Self‐care in migrants with type 2 diabetes, during the COVID‐19 pandemic

Abstract

Introduction: Type 2 diabetes is increasing globally and particularly affects vulnerable groups in society, such as migrants. Research shows that type 2 diabetes is a risk factor for severe illness when infected with COVID-19. Diabetes-related complications can be prevented with good glycaemic control. In addition, good glycaemic control has been shown to be an important cornerstone for preventing severe illness in individuals infected with COVID-19. In order to maintain good glycaemic control, self-care is needed. The purpose of this article is to describe self-care maintenance and possible changes in self-care maintenance and to explore factors related to unchanged self-care maintenance in migrant patients with type 2 diabetes during the COVID-19 pandemic. The second aim is to describe well-being, social support, and the need for support from healthcare services during the COVID-19 pandemic in migrant patients with type 2 diabetes.Design/Method: A triangulation design with cross-sectional data collection was used.Both quantitative and qualitative data were collected and interpreted together in a triangulation design. Patients were selected by a diabetes nurse from a computer system at a health center in south-eastern Sweden and invited to participate in the study.A questionnaire was translated into the languages most commonly used at the clinic and sent out to 332 migrant patients who had been diagnosed with type 2 diabetes and treated in primary care. This questionnaire assessed self-care maintenance for diabetes (questions inspired by the Self-Care of Diabetes Inventory), with questions added to every item to assess changes during the pandemic. When changes occurred, we asked the participants to elaborate. Open-ended questions asked the participants how they would like to receive information when there are changes in their healthcare. Descriptive statistical analyses were used for the quantitative data and qualitative data was analyzed using a directed approach to content analysis. Results:In total, 79 participants answered the questionnaire (mean age 69 ± 11, 51% male, 47% born in the Middle East). Of these, 76% stated a change in self-care. More than half (58%) stated changes in maintaining an active lifestyle, 40% had changed their physical exercise, and 38% had changed their behavior to avoid getting sick.

Atividade física, autocuidado e qualidade de vida em diabéticos Tipo 2 na pandemia de COVID-19

“…A baixa adesão ao autocuidado pode ser justificada pelas restrições durante o período da pandemia, provocando, assim, alterações no padrão de sono, distúrbios de alimentação e diminuição de hábitos saudáveis. O autocuidado visa a diminuição das comorbidades causadas ao DM e faz necessário que o paciente tenha participação ativa 19 .28 As mudanças no autocuidado nesse período ocorreram devido a ficar em casa ou cancelar atividades sociais por medo de encontrar pessoas durante a pandemia, outros foram mais ativos fisicamente por precaução relacionada ao COVID-19 20,21 .…”

Supporting Self-care in Migrants with Type 2 Diabetes

“…A consequence of that is that migrants are at risk of having uncontrolled disease with inadequate self-care and poor glycaemic control 6,11,20,22,[26][27][28][29][30] .…”

“…Several studies use the of Middle Range Theory of Self-Care of Chronic Illness 18 when exploring self-care in chronic illness such as type 2 diabetes 30,43,44 . According to this theory, self-care is defined as "a process of maintaining health by promoting health practices and managing illness" 18 .…”

“…Further, the content about diabetes in Arabic is provided as written information, pictures and videos, and thus available even to those who are unable to read; taking into account various linguistic health literacy levels can lead to equalities in accessing health care 111 . Language barriers and a lack of knowledge about the Western health care system can be a challenge for migrants 40,85 why migrants with culturally and linguistically diverse backgrounds express a need for written health information in their own languages 30,112 .…”

“…However, during the COVID-19 pandemic, we did explore self-care behaviour, focusing on self-care maintenance, changed in a migrant population during the pandemic 30 . In future research and with feedback that we received from the feasibility study (study IV), the final version of the website will be further developed and effectively tested using a Self-Care of Diabetes Inventory (SCODI) 128 questionnaire based on the Middle Range Theory of Self-care of Chronic Illness 18 .…”