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  • 1.
    Abdulhadi, Nadia M. Noor
    et al.
    Karolinska Inst ; Minist Hlth, Oman.
    Al-Shafaee, Mohammed Ali
    Sultan Qaboos Univ, Oman.
    Wahlström, Rolf
    Karolinska Inst ; Uppsala University.
    Hjelm, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Doctors' and nurses' views on patient care for type 2 diabetes: an interview study in primary health care in Oman2013In: Primary Health Care Research and Development, ISSN 1463-4236, E-ISSN 1477-1128, Vol. 14, no 3, p. 258-269Article in journal (Refereed)
    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 healthcare 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 healthcare 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.

  • 2.
    Albin, Björn
    et al.
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Hjelm, Katarina
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Äldre invandrares användning av hälso- och sjukvård2008In: Efterfrågad arbetskraft?: Årsbok 2008 från forskningsprofilen Arbetsmarknad, migration och Etniska relationer (AMER) vid Växjö universitet, 2008, p. 167-176Chapter in book (Other academic)
  • 3.
    Albin, Björn
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences. Lund University.
    Hjelm, Katarina
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences. Lund University.
    Chang Zhang, Wen
    Fujian Medical University, China.
    Health Care Systems in Sweden and China: Legal and formal organisational aspects2010In: Health Research Policy and Systems, ISSN 1478-4505, E-ISSN 1478-4505, Vol. 8, article id 20Article in journal (Refereed)
    Abstract [en]

    AIM: To describe and compare health care in Sweden and China with regard to legislation, organisation, and finance.

    METHODS: Literature review in Sweden and China to identify literature published from 1985 to 2008 using the same keywords. References in recent studies were scrutinized, national legislation and regulations and government reports were searched, and textbooks were searched manually.

    RESULTS: The health care systems in Sweden and China show dissimilarities in legislation, organisation, and finance. In Sweden there is one national law concerning health care while in China the law includes the "Hygienic Common Law" and the "Fundamental Health Law" which is under development. There is a tendency towards market-orientated solutions in both countries. Sweden has a well-developed primary health care system while the primary health care system in China is still under development and relies predominantly on hospital-based care concentrated in cities.

    CONCLUSION: Despite differences in health care systems, Sweden and China have similar basic assumptions, i.e. to combine managerial-organisational efficiency with the humanitarian-egalitarian goals of health care, and both strive to provide better care for all.

  • 4.
    Albin, Björn
    et al.
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Hjelm, Katarina
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Ekberg, Jan
    Växjö University, Faculty of Humanities and Social Sciences, School of Management and Economics.
    Elmeståhl, Sölve
    Mortality among foregn born and native born in Sweden 1970-19992005In: European Journal of Public Health, Vol. 15, no 5, p. 511-517Article in journal (Refereed)
  • 5.
    Albin, Björn
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Hjelm, Katarina
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Ekberg, Jan
    Lunds universitet.
    Elmståhl, Sölve
    Linnaeus University, Faculty of Business, Economics and Design, Linnaeus School of Business and Economics.
    County Differences in Mortality among Foreign-Born Compared to Native Swedes 1970-19992012In: Nursing Research and Practice, ISSN 2090-1429, E-ISSN 2090-1437, Vol. 2012, p. Article ID 136581-Article in journal (Refereed)
    Abstract [en]

    Background. Regional variations in mortality and morbidity have been shown in Europe and USA. Longitudinal studies have found increased mortality, dissimilarities in mortality pattern, and differences in utilization of healthcare between foreign- and native-born Swedes. No study has been found comparing mortality among foreign-born and native-born Swedes in relation to catchment areas/counties. Methods. The aim was to describe and compare mortality among foreign-born persons and native Swedes during 1970–1999 in 24 counties in Sweden. Data from the Statistics Sweden and the National Board of Health and Welfare was used, and the database consisted of 723,948 persons, 361,974 foreign-born living in Sweden in 1970 and aged 16 years and above and 361,974 matched Swedish controls. Results. Latest county of residence independently explained higher mortality among foreign-born persons in all but four counties; OR varied from 1.01 to 1.29. Counties with a more rural structure showed the highest differences between foreign-born persons and native controls. Foreign-born persons had a lower mean age (1.0–4.3 years) at time of death. Conclusion. County of residence influences mortality; higher mortality is indicated among migrants than native Swedes in counties with a more rural structure. Further studies are needed to explore possible explanations. 

  • 6.
    Albin, Björn
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences. Lund University.
    Hjelm, Katarina
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences. Lund University.
    Ekberg, Jan
    Linnaeus University, Faculty of Business, Economics and Design, Linnaeus School of Business and Economics.
    Elmståhl, Sölve
    Lund University.
    Residential mobility among foreign-born persons living in Sweden is associated with lower morbidity2010In: Clinical Epidemiology, ISSN 1179-1349, E-ISSN 1179-1349, Vol. 9, no 2, p. 187-194Article in journal (Refereed)
    Abstract [en]

    Aim: to analyze the pattern of mortality in deceased foreign-born persons living in Sweden during the years 1970-1999 in relation to distance mobility.

    MEthods: Data from Statistics Sweden and the National Board of Health and Welfare was used, and the study population consisted of 281,412 foreign-born persons aged 16 years and over who were registered as living in Sweden in 1970.

    Results: Distance mobility did not have a negative effect on health. Total mortality was lower (OR 0.71; 95% CI 0.69-0.73) in foreign-born persons in Sweden who had changed their county of residence during the period 1970-1990. Higher death rates were observed, after adjustment for age, in three ICD diagnosis groups "Injury and poisoning", "External causes of injury and poisoning", and "Diseases of the digestive system" among persons who had changed county of residence.

  • 7.
    Albin, Björn
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Hjelm, Katarina
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Ekberg, Jan
    Linnaeus University, Faculty of Business, Economics and Design, Linnaeus School of Business and Economics.
    Elmståhl, Sölve
    Hälsa, Vård och Samhälle, Lunds universitet.
    Utilization of In-Hospital Care among Foreign-Born Compared to Native Swedes 1987-1999 (Open Access)2012In: Nursing Research and Practice, ISSN 2090-1429, E-ISSN 2090-1437, Vol. 2012, p. Article ID 713249-Article in journal (Refereed)
    Abstract [en]

    In previous longitudinal studies of mortality and morbidity among foreign-born and native-born Swedes, increased mortality and dissimilarities in mortality pattern were found. The aim of this study is to describe, compare, and analyse the utilization of in-hospital care among deceased foreign- and Swedish-born persons during the years 1987–1999 with focus on four diagnostic categories. The study population consisted of 361,974 foreign-born persons aged 16 years and upward who were registered as living in Sweden in 1970, together with 361,974 matched Swedish controls for each person. Data from Statistics Sweden (SCB) and the National Board of Health and Welfare Centre for Epidemiology, covering the period 1970–1999, was used. Persons were selected if they were admitted to hospital during 1987–1999 and the cause of death was in one of four ICD groups. The results indicate a tendency towards less health care utilization among migrants, especially men, as regards Symptoms, signs, and ill-defined conditions and Injury and poisoning. Further studies are needed to explore the possible explanations and the pattern of other diseases to see whether migrants, and especially migrant men, are a risk group with less utilization of health care.

