UTVECKLING OCH FÖRBÄTTRINGSARBETE Tidigare forskning samt denna litteraturstudie visar att kvinnors upplevelser a
Bilaga 1. Bedömningsmall för studier med kvalitativ metod (Olsson & Sörensen, 2011).
Poängsättning 0 1 2 3
Abstrakt (syfte, metod, resultat=3p) Saknas 1/3 2/3 Samtliga
Introduktion Saknas Knapphändig Medel Välskriven
Syfte Ej angivet Otydligt Medel Tydligt
Metod
Metodval adekvat till frågan Ej angiven Ej relevant Relevant Metodbeskrivning (repeterbarhet möjlig) Ej angiven Knapphändig Medel Utförlig
Triangulering Saknas Finns
Urval (antal, beskrivning,
representativitet) Ej acceptabel Låg Medel God
Patienter med DMT2 Ej undersökt Liten andel Hälften Samtliga
Bortfall Ej angivet >20% 5-20% <5%
Bortfall med betydelse för resultatet Analys
saknas/ Ja Nej
Kvalitet på analysmetod Saknas Låg Medel Hög
Etiska aspekter Ej angivna Angivna
Resultat
Frågeställningen besvarad Nej Ja
Resultatbeskrivning (redovisning,
kodning etc) Saknas Otydlig Medel Tydlig
Tolkning av resultatet (citat, kod, etc) Ej acceptabel Låg Medel God
Diskussion
Problemanknytning Saknas Otydlig Medel Tydlig
Diskussion av egenkritik och felkällor Saknas Låg God
Anknytning till tidigare forskning Saknas Låg Medel God
Slutsatser
Överensstämmelse med resultat
(resultatets huvudpunkter belyses) Slutsats saknas Låg Medel God
Ogrundade slutsatser Finns Saknas
Total poäng (max 48 p) p p p p
31 Bilaga 2. Artikelmatris över inkluderade artiklar.
Author Year Country Title Study design Setting Population
Inclusion & exclusion criteria
The aims Method Participants Main findings Study
quality
Ahlin & Billhult, 2012
Sweden
Lifstyle changes-a continuous, inner struggle for women with type 2 diabetes: A qualitative study
A qualitative study.
Inklusion criteria: 10 women diagnosed with type 2 diabetes and recommended lifestyle changes.
Women were selected using a diabetes database to achieve variation in age (37-87 years), mean time from diagnosis (10 years), and severity of disease.
To describe how women handle necessary lifestyle changes due to a chronic disease using diabetes as a model.
In-depth interviews and analysis were performed using the phenological ideas of Giorgi.
10 total
(women) The findings reveal perceptions of a continuous struggle with the demands of making lifestyle changes. Five themes emerged: the ambiguous feeling of others’ involvement, becoming a victim of pressurizung demands, experiencing knowledge deficits, experiencing an urge, and finding reason s to justify not changing. Grade 1 Gomersall at al, 2012 UK Getting one's thoughts straight: A dialogical analysis of women's accounts of poorly controlled type 2 diabetes. A Qualitative study.
8 female patients with poorly controlled T2DM were recruited from diabetes centres in two hospitals in the North of England. Age (M=61,4) To explore the process of ‘getting one’s thoughts straight’ in relation to self-management for women with poorly controlled type 2 diabetes.
Interviews with a biographic-narrative method. Narratives were analysed using a dialogical approach.
8 total
(women) Findings presented in four sections: the dialogical character of unofficial truth; the monologic character of official truth; getting one’s thoughts straight: resolving the search for internally persuasive discourse; and seeking, but not finding: the struggle to locate an internally persuasive discourse.
