Beliefs about health and illness in Swedish and African-born women with gestational diabetes living in Sweden

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

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

Design: Exploratory descriptive study.

Methods: Semi-structured interviews. Consecutive sample of women diagnosed with gestational diabetes, 13 born in Sweden and 10 born in Africa, from a diabetes clinic in Sweden. Qualitative content analysis of data was applied.

Results: Beliefs were mainly related to individual and social factors. Health was described as freedom from disease and being healthy. Swedish women perceived heredity and hormonal changes as causing gestational diabetes, avoided work-related stress, had a healthy lifestyle, worried about the baby's health and development of type 2 diabetes, sought information, used more medications and health care and were on sick-leave more often because of pregnancy-related problems than African women, who did not know the cause of gestational diabetes, had a passive self-care attitude and followed prescriptions, often reported being told by staff that gestational diabetes would disappear after delivery and stated more pregnancy-related problems which they treated with rest or watchful waiting.

Conclusions: Health/illness beliefs differed and affected self-care and care seeking. Lower risk awareness in African-born women was related to limited knowledge about the body and gestational diabetes, which was further amplified by healthcare professionals informing them about gestational diabetes being transient.

Relevance to clinical practice: Individual beliefs and risk awareness must be elicited, and adequate information must be given to prevent negative health effects of gestational diabetes.