  • 8.
    Albin, Björn
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Lund Univ.
    Hjelm, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Lund Univ.
    Elmståhl, Sölve
    Lund University.
    Comparison of Stroke mortality in Finnish-born migrants living in Sweden 1970-1999 and in Swedish-born individuals2014In: Journal of Immigrant and Minority Health, ISSN 1557-1912, E-ISSN 1557-1920, Vol. 16, no 1, p. 18-23Article in journal (Refereed)
    Abstract [en]

    A limited number of studies have been found on stroke mortality in migrants showing higher mortality for some groups. Influence of time of residence has been studied by one research group. An earlier study showed a significantly higher number of deaths in Diseases of the circulatory system in Finnish migrants compared with native Swedes. To test the hypothesis of a higher mortality in and a decrease in mortality over time in stroke among Finnish migrants in Sweden. The study was based on National Population data, the study population included 321,407 Swedish and 307,174 foreign born persons living in Sweden 1987-1999. Mean age was lower at time for death for Finnish migrants than native Swedes, men 5.1 years difference and women 2.3 years. The difference decreased over time. The risk of death by stroke was higher for migrants with short time of residence than with long time (<= 10 years, OR 1.61-1.36 vs >= 11 year, OR 1.18). Migrants with short time of residence died 9.8-5.3 years earlier than native Swedes. The hypothesis was confirmed and an indication of adjustment to life in the new country was found. International studies show similar results for other migrant groups but further studies are needed to verify if the same pattern can be found in other migrants groups in Sweden and to generalise the findings.

  • 9.
    Albin, Björn
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Hjelm, Katarina
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Elmståhl, Sölve
    Institutionen för Hälsa, Vård och Samhälle, Avd för Geriatrik, Lunds universitet.
    Lower prevalence of hip fractures in foreign-born individuals than in Swedish-born individuals during the period 1987-19992010In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 11, p. Article ID: 203-Article in journal (Refereed)
    Abstract [en]

    Cultural background and environmental factors such as UV-radiation and lifestyle during childhood and adolescence may influence the risk of a hip fracture event later in life. Differences in prevalence might occur between the indigenous population and those who have migrated to a country.

    METHODS: The study was based on national population data. The study population consisted of 321,407 Swedish-born and 307,174 foreign-born persons living in Sweden during the period 1987-1999.

    RESULTS: Foreign-born persons had reduced risk of hip fracture, with odds ratios (ORs) of 0.47-0.77 for men and 0.42-0.88 for women respectively. Foreign-born women had the hip fracture event at a higher age on average, but a longer time spent in Sweden was associated with a small but significant increase in risk.

    CONCLUSIONS: There was a reduced risk of hip fracture in all foreign-born individuals, and that the hip fracture event generally happened at a higher age in foreign-born women. Migration must therefore be considered in relation to the prevalence and risk of hip fracture. Migration can therefore have a positive effect on one aspect of the health of a population, and can influence and lower the total cost of healthcare due to reduced risk and prevalence of hip fracture.

     

     

     

     

  • 10. Berterö, Carina
    et al.
    Hjelm, Katarina
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Social support as described by foreign-born persons diagnosed with type 2 diabetes mellitus and living in Sweden2010In: Nursing and Health Sciences, ISSN 1441-0745, E-ISSN 1442-2018, Vol. 12, no 4, p. 507-514Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore and describe the meaning of support and its impact on the life situation of foreign-born persons diagnosed with type 2 diabetes mellitus and living in Sweden in relation to gender, age, and the duration of the disease. Mixed methods were used on a purposive sample of 34 foreign-born adults who had been diagnosed with type 2 diabetes mellitus. Qualitative data were collected by semi-structured interviews and quantitative data were collected by the Norbeck Social Support Questionnaire (NSSQ). The meaning of “support” was described by the participants as medical support, information support, and aiding support to learn to manage diabetes. Support influenced the participants' entire life and their need for it was related to the severity of the diabetes and differences regarding age and gender. The participants scored low on the NSSQ regarding total emotional support, total aid, and total function and 42% had lost an important relationship during the last year. Their marital status had no impact on emotional support but aid was significant. Medical support, with regular follow-up and information, is important in obtaining affirmation and aids in learning to manage diabetes mellitus.

  • 11.
    Ekberg, Jan
    et al.
    Växjö University, Faculty of Humanities and Social Sciences, School of Management and Economics. Växjö University, Faculty of Humanities and Social Sciences, School of Management and Economics. Nationalekonomi och Statistik.
    Albin, Björn
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work. Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work. Vårdvetenskap.
    Hjelm, Katarina
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work. Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work. Vårdvetenskap.
    Higher mortality and different pattern of causes among foreign born compared to native in Sweden 1970-19992006In: Journal of Immigrant Health, Vol. 7, no 2Article in journal (Refereed)
  • 12.
    Ge, Li
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Fujian University of Traditional Chinese Medicine, China.
    Albin, Björn
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Hadziabdic, Emina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Hjelm, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Rask, Mikael
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Beliefs about health and illness and health-realted behavior among urban women with gestational diabetes mellitus in the south east of China2016In: Journal of Transcultural Nursing, ISSN 1043-6596, E-ISSN 1552-7832, Vol. 27, no 6, p. 593-602Article in journal (Refereed)
    Abstract [en]

    Purpose: The incidence of gestational diabetes among Chinese women is 4.3%. No study has previously been conducted about beliefs and health-related behavior among urban Chinese women with this disease. This article aims to explore beliefs about health and illness and health-related behavior among women in this group in a Chinese sociocultural context.

    Design: A qualitative exploratory study was conducted and semistructured individual interviews (n = 15) were processed by content analysis.

    Results: Beliefs about health and illness among these women were foremost attributed to the individual, social, and natural worlds. They feared the negative influence of gestational diabetes, but some of them believed in “letting nature take its course” and “living in the present.” Their care-seeking behavior varied between the professional, popular, and folk sectors. They sought a balance between following professionals’ advice and avoiding practical difficulties.