Grade 1
32
Hjelm & Berterö, 2009 Sweden Social support as described by Swedish people diagnosed with type 2 diabetes mellitus
A mixed (qualitative - qvantitative) study. A purposive sample of 40 Swedish adults, 24 men and 16 women (age 32-80 years) Inclusion criteria: adults, (aged >=18 years), diagnosed with Type 2 diabetes)
To identify and describe the meaning of support and its impact on the lifesituation
of people diagnosed with Type 2 diabetes mellitus in relation to gender, age
and duration of disease
Mixed methods. Qualitative data were collected by semi-structured interviews and quantitative datacollected using the Norbeck Social Support Questionnaire (NSSQ). The interviews were transcribed verbatim and analysed using qualitative content analysis
40 total (24 men and 16 women)
Participants described the meaning of support as mainly concerning informative and emotional support in managing diabetes. Women,
independent of the duration of diabetes, experienced support as limited or non-existent when treated outside hospital/specialized care. Respondents considered the need for support individual, differing with regard to gender and age. Men were assumed to need more support and women were considered to have better networks. Men scored higher on emotional support, aid and network than women.
Grade 1 Li at al, 2013 Singapore ‘Diabetes is nothing’: The experience of older Singaporean women living
and coping with type 2 diabetes.
A descriptive qualitative study.Patients (10 women) were recruited from a major
outpatient clinic in Singapore. Inclusion criteria: Englishor Mandarin speaking females, age 60-69, diagnosed with T2DM, who were currently being managed at the polyclinic and being treated with lifestyle management, dietary control and/or oral
medication and/or insulin.
To understand the experiences and ways of coping adopted by older
Singaporean Chinese women with T2DM.
Purposive sampling with a focus on people who were coping with diabetes. Semi- structured interviews. The audiotaped recordings of the interview were transcribed into textual documents in their respective languages. A manual thematic data analysis method and process was used.
10 total
(women) Three themes were identified:(1)Living with diabetes; (2) Coping with diabetes; (3) Caring for the self with diabetes.
Findings indicate that women living and coping with diabetes confront numerous issues.
Grade 1
33
Low at al, 2014 Malaysia
Mixed feelings about the Diagnosis of Type 2 Diabetes Mellitus: A Consequence of Adjusting to Health Related Quality of Life.
A qualitative exploratory study design, using a thematic analysis.
12 patients (5 men and 7 women) with DMT2 were interwied.
To explore patients’ reactions to the diagnosis of DMT2 and their health related quality of life.
In-dept interviews were audio-taped and transcribed verbatim between
september 2012 - april 2013, using semi-structured guide with open ended questions.
Thematic analysis (Nvivo 10).
12 total (5 men and 7 women)
Patients shared their mixed feelings about the diagnosis of T2DM. Six domains of quality of life emerged from these interviews, namely physical and social functioning, work function and social obligations, dietary freedom and conforming to treatment standard. Diabetes management needs to take these themes and patients’ feelings associated with their quality of life in consideration.
Grade 1
Lundberg & Thrakul, 2011
Sweden, Thailand Diabetes type 2 self- management among Thai Muslim women.
An explorative qualitative study using ehtnography.
29 women aged 40–80 years, living in an urban Muslim community of Bangkok in the catchment area of a university hospital participated.
Inclusion criteria: women with diabetes type 2, age >= 20 years, be able to read and write, give informed consent.
To explore and describe Thai Muslim women’s self-management of diabetes type 2. Purposive convenience sampling was used. The ethnographic method was based on the use of qualitative (semi-
struktured) interview med four open-ended questions and participant observation. The interviwes were tape recorded while notes were made from observations, transcribed verbatim, subjected to open and axial coding.
29 total
(women) Four themes of self-management among Thai Muslim women with DMT2 emerged, viz., daily life practices (dietary management, exercise, use of medicine, see doctor to follow-up, self-monitoring of blood sugar and use of herbal remedies), impact of the illness (feeling psychological burden of diabetes and struggling to control the disease), everyday life as before (maintaining religious practices and learning to live with the disease) and family support.
Grade 1
Park & Wenzel, 2012
USA
Experience of social role strain in Korean
A descriptive qualitative study. Partisipants (10 women) for the companion study were recruited at an
outpatient clinic in a general
To expand our understanding of the experience of social role strain in the context of diabetes
In-depth semi- structured interviews, open-ended questions
All audiotapes were transcribed verbatim.
10 total
(women) Korean women in this study reported ‘resentment regarding previous role strain’. This psychosocial burden was heightened by a noted pattern of ‘sacrificing self in favour of others’,
Grade 1
34
women with type
2 diabetes. hospital in CheonAn, SouthKorea. Inclusion criteria: middle-aged women, living in a mid-sized city, who were previously diagnosed with type 2 diabetes for more than 6 months.
care among middle- aged married Korean women with type 2 diabetes.
