RESUMO
Background: It is necessary to understand the way women think about their health. There is a 揷ulture of silence� among women regarding urinary incontinence (UI). Physiotherapy is proven effective mode of therapy in case of UI. Objectives: This study aimed to explore the attitude of the women toward UI, to understand the related sociocultural factors and health-seeking behavior, and to ascertain the challenges encountered in community-based physiotherapy interventions. Methods: A qualitative study was conducted among women who refused to participate in a physiotherapy intervention for UI in the rural community of Gujarat, India. Fourteen in-depth key informant interviews were conducted using an interview guide. The responses were noted and compiled into a composite interview script. Interviews were not recorded due to nonavailability of consent. Interviews were reviewed by investigators and content analysis was carried out. Key themes were identified after multiple iterations. Results: Most of the women were unaware of the UI and believed that it may be due to their gender or due to aging. Physiotherapy interventions were disregarded due to various reasons such as shy nature, lack of priority and privacy, dependency, self-neglect, and influence of social and cultural norms. Conclusion: Cultural and social systems were more important determinants of health seeking than health systems themselves particularly when sensitive issue such as UI in women of rural Western India was concerned.
RESUMO
La diabetes mellitus gestacional (DMG) es un problema de salud pública en México, cuya primer línea de tratamiento es la dietoterapia. Se requieren habilidades de automanejo para el control de la enfermedad. En este trabajo se estudiaron cinco mujeres con DMG, quienes manifestaron su percepción de riesgo de la presencia de la DMG y vivencias en algunas prácticas del autocuidado. Se obtuvieron datos sociodemográficos; se realizaron entrevistas en profundidad, las cuales se analizaron con el paquete Atlas ti V.5. Los resultados demuestran que las mujeres están conscientes del papel que juega la alimentación y la actividad física en mejorar el control de su enfermedad, además de los riesgos perinatales a los que se asocia la DMG. El cumplimiento de las recomendaciones dietéticas en su mayoría fue parcial, pero se demuestran cambios positivos y graduales en el estilo de vida. Las percepciones desde las emociones que les produce la DMG, fue factor clave para que llevaran a cabo la dieta. En conclusión, el tratamiento médico y dietético influye en el comportamiento cultural alimentario de las mujeres con DMG. Los profesionales de la salud deben tomar en cuenta los determinantes socioculturales al diseñar e implementar estrategias de tratamiento.
Gestational diabetes mellitus (GDM) is a public health problem in Mexico and diet therapy is the main form of treatment. Self-management abilities are required to control the disease. Five women with GDM were studied to assess GDM risk perception and experiences related with self-management practices. Sociodemographic data were obtained and in-depth interviews were conducted and subsequently analyzed using Atlas ti V.5 software. The results revealed that women were conscious regarding the role of diet and physical activity in improving GDM control, and about the perinatal risks associated with the disease. Adherence to diet recommendations was partial, but gradual and positive lifestyle changes were observed. Emotionally, perception about having GDM was a key factor with respect to adhering to the diet. In conclusion, the medical and dietary treatment influences the cultural food behavior of women with GDM. Health professionals should consider sociocultural determinants when designing and implementing treatment strategies.