    Conclusion: The beliefs and health-related behavior among them were influenced by Chinese culture, which can sometimes but not always reduce the effect of the disease.

  • 13.
    Hadziabdic, Emina
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Albin, Björn
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Heikkilä, Kristiina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Hjelm, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Family members’ experiences of the use of interpreters in healthcare2014In: Primary Health Care Research and Development, ISSN 1463-4236, E-ISSN 1477-1128, Vol. 15, no 2, p. 156-169Article in journal (Refereed)
    Abstract [en]

    Aim The aim was to explore adults’ experiences of their family members’ use of interpreters in health-care encounters.

    Background Language barriers are a major hindrance for migrants to receive appropriate healthcare. In a foreign country, family members often need support in care of migrant patients. No previous studies focusing on adult family members’ experiences of the use of interpreters in healthcare have been found.

    Method A purposive sample of 10 adult family members with experiences of the use of interpreters in health-care encounters. Data were collected between May and September 2009 by focus-group interviews and analysed with qualitative analysis according to a method described for focus groups.

    Findings Three categories emerged from the analysis: (1) Experiences of the use of professional interpreters, (2) Experiences of being used as an interpreter and (3) Experiences of what needs to be improved when using interpreters. The main findings showed no agreement in family members’ experiences; interpretation should be individually and situationally adapted. However, when family members acted as interpreters, their role was to give both practical and emotional support, and this led to both positive and negative emotions. Use of simple language, better collaboration in the health-care organization and developing the interpreters’ professional attitude could improve the use of professional interpreters. The type of interpreter, mode of interpretation and patient's preferences should be considered in the interpretation situation. In order to achieve high-quality healthcare, health-care professionals need to organize a good interpretation situation case-by-case, choose the appropriate interpreters with the patient in focus and cooperate with members of the patient's social network.

  • 14.
    Hadziabdic, Emina
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Albin, Björn
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Heikkilä, Kristiina
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Hjelm, Katarina
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Healthcare staffs perceptions of using interpreters:  a qualitative study2010In: Primary Health Care Research and Development, ISSN 1463-4236, E-ISSN 1477-1128, Vol. 11, no 3, p. 260-270Article in journal (Refereed)
    Abstract [en]

    Aim: To describe how healthcare professionals experience and perceive the use of interpreters in their contacts with patients with whom they do not share a common language.

    Methods: An explorative descriptive study. The study was conducted in different healthcare settings in Sweden and included 24 healthcare staff, of whom 11 were physicians, 9 nurses, 2 physiotherapists and 2 assistant nurses. Data were generated through written descriptions of the use of interpreters in healthcare and  analysed using qualitative content analysis.

    Findings: Two main categories emerged: 1) aspects related to the interpreter and 2) organizational aspects. It was shown that having a face-to-face, professional, trained interpreter, with a good knowledge of both languages and of medical terminology, translating literally and objectively, was perceived positively. The organizational aspects that affected the perception were functioning or non-functioning technical equipment, calm in the interpretation environment, documentation of the patients’ language ability, respect for the appointed time, and the level of availability and service provided by the interpreter agency.

    Conclusion: It is important to develop a well-functioning interpreter organization that offers trained interpreters with a professional attitude to improve and ensure cost-effective and high-quality encounters and care.

  • 15.
    Hadziabdic, Emina
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Albin, Björn
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Hjelm, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Arabic-speaking migrants’ attitudes, opinions, preferences and past experiences concerning the use of interpreters in healthcare: a postal cross-sectional survey2014In: BMC Research Notes, ISSN 1756-0500, E-ISSN 1756-0500, Vol. 7, article id 71Article in journal (Refereed)
    Abstract [en]

    Background

    Good communication is an important prerequisite for equal treatment in a healthcare encounter. One way to overcome language barriers when patients and healthcare staff do not share the same language is to use a professional interpreter. Few previous studies have been found investigating the use of interpreters, and just one previous study from the perspective of European migrants, which showed that they perceived interpreters as a communication aid and a guide in the healthcare system as regards information and practical matters. No previous study has gathered quantitative information to focus on non-European migrants’ attitudes to the use of interpreters in healthcare encounters. Thus, the aim of this study was to investigate Arabic-speaking individuals’ attitudes, opinions, preferences and past experiences concerning the use of interpreters in healthcare in order to: (i) understand how persons’ expectations and concerns regarding interpreters may vary, both within and across cultural/linguistic populations; (ii) understand the consequences of diverse opinions/expectations for planning responsive services; and (iii) confirm findings from previous qualitative studies.

    Method

    A postal cross-sectional study using a structured self-administered 51-item questionnaire was used to describe and document aspects of Arabic-speaking individuals’ attitudes to the use of interpreters in healthcare. The sample of 53 Arabic-speaking migrants was recruited from three different places. Participants were mostly born in Iraq and had a high level of education and were almost equally divided between genders. Data were analysed with descriptive statistics.

    Results

    The main findings were that most of the participants perceived the interpreter’s role as being a communication aid and a practical aid, interpreting literally and objectively. Trust in the professional interpreter was related to qualification as an interpreter and personal contact with face-to-face interaction. The qualities of the desired professional interpreter were: a good knowledge of languages and medical terminology, translation ability, and sharing the same origin, dialect and gender as the patient.

    Conclusion

    This study confirmed previous qualitative findings from European migrant groups with a different cultural and linguistic background. The study supports the importance of planning a good interpretation situation in accordance with individuals’ desire, irrespective of the migrant’s linguistic and cultural background, and using interpreters who interpret literally and objectively, who are highly trained with language skills in medical terminology, and with a professional attitude to promote communication, thus increasing cost-effective, high-quality individualized healthcare.

  • 16.
    Hadziabdic, Emina
    et al.
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Heikkilä, Kristiina
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Albin, Björn
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Hjelm, Katarina
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Migrants' perceptions of using interpreters in health care2009In: International Nursing Review, ISSN 0020-8132, E-ISSN 1466-7657, Vol. 56, no 4, p. 461-469Article in journal (Refereed)
  • 17.
    Hadziabdic, Emina
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Heikkilä, Kristiina
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Albin, Björn
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Hjelm, Katarina
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Problems and consequences in the use of professional interpreters: qualitative analysis of incidents from primary healthcare.2011In: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800, Vol. 18, no 3, p. 253-261Article in journal (Refereed)
    Abstract [en]

    The aim was to explore what probklems were reported by healthcare straff in primary healthcare concerning the use of interpreters and what consequences that might lead to. A single-case study of a real life situation was implemented by analysing 60 incident reports written by different health care professionals. Qualitative content analysis was applied. The results showed that the main problems were related to language in terms of lack of available interpreters in a particular language, and to organisational routines with difficulties in availability of interpreters and access to the interpreter agency. The consequences reported were incorrect use of time and resources, with increased workload and thus delayed treatment. Other consequences were limited possibilities to communicate and consultations carried out without a professional interpreter and instead using family members.

