From diagnosis to health: a cross-cultural interview study with immigrants from Somalia.
OBJECTIVE
Being diagnosed as having a chronic disease gives rise to emotions. Beliefs about health are culturally constructed and affect people's decisions regarding treatment. No studies have been reported that focus on the health beliefs of immigrants of Somalian origin with diabetes and how these people experiences the diagnosis. Therefore the aim of the present study was to investigate how immigrants from Somalia living in Sweden experienced receiving the diagnosis and describe their beliefs about health.


METHODS
The sample consisted of 19 adults with diabetes born in Somalia and now living in Sweden who were interviewed with the aid of an interpreter. The interviews were subjected to qualitative content analysis.


RESULTS
From the analysis of what the participants said about their experiences of the diagnosis there emerged three themes: 'Existential brooding', 'Avoiding the diagnosis' and 'Accepting what is fated'. Three themes also emerged from the analysis of what they said about beliefs about health: 'Health as absence of disease', 'Health as general well-being' and 'Fated by a higher power'. A major finding was that women when they communicated their experiences regarding the diagnosis and health beliefs made more use of supernatural beliefs than men did. The participants, irrespective of gender, did not immediately respond with shock or other strong emotion when they received the diagnosis.


CONCLUSIONS
The study provides health-care staff with knowledge concerning a minority group's experiences of being diagnosed as having diabetes and their beliefs about health. The findings indicate that men and women differ in how they experiences the diagnosis and how they described their health beliefs. The quality improvement of health education and nursing for patients with diabetes calls for consideration of the variation of beliefs related to cultural background and gender.
Wallin
Anne-Marie
AM
Department of Community Medicine and Public Health, Orebro County Council, Orebro, Sweden. anne-marie.wallin@orebroll.se
Ahlström
Gerd
G
D003431:Cross-Cultural Comparison; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000523:psychology; D054242:Emigrants and Immigrants; D006304:Health Status; D006801:Humans; D007407:Interviews as Topic; D012998:Somalia