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Diabetes (DM) requires self-care that is demanding and
may cause stress. Social support can buffer effects of stress. No previous
study has been found comparing perceptions of foreign-born persons with DM,
concerning the content of and need for social support with a population of origin.
The aim was to compare the meaning of support and its impact on the life
situation in Swedish- and foreign-born persons
diagnosed with type 2 DM living in Sweden. A purposive sample of 74 persons; 34
foreign- and 40 Swedish-born, aged 32-80 years, diagnosed with type 2 DM, was included. The foreign-born
persons were mostly Middle Eastern and Ex-Yugoslavian refugees. Mixed methods
were used and data were collected by qualitative interviews and quantitative
data collected by the Norbeck Social Support Questionnaire (NSSQ). Studying the
figures measured by NSSQ, no significant differences were found according to
gender but foreign-born men scored lower than Swedish, especially in emotional
support and aid. The main findings showed that respondents, irrespective of
origin, described the meaning of the concept of support mainly as information
support in learning to manage DM. However, foreign-born persons also focused on
medical support with regular follow-ups while Swedes emphasized the need for
emotional support. Foreign- and Swedish-born persons are in general more
similar than dissimilar in describing the meaning, need and impact of support.
Irrespective of origin they want to learn to manage their disease and thus desire
and need regular follow-up and information immediately from being diagnosed.
Further studies are needed as the study is based on a limited sample.
Our premise for this literature review is the global demographic change caused by the world’s population living longer and becoming older, and extensive international migration leading to multicultural societies. Increasing age leads to health problems, often long-term or chronic, requiring investments in health care. Worse health and dissimilarities in pattern of morbidity/ mortality have been found in foreign-compared to Swedish-born persons, so it is reasonable to assume that this affects use of health care. The exploratory review focuses on elderly migrants’ (>65 years) use of healthcare. The databases Pub Med, EBSCO, CINAHL and ERIC were searched in 2000-2013. A limited number of studies were found; few had a comparative approach, most were from the USA, and focused on migrants from the former Soviet Union or countries in South-East Asia. A range of factors were identified that influence patterns of health care use: language fluency, ability to communicate, self-reported health status, prevalence of chronic disease, physical distance from care provision, availability of transport to reach care, cost of care, the health insurance system, cultural norms and values regarding different forms of care, level of education, and length of residence in the host country. Most studies treated health care from a general perspective and collected data from community and hospital settings, without analysing usage separately. Some studies indicated elderly migrants making use of health care less than other groups but the pattern is not unambiguous: other studies show that there is an overuse of health care. It is therefore difficult to show any particular pattern, or possible differences in use, regarding community versus in-patient care. Studies focusing on migrants’ actual use of health care are few and further research is needed, especially because elderly people form the largest group of users of health care and will be even larger in the future.