  • 18.
    Hadziabdic, Emina
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Hjelm, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University.
    Arabic-speaking migrants' experiences of the use of interpreters in healthcare: a qualitative explorative study2014In: International Journal for Equity in Health, ISSN 1475-9276, E-ISSN 1475-9276, Vol. 13, article id 49Article in journal (Refereed)
    Abstract [en]

    Introduction: Arabic-speaking migrants have constituted a growing population in recent years. This entails major challenges to ensure good communication in the healthcare encounter in order to provide individual and holistic healthcare. One of the solutions to ensure good communication between patient and healthcare staff who do not share the same language is to use a professional interpreter. To our knowledge, no previous qualitative studies have been found concerning Arabic-speaking migrants and the use of interpreters. This study aims to ascertain their individual experiences which can help extend our understanding of the studied area. Method: A purposive sample of 13 Arabic-speaking persons with experience of using interpreters in healthcare encounters. Data were collected between November 2012 and March 2013 by four focus-group interviews and analysed with qualitative analysis according to a method described for focus groups. Results: Four categories appeared from the analysis: 1) The professional interpreter as spokesperson; 2) Different types of interpreters and modes of interpretation adapting to the healthcare encounter; 3) The professional interpreter's task and personal properties affected the use of professional interpreters in a healthcare encounter; 4) Future planning of the use of professional interpreters in a healthcare encounter. The main findings were that the use of interpreters was experienced both as a possibility and as a problem. The preferred type of interpreters depended on the interpreter's dialect and ability to interpret correctly. Besides the professional interpreter's qualities of good skill in language and medical terminology, translation ability, neutrality and objectivity, Arabic-speakingparticipants stated that professional interpreters need to share the same origin, religion, dialect, gender and political views as the patient in order to facilitate the interpreter use and avoid inappropriate treatment. Conclusion: The study showed that the personal qualities of a good interpreter not only cover language ability but also origin, religion, dialect, gender and political views. Thus, there is need to develop strategies for personalized healthcare in order to avoid inappropriate communication, to satisfy the preferences of the person in need of interpreters and improve the impact of interpretation on the quality of healthcare.

  • 19.
    Hadziabdic, Emina
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Hjelm, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Working with interpreters: practical advice for use of an interpreter in healthcare2013In: International Journal of Evidence-Based Healthcare, ISSN 1744-1595, E-ISSN 1744-1609, Vol. 11, no 1, p. 69-76Article in journal (Refereed)
    Abstract [en]

    The aim of this descriptive commentary is to improve communication in healthcare when an interpreter is used by providing practical advice to healthcare staff when they consider using interpreters. This descriptive commentary considered the issues of preparation and implementation of interpretation sessions to reveal the complexities and dilemmas of an effective healthcare encounter with interpreters. Using the design of a discursive paper, this article seeks to explore and position of what is published in the literature on the topic studied and on the basis of previous studies to provide practical advice on the use of interpreters. The descriptive commentary showed that the interpreter should be used not only as a communication aid but also as a practical and informative guide in the healthcare system. In preparing the interpretation session, it is important to consider the type (trained professional interpreter, family member or bilingual healthcare staff as interpreters) and mode (face to face and telephone) of interpreting. Furthermore, it is important to consider the interpreter's ethnic origin, religious background, gender, language or dialect, social group, clothes, appearance and attitude. During the healthcare encounter, the interpreter should follow the recommendations given in guidelines for interpreters. Healthcare staff should choose an appropriate room and be aware of their own behaviour, appearance and attitude during the healthcare encounter. Good planning is needed, with carefully considered choices concerning the right kind of interpreter, mode of interpretation and individual preferences for the interpretation in order to deliver high-quality and cost-effective healthcare. Depending on the nature of the healthcare encounter, healthcare staff need to plan interpreting carefully and in accordance with the individuals' desires and choose the type of interpreter and mode of interpreting that best suits the need in the actual healthcare situation in order to deliver high-quality healthcare.

  • 20.
    Hjelm, Katarina
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Bemötande i vård och omsorg - transkulturellt perspektiv.2009In: Vårdhandboken, Förbundet Sveriges Kommuner och Landsting Sjukvårdsrådgivningen SVR AB , 2009, p. 1-10Chapter in book (Other academic)
    Abstract [en]

    Handboken är till för dig som snabbt vill få tillgång till uppdaterad kunskap i tillämpad hälso- och sjukvård. Innehållet är färskvara och uppdateras kontinuerligt. Handboken finns inte i tryckt version utan endast på webben.

    Det här avsnittet tar upp frågor som rör bemötande i vården och vad som kan vara viktigt att tänka på ur ett transkulturellt perspektiv.

  • 21.
    Hjelm, Katarina
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Bemötande I vård och omsorg, transkulturellt perspektiv. 2011 reviderat2011In: Vårdhandboken, Inera , 2011Chapter in book (Other academic)
    Abstract [sv]

    Bokkapitel som handlar om bemötande och vård av personer med utländsk bakgrund.

  • 22.
    Hjelm, Katarina
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work. Vårdvetenskap.
    Flervetenskapliga perspektiv i migrationsforskning: Årsbok 2006 från forskningsprofilen Arbetsmarknad, Migration och Etniska relationer (AMER) vid Växjö universitet2006Book (Other academic)
    Abstract [sv]

    Förord

    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

    Katarina Hjelm

  • 23.
    Hjelm, Katarina
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Patientutbildning vid diabetes: En systematisk litteraturöversikt2009Report (Other academic)
    Abstract [sv]

    Extern granskning av rapporten: Patientutbildning vid diabetes - En systematisk litteraturöversikt, utgiven av SBU-statens beredning för medicinsk utvärdering. Rapporten redovisar det vetenskapliga underlaget kring patientutbildning vid diabetes. En SBU-rapport är ett opartiskt arbete som bygger på en systematisk och kritisk genomgång av den vetenskapliga litteraturen på området. Arbetet utförs av ledande experter och forskare.

