Margareta Östman

Increased knowledge concerning the differences in the illness perception and self-management among sexes is needed for planning proper support programs for patients with diabetes. The aim of this study was to investigate the illness perception and self-management among Thai women and Thai men with type 2 diabetes and to investigate the psychometric properties of the translated instruments used. In a suburban province of Thailand, 220 women and men with type 2 diabetes participated in a cross-sectional descriptive study. The participants were selected using a multistage sampling method. Data were collected through structured interviews and were analyzed using group comparisons, and psychometric properties were tested. Women and men with type 2 diabetes demonstrated very similar experiences regarding their illness perception and no differences in self-management. Women perceived more negative consequences of the disease and more fluctuation in the symptoms than men, whereas men felt more confident about the treatment effectiveness than women. Furthermore, the translated instruments used in this study showed acceptable validity and reliability. The Thai sociocultural context may influence people’s perceptions and affect the self-care activities of Thai individuals, both women and men, with type 2 diabetes, causing differences from those found in the Western environment. Intervention programs that aim to improve the effectiveness of the self-management of Thai people with diabetes might consider a holistic and sex-related approach as well as incorporating Buddhist beliefs.

Background: Supporting families where one person suffers from long-term severe mental illness (SMI) is essential, but seems hard to reach. The aim of this study was to examine professionals’ views of supporting relatives of persons with SMI. Material: Individual interviews mirroring personal narratives and group interviews reflecting group-processed answers were conducted among 23 professionals and analyzed thematically. Results: Three themes emerged: (a) information and group interaction reduces stigma and increases well-being, (b) professionals need to feel secure and confident about how the support structure works and (c) collaboration is difficult but required on several levels. Conclusion: Trusting relationships with families were considered important, although seldom achieved; professionals wished to feel secure in their role toward relatives of a person with SMI; and professionals wanted to feel confident when working together with other services to support families.

The object of this paper was to investigate the experiences of patients with severe mental illness (SMI) living in a community, including their utilization of care and treatment services. Psychiatric care and social services staff members were asked to make an inventory of those they served in two districts of Malmö, Sweden. Participants had to be over 18 years of age and unable to manage their daily lives without help from others. Almost all of the 80 participants (95 %) were under psychiatric care. A majority (86 %) was receiving dental treatment, and 61 % were supported by social services. Fifty-four percent of the participants received somatic care on an ongoing basis. Although the majority reported the care given as sufficient, one-third of this SMI population considered the care and support they received to be insufficient. Satisfying those who are dissatisfied with the care they are being given would be a significant challenge for service providers, since the unsatisfied are shown to have more difficult lives.

Overweight and obesity in younger children could better be brought in focus through a deeper understanding of how Child Health Care nurses (CHC-nurses) perceive their work with the problems of overweight at the CHC Centers. The aim of this study was to elucidate the CHC-nurses conceptions of their preventive work with childhood overweight and obesity in Child Health Care.

Women are at a higher risk for long-term sick leaves and mental ill health. The aim of this study was to explore a supportive program's meaning for women with anxiety/stress/depression problems that are unemployed and/or on a sick leave, and for the personnel involved. Seven women and the personnel (n = 5) were interviewed individually pre- and post-intervention. Data was analyzed using content analysis. The program appeared to provide participants with tools to handle their physical and mental health, and occupational support, improving their social situation. Collaboration between organizations appears to be beneficial for all parties involved.

This paper seeks to investigate the impact of mental illness on the sexuality of patients with a schizophrenic disorder who live in the community in a long-term relationship with a partner. We conducted qualitative, in-depth interviews with five such patients who were in treatment at a psychiatric outpatient clinic, and three of their partners. The data were analyzed by thematic analysis and identified the following areas of concern: relationships outweigh sexuality; uncertainties about one’s sexual capacity; the dwindling of sexual fantasies, feelings of desire, and satisfaction; and, a lack of communication and support in sexual matters. Both patients and partners reported feeling overlooked by psychiatric services as sexual beings. They also expressed dissatisfaction with a patient-therapist treatment model that excluded their partners. Our findings indicate that dysfunctional sexuality affects both patients suffering from severe mental illness and their partners. Patients and partners deplore the lack of opportunity to discuss questions related to their sexuality and long-term relationships with psychiatric clinicians. Sexual problems arising from, or exacerbated by, schizophrenia require supportive services, whether in the form of general, psychiatric, or couples therapy.

