In a multicultural society the frequency of contact with migrant diabetic individuals will increase, as well as the need for knowledge about their beliefs about health and illness, which have rarely been studied. The aim of the present study was to explore beliefs about health and illness among migrant Yugoslavian and Swedish diabetic subjects that might affect their self-reported self-care practices and care-seeking behaviours. The study design was explorative, and a purposive sampling procedure was used. Fifteen females born in Sweden and 13 in former Yugoslavia, aged 33-73 years, with previously known diabetes mellitus were recruited from primary health care centres in southern Sweden. Median time of residence in Sweden was 5 years (range 2-30 years). Eight of the Yugoslavians had their diabetes diagnosed in Sweden. Focus-group interviews including scenarios of common problems related to diabetes mellitus were held. Yugoslavian females in general gave less tangible examples concerning beliefs about health and illness. Yugoslavians were orientated towards feelings related to their migratory experiences, enjoyed life by making deviations from dietary advice and retaining former traditions, and were less inclined towards self-monitoring and preventive foot care. They also expressed a passive role, depending on health care personnel, and discussed the influence of supernatural forces. Swedes expressed themselves in terms of medicine and a healthy lifestyle, took active part in their self-care and let self-monitoring guide their actions. Self-care was mainly practised to restore health when ill in both groups, and when help was needed it was sought in the professional sector (nurse or physician). Yugoslavians expressed higher confidence in physicians and used more natural cure medicine, side by side with biomedicine, while Swedes more frequently used alternative medicine. Demonstrated dissimilarities illustrate that beliefs about health and illness differ between migrant Yugoslavian and Swedish diabetic individuals, and are essential for self-care practice and care-seeking behaviour and must be considered when planning diabetes care.

Occupational therapy assessment of the physical environment in the home in relation to the functional capacity of an individual is essential prior to environmental adaptations to reduce handicap. Standardized methods for research and clinical use are in great demand. To introduce and develop a new instrument for occupational therapy assessment, the novel ideogram “The Enabler” was translated into Swedish and revised. It was first tested in practice by occupational therapists in primary health care. After further revisions of “The Enabler” and pre-teaching of raters, each of 30 individuals in their home environments was assessed by two independent raters. Reliability was evaluated using the kappa statistic. After only a few lessons in advance, the raters were able to administer the assessment in practice in a reliable way, agreement between raters was very good to good, k̄ = 0.68–0.87. The Swedish revised version of “The Enabler” is a useful tool for occupational therapy home evaluation and research.

The ADL Staircase is a hierarchical instrument for assessment of independence/ dependence in personal and instrumental activities of daily living (P-ADL and I-ADL). Its development was based on Katz's ADL-Index, applying the same assessment principles. The cumulativity among the items has previously been confirmed in Swedish urban elderly population samples. The purpose of this study was to test the instrument in a rural setting. Due to local environmental conditions, the authors developed alternative definitions for the "transportation" item. Data collected using 133 respondents suggested a different cumulative order among the I-ADL items from that identified in urban samples, and significant gender differences were found. The scale's cumulativity was analysed in-depth, and it revealed different results depending on which scaling analyses were used. Environmental factors highlighted the methodological difficulties inherent in I-ADL assessments, and the results revealed a higher prevalence of disability compared to previous gerontological studies. In clinical practice, awareness of the consequences of I-ADL assessments' limited generalizability between settings is strongly recommended. The study also has theoretical implications for further understanding of the complexity of disablement.

Empirical research elucidating the relationships between aspects of functional competence and environmental factors is lacking. This study aimed to analyse how functional limitations in the individual

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