title: Management of gestational diabetes from the patient's perspective--a comparison of Swedish and Middle-Eastern born women.
abstract: OBJECTIVE
  To explore patients' evaluation of a specialized diabetes clinic for management of women with gestational diabetes born in Sweden and the Middle East and its contribution to a decreased level of stress and improved coping capability to promote health in patients receiving care.
  
  
  BACKGROUND
  No studies comparing patients' perceptions of healthcare in women of different origin with gestational diabetes have been found. A perceived clinical problem in specialized diabetes care is of lower activity level in self-care in foreign- than Swedish-born women and the question is whether the healthcare organization is optimal in meeting different individuals' needs.
  
  
  METHODS
  Explorative study.
  
  
  METHODS
  Semi-structured individual interviews by external evaluators.
  
  
  METHODS
  Consecutive sample. Females with gestational diabetes, 13 born in Sweden and 14 born in the Middle East.
  
  
  RESULTS
  The healthcare model was perceived as functioning well. Swedish women were problem focused and information seeking. Frustration and stress were increased due to perceived delay in information concerning gestational diabetes, limited access to telephone service and lack of confidence in staff because they lacked the expected competence. Control of gestational diabetes and pregnancy by different persons led to perceived lack of holistic care. Women from the Middle East felt cared, had been given the necessary information and claimed to follow advice. Adequate information reduced respondents' anxiety and increased their control over the situation.
  
  
  CONCLUSIONS
  The clinic needs to be further improved by adapting programmes to persons to become problem focused by giving adequate information immediately.
  
  
  CONCLUSIONS
  Cultural differences in coping strategies and attitudes to gestational diabetes need to be considered. Training of staff working with gestational diabetes patients is urgently needed.
authors.affiliation: Department of Community Medicine, University of Lund, Sweden. katarina.hjelm@vxu.se
authors.forename: Katarina
authors.initials: K
authors.lastname: Hjelm
authors.forename: Karin
authors.initials: K
authors.lastname: Bard
authors.forename: Per
authors.initials: P
authors.lastname: Nyberg
authors.forename: Jan
authors.initials: J
authors.lastname: Apelqvist
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000553:Ambulatory Care / Q000458:organization & administration*; D001294:Attitude to Health; D003431:Cross-Cultural Comparison; D016640:Diabetes, Gestational / Q000208:ethnology / Q000523:psychology / Q000628:therapy*; D004644:Emotions; D005260:Female; D006801:Humans; D008877:Middle East / Q000208:ethnology; D018802:Patient-Centered Care; D011247:Pregnancy; D017064:Process Assessment, Health Care; D012036:Refugees / Q000523:psychology; D013548:Sweden