  • 24.
    Hjelm, Katarina
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Social support as described by Foreign-and Swedish-born persons with diabetes living in Sweden.2011Conference paper (Other academic)
    Abstract [en]

    Social support can buffer stress. Diabetes self-care is demanding and causes stress. Migrants are particularly vulnerable as they need to adapt to life in the new country, migrational experiences, and broken/weak social networks. The aim was to explore meaning of support and impact on the life-situation in foreign-born persons diagnosed type 2 diabetes living inSweden in relation to gender, age, duration of diabetes. Purposive sample: 34 foreign-born persons, 24 ♂ and 10 ♀, 36-73 years.Most from Ex Yugoslavia and the Middle East, resident in Sweden 3-50 years (14.5 yrs Md). Most married, had children, 1/3 retired. Duration of diabetes 1-36 years, most treated with oral drugs or diet.

    MIXED METHODS DESIGN: 1) Qualitative data: Semi-structured interviews, qualitative content analysis. 2) Quantitative data: Norbeck social Support Questionnaire (NSSQ), statistical analysis.

     FINDINGS: "The support I need most is firstly to learn to know how to organize my diabetes so that everything will be fine in my daily life. A plan to be able to manage diabetes, regular checks and investigations by specialists… learn to know what factors contribute to increased blood sugar…”   

    Meaning of support/social support: MEDICAL SUPPORT - regular disease control, INFORMATIVE SUPPORT – knowledge how to manage diabetes. Limited support expressed in general; Men focused on information and communication about diabetes and women focused on financial aid as diabetes food is expensive, 3-4 times more than ordinary. 

    Often diagnosed by physician in primary health care. Referred to specialized diabetes clinics, at hospital or in primary health care, often not until 1-2 years after being diagnosed! Then adequate support was perceived. Support needed ;  considered individual, related to severity of diabetes, and gender. 42% had lost an important relationship previous year. Limited number of persons in network, 5.7 (r 1-14) 

    Diabetes self-care demands knowledge, informative and medical support is important to gain control. Informants perceived lack of support, particularly during being diagnosed, in contact with physicians and primary health care.Adequate support – information, regular follow-ups – is needed without delay from diagnosis by professionalstrained in diabetes care. The individuals own perception on support need to be searched for and in the context of socioeconomic factors.  

     

     

  • 25.
    Hjelm, Katarina
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Social support described by foreign-and Swedish-born persons with diabetes.2011In: Social support described by foreign-and Swedish-born persons with diabetes. Biennial international symposium in ICCHNR, International conferences in community health nursing Research, Edmonton May 2011. , ICCHNR , 2011Conference paper (Refereed)
    Abstract [en]

    Aim: To explore meaning of support and impact on the life-situation in foreign-born persons diagnosed type 2 diabetes living inSweden in relation to gender, age, duration of diabetes. 

    MIXED METHODS DESIGN:  1) Qualitative data: Semi-structured interviews, qualitative content analysis, and 2) Quantitative data: Norbeck Social Support Questionnaire (NSSQ), statistical analysis.

     STUDY POPULATION: Purposive sample: 34 foreign-born persons, 24 ♂ and 10 ♀, 36-73 years. Most from Ex Yugoslavia and the Middle East, resident in Sweden 3-50 years (14.5 yrs Md). Most married, had children, 1/3 retired. Duration of diabetes 1-36 years, most treated with oral drugs or diet.

     FINDINGS:  Meaning of support/social support expressed as medical support - regular disease control, and informative support – knowledge how to manage diabetes. Limited support expressed in general. Men focused on information and communication about diabetes. Women focused on financial aid as diabetes food is expensive, 3-4 times more than ordinary. Limited or non-existing support experienced while being diagnosed irrespective duration of diabetes or year diagnosed  negatively affecting the life-situation. Expressed lack of support and disappointment with insufficient competence in diabetes in primary health care staff

    Support was considered individual, related to severity of diabetes, and gender. 42% had lost an important relationship previous year, limited number of persons in network, 5.7 (r 1-14). 

    Diabetes self-care demands knowledge, informative and medical support is important to gain control. Informants perceived lack of support, particularly during being diagnosed, in contact with physicians and primary health care.Adequate support – information, regular follow-ups – is needed without delay from diagnosis by professionalstrained in diabetes care.

     

     

  • 26.
    Hjelm, Katarina
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Albin, Björn
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Benato, Rosa
    City University Lonfon.
    Sourtzi, Panayota
    University of Athens.
    Migration and Health2012In: Nursing Research and Practice, ISSN 2090-1429, E-ISSN 2090-1437, Vol. 2012, p. Article ID: 621914-Article in journal (Other academic)
  • 27.
    Hjelm, Katarina
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Atwine, Fortunate
    Nbarara University of Science and Technology (MUST), Uganda.
    Health-care seeking behaviour among persons with diabetes in Uganda study: an interview study2011In: BMC International Health and Human Rights, ISSN 1472-698X, E-ISSN 1472-698X, Vol. 26, article id 11Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to explore healthcare-seeking behaviour, including use of complementary alternative medicine (CAM) and traditional healers, in Ugandans diagnosed with DM. Further, to study whether gender influenced healthcare-seeking behaviour. A descriptive study with a snowball sample from a community in Uganda was implemented. Semi-structured interviews were held with 16 women and 8 men, aged 25-70. Data were analysed by qualitative content analysis. The results showed that healthcare was mainly sought among doctors and nurses in the professional sector because of severe symptoms related to DM and/or glycaemic control. Females more often focused on follow-up of DM and chronic pain in joints, while males described fewer problems. Among those who felt that healthcare had failed, most had turned to traditional healers in the folk sector for prescription of herbs or food supplements, more so in women than men. Males more often turned to private for-profit clinics while females more often used free governmental institutions. In conclusion, healthcare was mainly sought from nurses and physicians in the professional sector and females used more free-of-charge governmental institutions. Perceived failure in health care to manage DM or related complications led many, particularly women, to seek alternative treatment from CAM practitioners in the folk sector. Living conditions, including healthcare organisation and gender, seemed to influence healthcare seeking, but further studies are needed.

  • 28.
    Hjelm, Katarina
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Bard, Karin
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Beliefs about health and illness in Latin-American migrants with diabetes living in Sweden2013In: Open Nursing Journal, ISSN 1874-4346, E-ISSN 1874-4346, Vol. 7, p. 57-65, article id TONURSJ-7-57Article in journal (Refereed)
    Abstract [en]

    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.

  • 29.
    Hjelm, Katarina
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Bard, Karin
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Apelqvist, Jan
    Department of Endocrinology, Malmö University hospital, Lund university.
    Gestational diabetes: prospective interview-study of the developing beliefs about health, illness and health care in migrant women.2012In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 21, no 21-22, p. 3244-3256Article in journal (Refereed)
    Abstract [en]

    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.

