rolf
    Karolinska Institutet, Stockholm, Sweden.
    Hjelm, Katarina
    Linnaeus University, Växjö, Sweden .
    Doctors' and nurses' views on patient care for type 2 diabetes: an interview study in primary health care in Oman2013Inngår i: Primary Health Care Research and Development, ISSN 1463-4236, E-ISSN 1477-1128, Vol. 14, nr 3, s. 258-269Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIM: This study aimed at exploring the experiences of primary health-care providers of their encounters with patients with type 2 diabetes, and their preferences and suggestions for future improvement of diabetes care.

    BACKGROUND: Barriers to good diabetes care could be related to problems from health-care providers' side, patients' side or the health-care system of the country. Treatment of patients with type 2 diabetes has become a huge challenge in Oman, where the prevalence has increased to high levels.

    METHOD: Semi-structured interviews were conducted with 26 health-care professionals, 19 doctors and seven nurses, who worked in primary health care in Oman. Qualitative content analysis was applied. Findings Organizational barriers and barriers related to patients and health-care providers were identified. These included workload and lack of teamwork approach. Poor patients' management adherence and influence of culture on their attitudes towards illness were identified. From the providers' side, language barriers, providers' frustration and aggressive attitudes towards the patients were reflected. Decreasing the workload, availability of competent teams with diabetes specialist nurses and continuity of care were suggested. Furthermore, changing professional behaviours towards a more patient-centred approach and need for health education to the patients, especially on self-management, were addressed. Appropriate training for health-care providers in communication skills with emphasis on self-care education and individualization of care according to each patient's needs are important for improvement of diabetes care in Oman.

  • 78.
    Ring Jacobsson, Lisa
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Medicinska fakulteten.
    Milberg, Anna
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, LAH Linköping.
    Hjelm, Katarina
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Medicinska fakulteten.
    Friedrichsen, Maria
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i östra Östergötland, Palliativt kompetenscentrum.
    Experiences, Own Management and Beliefs regarding Residual Symptoms among People with Coeliac DiseaseManuskript (preprint) (Annet vitenskapelig)
    Abstract [en]

    Objective: To explore experiences and beliefs concerning residual symptoms despite a gluten-free diet in women and men with coeliac disease, with a focus on causes and management.

    Background: Between 7% and 30% of people with coeliac disease suffer from residual symptoms, despite following a long-term gluten-free diet, and it has been proposed that women in particular, continue to experience such inconveniences. There is a lack of knowledge about own beliefs concerning the underlying causes of persistent symptoms among people with coeliac disease and their own management of these symptoms.

    Methods: A qualitative explorative design with semi-structured interviews with 22 adults, 11 females and 11 males, with coeliac disease in Sweden. Data were analyzed using qualitative content analysis.

    Results: The disease was continuing to have a substantial impact on the informants’ lives even after several years’ treatment. The interviews revealed residual symptoms of both a gastrointestinal and extra-intestinal nature, which were considered to influence their personality. The management of persistent symptoms resembled thorough detective work, and both efforts to find the missing puzzle piece and strategies to prevent problems were used. Beliefs about the underlying causes of these symptoms were bodily convictions and that it was impossible to live completely gluten-free.

    Conclusion: People with treated coeliac disease, irrespective of gender, may experience residual symptoms of both a physical and psychological nature, causing major negative impacts on their lives in different ways. In the light of this, healthcare staff should change their practices regarding the follow-up of these people, and in addition to medical care should  provide guidance on management strategies to facilitate the daily life of these people. Furthermore, information to people who have just been diagnosed should make them aware of the possibility that they may come to experience continued symptoms, despite treatment.

  • 79.
    Ring Jacobsson, Lisa
    et al.
    Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad.
    Milberg, Anna
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i östra Östergötland, Palliativt kompetenscentrum. Region Östergötland, Närsjukvården i östra Östergötland, LAH Öst.
    Hjelm, Katarina
    Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad.
    Friedrichsen, Maria
    Linköpings universitet, Medicinska fakulteten. Östergötlands Läns Landsting, Närsjukvården i östra Östergötland, Palliativt kompetenscentrum. Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad.
    Gaining perspective on own illness - The lived experiences of a patient education program for women with treated coeliac disease.2016Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, nr 9-10, s. 1229-1237Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aims and Objectives

    To explore the lived experiences of women with coeliac disease after attending a patient education programme, to gain a broader perspective of its influence.

    Background

    Adults, particularly women, with coeliac disease report suffering from poor well-being and reduced quality of life in terms of health. Patient education programmes might support and encourage them in the search for possible improvements in lifestyle and in their approach to the disease.

    Design

    A qualitative phenomenological study.

    Methods

    Personal narrative interviews with 14 women suffering from coeliac disease who had participated in an educational programme. Data analysis in accordance with Giorgi was performed.

    Results

    The essential structure of women's lived experiences following their participation in the patient education programme was found to be an interaction with others with the same disease, which left the women feeling individually strengthened. The interaction enabled the participants to acquire a broader view of their life with coeliac disease. As a result, this realigned their sense of self in relation to their own disease.

    Conclusion

    In coping with coeliac disease, it seems that women need interaction with others with the disease to experience togetherness within a group, get the opportunity to compare themselves with others and to exchange knowledge. The interaction appears to result in that women acquire an overview of life with the disease, develop a greater confidence and dare to try new things in life.

    Relevance to clinical practice

    When designing a patient education programme it seems important to consider the needs of persons to meet others with the same disease, and to ask them about their need for knowledge, rather than simply assuming that health care professionals know what they need.

  • 80.
    Rydé, Kerstin
    et al.
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    Hjelm, Katarina
    Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten.
    How to support patients who are crying in palliative home care: an interview study from the nurses' perspective.2016Inngår i: Primary Health Care Research and Development, ISSN 1463-4236, E-ISSN 1477-1128, Vol. 17, nr 5, s. 479-488Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim The aim of this study was to explore how nurses can support patients who are crying in a palliative home care context.

    BACKGROUND: In palliative care the nurse has a central role in the team whose duty it is to create a sense of security and trust, as well as to give comfort and support the patients. The nurse's responsibility is to identify different needs of the patients for support and develop a relationship with them. Patients may express their pain, anxiety, fear and suffering by crying. No studies have been found which focus on how nurses can support patients who are crying in different ways and crying for different reasons.

    METHODS: A qualitative explorative study was performed. Semi-structured interviews were held with eight nurses aged 32-63 years (Median 40) working in Swedish palliative home care. The data were analysed using Qualitative Content analysis. Findings It was reported that the nurse should meet and confirm the patient during different types of crying episodes and should also be able to alternate between being close and physically touching the in such close contact with the patients, the nurse can provide emotional support by showing empathy, merely being present and letting the patients cry as much as they want. When the crying finally stops, the nurse can support the person by speaking with them, showing sensitivity, humility and respect for the patient's wishes. A few examples of the patients' need for information or practical support emerged. The nurse can emotionally support the person who is crying by just being present, confirming, showing empathy, offering a chance to talk and showing respect for their individual needs and the different ways they may cry.

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