生育后患妊娠期糖尿病的中东移民女性——在随访访谈中表现出对健康和疾病信念的积极长期发展。
Migrant Middle Eastern women with gestational diabetes seven years after delivery - positive long-term development of beliefs about health and illness shown in follow-up interviews.
机构信息
Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
Department of Endocrinology, Division of Diabetes Care, Malmö University Hospital, Lund University, Malmö, Sweden.
出版信息
Prim Health Care Res Dev. 2021 May 26;22:e21. doi: 10.1017/S1463423621000232.
AIM
No previous studies have been found focusing on the long-term development of beliefs about health, illness and healthcare in migrant women with gestational diabetes mellitus (GDM). The aim of this study was to explore this and the influence on health-related behaviour (i.e. self-care and care seeking) in migrant women from the Middle East living in Sweden seven years after delivery.
BACKGROUND
GDM is increasing, particularly in migrant women. The risk of adverse outcomes of GDM for health can be improved by interventions reducing blood glucose and lifestyle modifications which medicalise the woman's pregnancy due to intensive follow-up and demanding self-care. The reactions might have an enduring impact on the women's long-term psychological and physical health and adoption of preventive health behaviours.
METHOD
Qualitative exploratory study. Semi-structured follow-up interviews 7 years after delivery with women previously interviewed in gestational weeks 34-38 and 3 and 14 months after delivery. Data analysed with qualitative content analysis.
FINDINGS
Health meant freedom from illness, feeling well and living long to be able to care for the children. The present situation was described either positively, changing to a healthier lifestyle, or negatively, with worries about being affected by type 2 diabetes. Beliefs changed among the majority of women, leading to a healthier lifestyle, and they looked positively back at the time when diagnosed and their reactions to it. With few exceptions, they were confident of being aware of future health risks and felt responsible for their own and their children's health/lifestyle. None except those diagnosed with type 2 diabetes had been in contact with healthcare since the last follow-up a year after delivery. Yet, they still would like and need a healthcare model delivering more information, particularly on developing a healthy lifestyle for children, and with regular check-ups also after the first year after delivery.
目的
目前尚未有研究聚焦于妊娠糖尿病（GDM）移民女性健康、疾病和医疗观念的长期发展。本研究旨在探讨这一问题，以及其对中东移民女性分娩后七年健康相关行为（即自我护理和寻求护理）的影响。
背景
GDM 的发病率不断上升，尤其是在移民女性中。通过降低血糖和生活方式改变等干预措施，可以改善 GDM 对健康的不良后果，这些干预措施使女性的怀孕变得更加医学化，因为需要进行强化随访和严格的自我护理。这些反应可能会对女性的长期身心健康和预防保健行为产生持久影响。
方法
定性探索性研究。对之前在妊娠 34-38 周、产后 3 个月和 14 个月接受过访谈的女性进行了分娩后 7 年的半结构式随访访谈。采用定性内容分析法对数据进行分析。
结果
健康意味着没有疾病、感觉良好和长寿，以便能够照顾孩子。目前的情况要么被描述为积极的，即转向更健康的生活方式，要么被描述为消极的，即担心会受到 2 型糖尿病的影响。大多数女性的信念发生了变化，导致了更健康的生活方式，她们对被诊断时的情况和反应持积极态度。除了少数例外，她们对未来的健康风险有信心，并认为自己对自己和孩子的健康/生活方式负责。除了被诊断为 2 型糖尿病的女性之外，自上次产后一年的随访以来，没有任何人与医疗保健机构有过接触。然而，她们仍然希望并需要一种提供更多信息的医疗保健模式，特别是关于为孩子培养健康生活方式的信息，并且希望在产后第一年之后也能定期进行检查。
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