Transcripts were analysed to identify and categorize participants’ experiences. Themes derived from the data were explored across role strain groups to establish commonalities or differences.
which complicated both their personal lives and their ability to take care of themselves physically. Added to this were feelings of guilt related to their diabetes and the requirements of day-to-day management expressed as, ‘my diabetes makes me a
liability’. Pera, 2011
Spain
Living with diabetes: quality of care and quality of life.
A descriptive, exploratory evaluation study using qualitative methodology Participants consisted of 40 adult patients ( 18 men and 22 women) diagnosed with DM and followed up in a public hospital in Barcelona, Spain.
To characterize the experience of living with diabetes mellitus and identify patients’ opinions of the quality of care received and the results of interventions
Intentional sampling was performed, and included all groups representative of
patients (gender, age, type of diabetes, and treatment) Twenty-six semistructured individual interviews and two focus groups composed of seven subjects each (DM type 1 and DM type 2). Both the interviews and the focus groups were recorded on audiotape and
transcribed verbatim Data were analyzed using content analysis and constant comparison following the method proposed by Miles and Huberman.
40 total (18 men and 22 women)
Patients described DM as a disease that is difficult to control and that provokes lifestyle changes requiring effort and sacrifice. Insulin treatment increased the perception of disease severity. The most frequent and dreaded complication was
hypoglycemia. The main problems perceived by patients affecting the quality of care were related to a disease-centered medical approach, lack of information, limited participation in decision- making, and the administrative and bureaucratic problems of the health care system.
Grade 1
35
Sarkadi& Rosenqvist, 2003 Sweden
Intimacy and women with type 2 diabetes: an exploratory study using focus group interviews.
A qualitative study. 37 women ( (ages 44-80 years) from
preexisting mixed-sex groups of a diabetes educational program in 4 localities in Sweden were selected to participate
Inclusion criteria: Women with type 2 diabetes, who also completed a questionnaire on sexual functioning.
To explore if and how women
perceived diabetes as affecting their social and sexual intimacy and if they wished to receive professional attention for any sexual disturbances that they experience.
A series of five focus group interviews combined with a structured anonymous questionnaire. The
interviews were transcribed. Data from the questionnaire were used to discribe the sample in terms of demograhpic and disease- specific variabels, as well as sexual functioning and satisfaction. Qualitative analys of the material followed the pathway recommended by Malterud.
37 total (women) 4 refused 33 participated
Categories that was found were guilt and embarrassment in diabetes; female intimacy and shame; sexual dysfunction, an invisible problem; and the female patient. Asking women about intimacy revealed self- blame and embarrassment regarding their diabetes and sexual functioning. Several women who had experienced sexual dysfunction described barriers that made it difficult to obtain optimal care and/or self-care measures to cope with vaginal dryness, pain during intercourse, and decreased desire. Many of the women had the social and emotional
resources to cope with their disease. Nonetheless, they experienced guilt, shame, and embarrassment, which are potentially oppressive features of having DMT2.
Grade 1
Weiler & Crist, 2009 USA
Diabetes Self- Management in a Latino Social Environment.
A qualitative descriptive study. Demographic data was collected on all study participants and analyzed quantitatively. 6 women and 4 men, age 46-65 years, the mean duration of diabetes was 10 years.
To explore the socio- cultural influences andsocial context associated with living with type 2 diabetes among rural, migrant Latino adults.
A grounded theory
technique was conducted to provide.
Semi-structured interviews. Interviews were audio- recorded and transcribed. Data was analyzed utilizing the process of constant comparative analysis using conventional content analysis strategies. 10 participants (6 women and 4 men)
An over-arching meta-theme Self- Management in a Social Environment emerged. Every aspect of the process of self-management, as described in the four major themes, (1) Family Cohesion, (2)Social Stigma of Disease, (3) Social Expectations/ Perception of “Illness,” and (4) Disease Knowledge and
Understanding, was influenced by the social context.
Grade 1
36
Bilaga 3.Översikt över resultatets kategorier och underkategorier samt i vilka