  • 30.
    Hjelm, Katarina
    et al.
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Bard, Karin
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Berntorp, Kerstin
    Apelqvist, Jan
    Beliefs about health and illness postpartum in women born in Sweden and the Middle East.2009In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 25, no 5, p. 564-575Article in journal (Refereed)
    Abstract [en]

    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.

  • 31.
    Hjelm, Katarina
    et al.
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Bard, Karin
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Nyberg, Per
    Apelqvist, Jan
    Management of gestational diabetes from the patient's perspective--a comparison of Swedish and Middle-Eastern born women.2007In: Journal of Clinical Nursing: Management of gestational diabetes from the patient's perspective--a comparison of Swedish and Middle-Eastern born women., Vol. 16, no 1, p. 168-78Article in journal (Refereed)
    Abstract [en]

    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.

  • 32.
    Hjelm, Katarina
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University.
    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 ulcers2013In: Open Nursing Journal, ISSN 1874-4346, E-ISSN 1874-4346, Vol. 7, no 1, p. 123-132Article in journal (Refereed)
    Abstract [en]

    Diabetes mellitus is becoming pandemic, particularly affecting Sub-Saharan Africa, and the prevalence of complications is increasing. Diabetic foot disorders are a major source of morbidity and disability. Delay in the health care process due to patients' beliefs may have deleterious consequences for limb and life 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 found. The aim of the study was to explore beliefs about health and illness among Ugandans with diabetic foot ulcers that might affect self-care and care seeking behavior. In an explorative study with consecutive sample semi-structured interviews were held with 14 Ugandan men and women, aged 40-79, with diabetic foot ulcer. Knowledge was limited about causes, management and prevention of diabetic foot ulcers. Foot ulcers were often detected as painful sores, perceived to heal or improve, and led to stress and social isolation due to smell and reduced mobility. Most lacked awareness of the importance of complete daily foot care and seldom practiced self-care. Health was described as absence of disease and pain. Many feared future health and related it to contact with nurses in the professional sector from whom they sought information, blood tests and wound dressings and desired better organised diabetes clinics offering health education and more opening hours. Many have an under utilized potential for self-care and need education urgently, delivered in well-organised diabetes clinics working to raise awareness of the threat and prevent foot ulcers.

  • 33.
    Hjelm, Katarina
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Berntorp, Kerstin
    Department of Endocrinology, Malmö University hospital, Lund University.
    Apelqvist, Jan
    Department of Endocrinology, Malmö University hospital, Lund university.
    Beliefs about health and illness in Swedish and African-born women with gestational diabetes living in Sweden.2012In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 21, no 9-10, p. 1374-1386Article in journal (Refereed)
    Abstract [en]

    Aims.  Exploring beliefs about health and illness in women with gestational diabetes born in Sweden and Africa living in Sweden. Further , to study the influence of beliefs on self-care and care seeking. Design: Exploratory descriptive study. Methods.  Semi-structured interviews. Consecutive sample of women diagnosed with gestational diabetes, 13 born in Sweden and 10 born in Africa, from a diabetes clinic in Sweden. Qualitative content analysis of data was applied. Results.  Beliefs were mainly related to individual and social factors. Health was described as freedom from disease and being healthy. Swedish women perceived heredity and hormonal changes as causing gestational diabetes, avoided work-related stress, had a healthy lifestyle, worried about the baby's health and development of type 2 diabetes, sought information, used more medications and health care and were on sick-leave more often because of pregnancy-related problems than African women, who did not know the cause of gestational diabetes, had a passive self-care attitude and followed prescriptions, often reported being told by staff that gestational diabetes would disappear after delivery and stated more pregnancy-related problems which they treated with rest or watchful waiting. Conclusions.  Health/illness beliefs differed and affected self-care and care seeking. Relevance to clinical practice.  Individual beliefs and risk awareness must be elicited, and adequate information must be given to prevent negative health effects of gestational diabetes.

  • 34.
    Hjelm, Katarina
    et al.
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Berntorp, Kerstin
    Frid, Anders
    Åberg, Anders
    Lunds universitet.
    Apelqvist, Jan
    Beliefs about health and illness in women managed for gestational diabetes in two organisations.2008In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 24, no 2, p. 168-192Article in journal (Refereed)
    Abstract [en]

    The aim was 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.

    Semi-structured interviews were made in two different clinics. 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 were a consecutive sample of Swedish women diagnosed with GDM; 13 managed in clinic A and 10 managed in clinic B.

    The findings showed that 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.

    Beliefs differed and were related to the health-care model chosen.

  • 35.
    Hjelm, Katarina
    et al.
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Berterö, Carina
    Social support as described by Swedish people diagnosed with type 2 diabetes mellitus.2009In: Primary Health Care Research and Development, ISSN 1463-4236, E-ISSN 1477-1128, Vol. 10, no 1, p. 26-37Article in journal (Refereed)
    Abstract [en]

    Social support can buffer the level and effects of stress. Diabetes mellitus (DM) requires self-care that is demanding and might cause stress. No previous studies focusing perceptions of persons with DM from their own perspective on the content, need and desire they might have for social support.

    Aim: To identify and describe the meaning of support and its impact on the life-situation of people diagnosed with Tye 2 DM in relation to gender, age, and duration of DM.

    Methods: Mixed Methods design combining Qualitative data collected by semi-structured interviews and quantitative data collected by Norbeck Social Support Questionnaire (NSSQ).

    Purposive sample – explore a complex concept 40 Swedish persons diagnosed Type 2 DM Aged 32-80 years (Md 59 yrs),24 men and 16 women. Duration of DM 0.5-39 yrs.

    Findings:  Heterogenous sample according to age, employment, duration of DM   but Homogenous picture of findings.  Meaning of the concept of support/social support: focus mainly on informative and emotional support. Non-supportive situations were described concerning the relationship and communication with the physician. Physicians not listening to the patient and whom informants perceived lacked competence in diabetes care were often described.  Support experienced while being diagnosed with DM was expressed by ♀, irrespective of duration of DM and yr diagnosed, as limited or non-existent negatively affecting their entire life- situation. Many claimed lack of support when diabetes was detected. Often diagnosed at health care centres in primary health care. Lack of informative support expressed as lack of competence and limited knowledge about DM in health care staff. When being managed at diabetes clinics adequate support was experienced. Need for support w as perceived as individual, varying and differing with regard to gender. Men were perceived to need more support than women, as women were considered having better networks. Young were stated to need more than older, as they have less experience and are going to live longer. Men scored higher on emotional support (p=0.021), aid (p=0.045) and network (p=0.026) than women More women were married but no differences in emotional support, social status and aid. Differences for those with grandchildren in emotional support (p=0.039) and in functional network properties (p=0.047) but not in aid. 20% of informants had lost an important relationship previous year. Mean number of people in network 6.5, r 1-20. In conclusion, DM demands knowledge about managing the disease and self-care, why informative and emotional support is important to gain control over the situation. Informants had perceived lack of support, particularly during the process of diagnosis of DM, in their contact with physicians and with primary health care.

