Understanding mechanisms behind unwanted health behaviours in Nordic and South Asian women and how they affect their gestational diabetes follow‐ups: A qualitative study. Issue 10 (28th July 2021)

• Record Type: Journal Article
• Authors: Sharma, Archana; Birkeland, Kåre I.; Nermoen, Ingrid; Qvigstad, Elisabeth; Tran, Anh T.; Gulseth, Hanne L.; Sollid, Stina T.; Wium, Cecilie; Varsi, Cecilie
• Is Part Of: Diabetic medicine. Volume 38:Issue 10(2021)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2021-07-28
• Subjects: ethnic differences -- gestational diabetes -- healthcare delivery -- prevention of diabetes -- psychological aspects; Diabetes -- Periodicals; 616.462
• DOI: 10.1111/dme.14651
• Languages: English
• ISSNs: 0742-3071

Abstract

Abstract: Aims: The type 2 diabetes risk following gestational diabetes mellitus (GDM) is high, particularly among South Asian women in Western countries. Our study aimed to advance the knowledge regarding the mechanisms behind suboptimal follow‐up in the Nordic and South Asian women with previous GDM by comparing (1) their experiences, (2) health and disease perceptions and (3) barriers to and facilitators of health‐promoting behaviours. Methods: This qualitative study was conducted in three hospital outpatient clinics in Norway, comprising six focus group interviews with 28 women 1–3 years after a pregnancy with GDM. The participants were purposively sampled and grouped according to their ethnicity. The data were analysed using thematic analysis, and a theoretical approach was applied to support the analysis and discuss the study's findings. Results: Five main themes were identified: lack of resilience, emotional distress, 'caught between a rock and a hard place', postpartum abandonment and insufficient guidance. The key determinants of the maintenance of unwanted health behaviours after GDM were consistent across the ethnic groups. Although the importance of a culturally sensitive approach was emphasised, it appeared secondary to the need for a more organised public healthcare during and after GDM. Conclusions: Women's real‐life constraints, combined with the inadequate healthcare‐service implementation, could explain the non‐adherence to the lifestyle‐changes guidelines essential for preventing diabetes post‐GDM. We suggest promoting specific coping strategies and changing the healthcare service approach rather than relying on women's capacity to initiate the necessary changes.