Diabetes:: a cross-cultural interview study of immigrants from Somalia

Aim. To describe how diabetic immigrants from Somalia experience everyday life in Sweden and how they manage diabetes- related problems, with inclusion of a gender perspective. Background. To treat and care for minority populations successfully, healthcare staff in Sweden must thoroughly understand the illness experiences of different ethnic groups. However, no studies have so far been reported that focus on immigrants from Somalia with diabetes. Design. Descriptive, qualitative interview study with 19 diabetic adults born in Somalia and now living in Sweden. Method. Cross- cultural interviews with the aid of an interpreter. The transcribed interviews were subjected to qualitative latent content analysis, resulting in sub- themes and themes. Results. Four themes emerged: experience of distress in everyday life; everyday life continues as before; comprehensibility gives a feeling of control; and being compliant. A major finding was the variation in how the participants managed the fasting month of Ramadan. Several participants fasted and did not see the diabetes as an obstacle, others did see it as an obstacle or indicated that fasting was not compulsory for a sick person. Conclusions. This study provides healthcare staff with information about how a minority group experience and manage diabetes. The results indicate the importance of considering cultural background, as well as religious traditions such as Ramadan, in diabetes care. They also indicate that men and women differ in their reaction to diabetes and that care should be adapted to this. Relevance for clinical practice. It is important to develop evidence- based guidelines for diabetes care in ethnic groups that are fasting during Ramadan to prevent complications and promote relevant self- care. Further, the prescribed dietary advice must be culturally appropriate.