     

     

  • 36.
    Hjelm, Katarina
    et al.
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work. Vårdvetenskap.
    Hultsjö, Sara
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work. Vårdvetenskap.
    Mötet mellan vårdpersonal och patienter med utländsk bakgrund inom akutsjukvården i Sverige2006In: Flervetenskapliga perspektiv i migrationsforskning: Årsbok 2006 från forskningsprofilen Arbetsmarknad, Migration och Etniska Relationer (AMER) vid Växjö universitet, Växjö University Press, Växjö , 2006, p. 27-Chapter in book (Other academic)
    Abstract [sv]

    Inom svensk hälso- och sjukvård strävar man efter en individualiserad vård baserad på patientens behov (HSL 1982:763). Idag är nästan 11% av den svenska befolkningen (8,9 miljoner) utlandsfödd, och om även andra generationens invandrare (de som har en förälder född utomlands) inräknas är det ca 20 % av befolkningen. Det ökande antalet utlandsfödda personer i Sverige ställer nya krav på vårdpersonalen. Syftet med föreliggande explorativa undersökning var att identifiera om vårdpersonal inom somatisk och psykiatrisk akutsjukvård upplevde några problem i vården av invandrare, och att jämföra deras erfarenheter. Halvstrukturerade intervjuer i fokus-grupper (3-6 personer) genomfördes inom ambulanssjukvård, akutmottagning och psykiatrisk akutmottagning med psykiatrisk intensivvårdsavdelning. Undersökningsgruppen bestod av 13 män och 22 kvinnor som arbetade som sjuksköterskor, undersköterskor och mentalskötare med olika utbildning och yrkeserfarenhet (1,5-36 år, Md 19 år). Resultaten visade att det övergripande problemet som upplevdes var omhändertagandet av asylsökande patienter. Även svårigheter relaterade till olika kulturella beteenden, med fokus på en kraftigare verbal och icke verbal kommunikation framkommer som stora problem inom alla verksamheter. Andra likheter är språkförbistringar samt svårigheter i att hantera många anhöriga som finns runt patienten. Om man studerar olikheter mellan verksamheterna framkommer att man på akutmottagningen upplever större svårigheter i att hantera olika beteenden relaterade till kulturella skillnader. Den här studien visar att vårdpersonal skiljer asylsökande flyktingar från övriga invandrare beroende på de annorlunda problem man stöter på i vården av dem. Resultaten i studien tydliggör behovet av stöd från organisatoriska strukturer och modeller speciellt utarbetade för vården av asylsökande flyktingar. Effektiva och enkla rutiner som är lätta att följa och hög tillgänglighet till tolkar är nödvändigt i kommunikationen med patienter som pratar andra språk. Vårdpersonalen måste utveckla en djupare förståelse för individen och hur man möter individuella behov med hänsyn tagen till migrationserfarenheter och kulturell bakgrund.

  • 37.
    Hjelm, Katarina
    et al.
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Löndahl, Magnus
    Katzman, Per
    Apelqvist, Jan
    Diabetic persons with foot ulcers and their perceptions of hyperbaric oxygen chamber therapy2009In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 18, no 14, p. 1975-1985Article in journal (Refereed)
    Abstract [en]

    To our knowledge there are no patients" evaluations of diabetes care in a high-technology area like the hyperbaric oxygen chamber. The burden on persons with diabetic foot complications might be increased if adjuvant therapy with hyperbaric oxygen therapy (HBOT) within a locked airtight vessel is given.

    Aim:  To elucidate how diabetic patients with limb-threatening foot lesions perceive and evaluate content and organisation of treatment in a multi-place hyperbaric oxygen chamber.

     

     

     

     

     

     

     

     

     

    Design/participants: An explorative study.  Participants were included in the HODFU study, a prospective randomised double-blind study, designed to evaluate whether HBOT heals more chronic foot ulcers than placebo treatment with hyperbaric air. Six females and 13 males, aged 44-83 years (Md 70), with diabetic foot ulcers, participated.

     

     

    Method: Focus-group interviews were held by an external evaluator.

     

    Results: Management was perceived as well-functioning with competent staff delivering quick treatment in a positive manner and in good co-operation. HBOT sessions, in groups, were described as unproblematic and pleasant, through sharing experiences with others, although time-consuming and tiring. Recognising the responsible physician and communication with other physicians in the health-care chain was perceived as problematic. Placebo treatment, when given, did not reveal any problems; many perceived HBOT as the last resort and respondents had a negative view of future health and expressed fears of new wounds and amputation.

     

    Conclusions and implications: From patients" perspective HBOT in the delivered health-care model was perceived as well-functioning, taking into consideration both technical and relational aspects of care in this high-technology environment. Communication with the patient and between different care givers, with a consistent message given and information about who is responsible and to whom one should turn, wherever treated, is the most crucial aspect of the model. Future fears need to be recognised and group interaction can be encouraged to share the burden of disease.

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

  • 38.
    Hjelm, Katarina
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Mufunda, Esther
    Zimbabwe Open University, Zimbabwe.
    Zimbabwean diabetics' beliefs about health and illness: an interview study2010In: BMC International Health and Human Rights, ISSN 1472-698X, E-ISSN 1472-698X, Vol. 10, article id 7Article in journal (Refereed)
    Abstract [en]

    Aim: 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: consecutive sample from diabetes clinic. Semistructured interviews with 21 persons aged 19-65 yrs. Data analysis with qualitative content analysis.

    Results: Health expressed as freedom from disease and well-being. Individual factors such as compliance with advice and drugs were considered important to promote health. A mixture of causes of DM stated, mainly individual factors as heredity, overweight and wrong diet combined with supernatural factors as fate, punishment from God and witchcraft were mentioned. Most did not recognize DM symptoms when falling ill but related health problems to other diseases. Limited knowledge about the disease and body was indicated. Poor economy was claimed harmful to health and a consequence of DM due to the need of buying expensive drugs, food, attending check-ups etc.

