Going up, going down: the experience, control and management of gestational diabetes mellitus among Southeast Asian migrant women living in urban Australia
Sansnee Jirojwong A , Suzanne Brownhill A , Hannah G. Dahlen A C , Maree Johnson B C and Virginia Schmied A DA School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia.
B Faculty of Health Sciences, Australian Catholic University, PO Box 968, North Sydney, NSW 2059, Australia.
C Ingham Institute for Applied Medical Research, PO Box 3151 (Westfields Liverpool), Liverpool, NSW 2170, Australia.
D Corresponding author. Email: v.schmied@westernsydney.edu.au
Health Promotion Journal of Australia 28(2) 123-131 https://doi.org/10.1071/HE15130
Submitted: 30 October 2015 Accepted: 4 August 2016 Published: 13 October 2016
Abstract
Issue addressed: In many developed countries the rate of gestational diabetes mellitus (GDM) for Asian-born women is higher than other groups. Studies suggest that some women have limited knowledge of the disease and poor self-management leading to health problems for themselves and their baby. Few studies report the experience of GDM among Southeast Asian migrant women living in Australia and factors that influence their management of the disease.
Methods: A qualitative interpretive design was used to explore Southeast Asian migrant women’s experience and management of GDM. Women diagnosed with the disease during pregnancy were recruited from an antenatal clinic at two Sydney metropolitan hospitals. Nineteen women were interviewed in their first language. Thematic analysis was used to analyse the data.
Results: A diagnosis of GDM conferred an unanticipated ‘up and down’ experience for this group of Southeast Asian women. Their experience of the disease, likened to an elevator ride, was modulated by ‘insulin’ and ‘information’ used to control the disease and manage blood glucose levels, dietary levels, exercise levels and anxiety levels.
Conclusions: Health promotion material that captures the fluctuating experience of GDM has the potential to help women, particularly at the time of diagnosis, to be better prepared, and health professionals to be better informed to control and manage the disease more effectively.
So what?: GDM is a serious problem. The model generated from our study has the potential to better inform health professionals to prepare women for the inevitable fluctuating physical and emotional effects of the disease. Culturally sensitive material and an educational strategy based on the model may also facilitate women’s lifestyle changes and compliance, and improve migrant women’s relationship with, and trust in, health professionals involved in their GDM care.
Key words: culture, diet, exercise, midwifery, pregnancy.
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