Women's call for caring care : perspectives of Chinese women with gestational diabetes mellitus about beliefs, self-care behavior, quality of care and lived experience

Sammanfattning: The overall aim of the thesis was to explore the perspectives of Chinese women with gestational diabetes mellitus (GDM) focused on their beliefs about health and illness and self-care behavior, the quality of care in China, and their lived experience.                      All the studies were conducted with qualitative methodology using individual interviews. Data were collected in obstetric clinics or wards at three different hospitals or the participants’ workplaces in the south east of China. Content analysis, according to Mayring, was used for data analysis in Study І (15 interviews) and Study II (17 interviews). Content analysis, according to Graneheim & Lundman, was used for data analysis in Study III (44 interviews). In Study IV (18 interviews), data were analyzed by using phenomenological hermeneutics, according to Lindseth & Norberg.     Three styles of beliefs about GDM among the Chinese women were explored in the thesis: GDM should be considered seriously; GDM was not a severe illness; and GDM was nothing to worry about. Correspondingly, three self-care behavior models were revealed: women strove to control GDM, and maintained their blood glucose values at a normal level; or women tried to control GDM based on the knowledge they received, but some of them felt helpless because the blood glucose level could not be maintained within the normal range; or women almost ignored GDM. They mainly sought help from professional sector and popular sector, and regarded health professionals and husbands as important people. They showed, however, that they sought a balance between following professionals’ advice and avoiding practical difficulties, which demonstrated the influence of health professionals, people around, and Chinese culture. The thesis highlighted a lack of knowledge, a lower level of risk awareness and poor self-care behavior among the women with GDM, as well as a lack of professional care resources for GDM and the lack of high-quality personalized care for the women. The core problem could be an resource imbalance between over-stretched hospitals and low-efficiency under-utilized primary healthcare centers. Their lived experience showed an eagerness to be cared for.    The thesis highlighted women’s call for caring care in China. The care of GDM for these women can most likely be improved by reform of clinical practice, particularly in primary healthcare services. It is necessary to increase the number of health professionals and material resources to a reasonable level, and to strengthen caring care in China.