Occupational well-being is a central issue underpinning factors that constitute a good life. This study aimed to explore occupational well-being among Middle Eastern immigrants to Sweden, as reflected in the occupations performed in the context of psychosocial health care. Ten participants experiencing mental health issues, who received occupation-based rehabilitation, were interviewed. Grounded theory methods for data collection and analysis were employed. The core category, being empowered by getting support – a paradoxical pathway to occupational well-being, described the participants' experiences of striving for empowerment and at the same time desiring support. The core category comprised the categories: striving for control, grasping the meaning in occupation, and striving for self-respect. The participants' ambivalence in relation to empowerment and support reflected the realities and truths embedded in both collective and individualist cultural views, which influenced the ways they viewed themselves in relation to their occupational needs and occupational well-being. Moreover, findings indicated that oscillating between different cultural views related to occupational needs might amplify or diminish the participants' experiences of occupational well-being, depending on the type of support received.

Purpose: This study aims to illuminate self‐perceived health‐related quality of life (HRQoL) among newly‐arrived Arabic‐speaking refugees in Malmö, Sweden participating in a specific group Health Promotion activity.Design/methodology/approach: Data consist of questionnaires, observations and oral evaluations in groups. Questions about HRQoL was measured by EQ‐5D self‐assessment containing five dimensions and three response options of severity, including a visual analog health rating scale. Participants' sleep patterns were measured by a sleep and recovery questionnaire with questions about sleep quality and sleep quantity.Findings: The results show that disturbed sleep relates to EQ‐5D variables and to health rating scores. Moreover, there are changes over time and participants' perceptions of their health and quality of life in most EQ‐5D variables have significantly increased after the end of activity. In the variables pain and depression an improvement remains even at second follow up and health rating scores are higher at both follow ups relative to what it was originally. Sleep and recovery problems were perceived as less difficult at the course completion and second follow up.Research limitations/implications: Because of practical and ethical reasons there is an absence of a control group in this study.Practical implications: The paper includes implications for education in medicine, health care and social work, for the design of the refugee reception programs and for the inter‐professional collaborations.Originality/value: The paper shows that health promotion interventions in group setting in the first stage of resettlement turn out to be useful according to HRQoL and knowledge of the health care system.

Objectives. To describe mental health status in native and non‐native Swedish‐speaking pregnant women and explore risk factors of depression and posttraumatic stress (PTS) symptoms. Design and setting. A cross‐sectional questionnaire study was conducted at midwife‐based antenatal clinics in Southern Sweden. Sample. A non‐selected group of women in mid‐pregnancy. Methods. Participants completed a questionnaire covering background characteristics, social support, life events, mental health variables and the short Edinburgh Depression Scale. Main outcome measures. Depressive symptoms during the past week and PTS symptoms during the past year. Results. Out of 1003 women, 21.4% reported another language than Swedish as their mother tongue and were defined as non‐native. These women were more likely to be younger, have fewer years of education, potential financial problems, and lack of social support. More non‐native speakers self‐reported depressive, PTS, anxiety and, psychosomatic symptoms, and fewer had had consultations with a psychiatrist or psychologist. Of all women, 13.8% had depressive symptoms defined by Edinburgh Depression Scale 7 or above. Non‐native status was associated with statistically increased risks of depressive symptoms and having ≥1 PTS symptom compared with native‐speaking women. Multivariate modeling including all selected factors resulted in adjusted odds ratios for depressive symptoms of 1.75 (95% confidence interval: 1.11–2.76) and of 1.56 (95% confidence interval: 1.10–2.34) for PTS symptoms in non‐native Swedish speakers. Conclusion. Non‐native Swedish‐speaking women had a more unfavorable mental health status than native speakers. In spite of this, non‐native speaking women had sought less mental health care.