    Conclusions: Limited knowledge about DM, based on beliefs about health and illness including biomedical and traditional explanations related to influence of supernatural forces were found, these affected self-care and care-seeking behaviour. Strained economy was claimed as of utmost importance affecting management of the disease and health. Systemic and structural conditions need to be considered toghether with educational efforts to promote health and prevent DM-complications. 

  • 39.
    Hjelm, Katarina
    et al.
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Nambozi, Grace
    Beliefs about health and illness - a comparison of men and women with diabetes mellitus living in Uganda2008In: International Nursing Review, ISSN 0020-8132, E-ISSN 1466-7657, Vol. 55, no 4, p. 434-441Article in journal (Refereed)
    Abstract [en]

    Self-care is an important part of management of Diabetes mellitus, 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.

    The aim was to explore beliefs about health and illness that might affect self-care practice and health care seeking behaviour in men and women with DM living in an area of Uganda.

    An exploratory study was made and semi-structured interviews held with 15 women and 10 men aged 21-70 yrs.

    The results indicated limited knowledge about the body and DM in men and women. Dissimilar were men’s focus on socio-economic factors, particularly affordability of drugs, sexual function and life-style, while women valued well-being, support in daily life and household activities and had a higher risk-awareness of DM. Limited self-care measures were used, and health professionals were consulted about health problems.

    Similarities and dissimilarities were found in beliefs about health and illness that affect self-care practice and health-care seeking. Underlying living conditions, with different gender roles, determine beliefs about health and illness which are based on individual knowledge. Measures to increase knowledge about DM are urgently needed.

  • 40.
    Hultsjö, Sally
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Berterö, Carina
    IMH, Avd för omvårdnad, Hälsouniversitetet, Linköping.
    Arvidsson, Hans
    IMH, Avd för Omvårdnad, Hälsouniversitetet, Linköping.
    Hjelm, Katarina
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Core components in the care of immigrants with psychoses:: A Delphi survey of patients, families, and health-care staff.2011In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 20, no 3, p. 174-184Article in journal (Refereed)
    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 person's 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.

  • 41.
    Hultsjö, Sally
    et al.
    Linköping University.
    Berterö, Carina
    Linköping University.
    Hjelm, Katarina
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Foreign-born and Swedish-born families' perceptions of psychosis care.2009In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 18, no 1, p. 62-71Article in journal (Refereed)
    Abstract [en]

    Aim: To describe how foreign-born and Swedish born families living in Sweden perceive psychosis care. Methods: Eleven foreign-born and 15 Swedish-born family members were interviewed. Data were analyzed using a phenomenographic approach. Findings: Three main descriptive categories were found: 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. Conclusion: 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.

  • 42. Hultsjö, Sally
    et al.
    Berterö, Carina
    Hjelm, Katarina
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Perceptions of psychiatric care among foreign- and Swedish-born people with psychotic disorders.2007In: Journal of Advanced Nursing: Perceptions of psychiatric care among foreign- and Swedish-born people with psychotic disorders., Vol. 16, no 1, p. 168-78Article in journal (Refereed)
    Abstract [en]

    Aim: to explore different perceptions of psychiatric care among foreign- and Swedish-born people with psychotic disorders.

    Method: A phenomenographic study was conducted in 2005–2006 using semi-structured interviews with a sample of 12 foreign-born and 10 Swedish-born persons 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 differed from Swedish-born persons as they struggled to attain an everyday life in Sweden, relied on healthcare staff as experts in making decisions, and held religious beliefs about mental illness. Among Swedish-born people, the need for more support to relatives and help to perform recreational activities was important.

  • 43.
    Hultsjö, Sally
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Hjelm, Katarina
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Community health-care staff's experiences of support to prevent type 2 diabetes among people with psychosis: An interview study with health staff.2012In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 21, no 5, p. 480-489Article in journal (Refereed)
    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.

  • 44.
    Hultsjö, Sally
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Hjelm, Katarina
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Organizing care for persons with psychotic disorders and risk of or existing diabetes mellitus type 22012In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 19, no 10, p. 891-902Article in journal (Refereed)
    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.

    Methods: qualitative and quantitative studies in the area were identified and reviewed. 

    Results: It were indicated 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.

  • 45.
    Lindqvist, Gunilla
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Albin, Björn
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Heikkilä, Kristiina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Hjelm, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Conceptions of daily life in women living with a man suffering from chronic obstructive pulmonary disease2013In: Primary Health Care Research and Development, ISSN 1463-4236, E-ISSN 1477-1128, Vol. 14, no 01, p. 40-51Article in journal (Refereed)
    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.

  • 46.
    Lindqvist, Gunilla
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Heikkilä, Kristiina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Albin, Björn
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Hjelm, Katarina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Conceptions of daily life in men living with a woman suffering from chronic obstructive pulmonary disease2013In: Primary Health Care Research and Development, ISSN 1463-4236, E-ISSN 1477-1128, Vol. 14, no 02, p. 140-150Article in journal (Refereed)
    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.

  • 47.
    Mufunda, Esther
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Albin, Björn
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Hjelm, Katarina
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Differences in health and illness beliefs in Zimbabwean men and women with diabetes (Open Access)2012In: Open Nursing Journal, ISSN 1874-4346, E-ISSN 1874-4346, Vol. 6, p. 117-125Article in journal (Refereed)
    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

  • 48.
    Mufunda, Esther
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Wikby, Kerstin
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Albin, Björn
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Hjelm, Katarina
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Level and determinants of diabetesknowledge in patients with diabetes in Zimbabwe: a cross-sectional study (Open Access)2012In: Pan-african medical journal, ISSN 0031-0565, Vol. 13, p. Article ID: 78-Article in journal (Refereed)
    Abstract [en]

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

    Methods: A cross-sectional descriptive study was performed using a standardized self-report Diabetes Knowledge Test questionnaire (DKT) of 58 respondents. Results were analysed with  statistical methods.The majority of the respondents scored average knowledge on the sub-scales: general knowledge, insulin use and total knowledge, with an overall score of 63.1± 14, 2%. Major knowledge gaps were found concerning diet, insulin use and glycaemic control. No significant differences in mean scores were detected in the DM knowledge sub-scales when comparingb mean knowledge scores in relation to socio-demographic and DM characteristics. However, DM -related complications were significantly associated with lower total and general DM knowledge, and female gender was an independent determinant of low general knowledge. In conclusion, knowledge gaps were evident regarding insulin use, diet and glycaemic control. Low DM knowledge was associated with being a female and could be a risk factor for development of DM-related complications. Knowledge gaps need to be addressed in diabetes education to prevent development of complications.

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