Encumbered by vulnerability and temporality - the meanings of trigger situations when learning to live with diabetes

AIMS AND OBJECTIVES: The aim of the study was to illuminate the meanings of trigger situations experienced in everyday life when learning to live with diabetes. BACKGROUND: Adults become active learners when faced with situations they do not know how to manage, triggering a need to understand something in a different way than before. Knowing more about experiential learning for persons living with diabetes is important for understanding how learning can be supported by health care. DESIGN: A life-world approach with a phenomenological hermeneutical method, inspired by the philosophy of Paul Ricoeur. METHODS: This method was used for interpreting transcriptions of interviews and consists of three stages: naïve understanding, structural analysis and a comprehensive understanding. Participants (n = 13), with either type I or type II diabetes, were interviewed on three different occasions over a three-year period after being diagnosed with diabetes. RESULTS: When learning to live with diabetes, the meanings of trigger situations were described as 'the unpredictable body heightens insecurity with awareness of one's own dependability', 'losing control in unsustainable situations' and 'encumbered by vulnerability and temporality in earlier familiar situations'. CONCLUSION: The meanings of trigger situations were to lose the smooth, unreflected way of managing an everyday life situation, interlaced with feelings of lost control of how to live with new insights of being vulnerable. Trigger situations meant an opportunity for learning, as well as being demanding, unplanned and with limited freedom of choice. Trigger situations presented life and body as unpredictable. RELEVANCE TO CLINICAL PRACTICE: If healthcare professionals can identify the worries and questions raised in trigger situations, knowledge gaps can be identified and reflected on to stimulate learning

Differences in health determinants between international and domestic students at a German university

Krämer A, Prüfer-Krämer L, Stock C, Tshiananga JT. Differences in health determinants between international and domestic students at a German university. Journal of American College Health. 2004;53(3):127-132.The authors used a standardized questionnaire to survey 201 international and 193 German students at the University of Bielefeld, Germany. to determine differences in health practices between the 2 groups and to identify targets for health-promotion interventions. Multivariate logistic regression models revealed that long-term female international students (those whose duration of residency in Germany was more than 2 years) had lower levels of physical activity and alcohol Consumption than their German counterparts and higher rates of smoking independently associated with international citizenship. Short-term international female students were less likely than German students to receive social support. Among men, long-term international student status was associated with daily smoking and inconsistent seat belt use, whereas short-term student status was associated with a lower rate of seat belt use, a higher level of perceived stress. and a healthier diet, compared with domestic students. Findings from the Study could give rise to health-promotion activities for international students at German universities: additional studies at other European universities are necessary before making further recommendations

Gesundheitssurvey bei ausländischen Studierenden an der Universität Bielefeld

Krämer A, Prüfer-Krämer L, Tshiang Tshiananga J, Stock C. Gesundheitssurvey bei ausländischen Studierenden an der Universität Bielefeld. In: Sonntag U, Gräser S, Stock C, Krämer A, eds. Gesundheitsfördernde Hochschulen : Konzepte, Strategien und Praxisbeispiele. Gesundheitsforschung. Weinheim: Juventa-Verl.; 2000: 115-126

Health status, health behavior and health resources of foreign students compared to German students at the University of Bielefeld

Prüfer-Krämer L, Tshiang Tshiananga J, Krämer A, et al. Health status, health behavior and health resources of foreign students compared to German students at the University of Bielefeld. In: Pasini W, Lobel HO, eds. Mobility & health: from hominid migration to mass tourism: proceeding of European conference on travel medicine : Venice, Cini Foundation, 25-27 March 1998. San Marino; 1998: 349-351