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Health and welfare among Thai migrant women in Sweden: Lived experiences of transnational marriage migration. A dissertation in caring science
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
2021 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background:

This dissertation uses Betty Neuman’s nursing theory within the caring sciences to enable in-depth knowledge regarding Thai women’s health in the context of marriage migration. Globalisation has provided new opportunities for marriage migration, for example for Thai women to move to Western countries to improve their lives and wellbeing. Western men seem to offer financial security and better living conditions, but are increased wealth and health really what marriage migration entails?

Aim:

The overall aim of this thesis was to explore what contributes to the health and wellness of Thai immigrant women living in Sweden.

Methods:

Semi-structured interviews were conducted with 40 women, using the sample criteria: (a) born in Thailand and self-identifying as Thai; (b) having lived in Sweden for at least five years; and (c) currently married or previously married/in a relationship with a Swedish man. Content analysis was used in Studies I and IV, phenomenography in Study II, and critical incidents methodology in Study III, to analyse the data.

Results:

Most interviewees came to Sweden dreaming of a better life. Study I: This dream was seldom realised, however, with 18 of 40 interviewees experiencing intimate partner violence in their marriages. Study II: The interviewed women experienced transnational family responsibilities based on traditional cultural beliefs and the Buddhist religion. These consisted of being a dutiful daughter, a caring mother, a kind relative, and a ‘giving’ person, as well as striving for a wealthy life. Study III: The women reported 438 critical health incidents in five main areas: psychological, sociocultural, physiological, developmental, and spiritual. Study IV: Remaining in a marriage was the woman’s vital objective in finding wealth and wellbeing. The interviewed women suggested using strategies such as not giving up hope; being honest and diplomatic; mutual care and respect; and continuous caretaking. According to most of them, cultural differences could be negotiated and transformed by caring, sharing, and remaining calm in everyday family situations.

Conclusion:

Scientific knowledge based on interdisciplinary research can contribute to increased awareness of vulnerable groups’ limited access to health and welfare. Marriage migration often leads to a particularly vulnerable position, which has a major impact on women’s health. The transnational family responsibility that often accompanies immigration contributes to negative effects on women’s quality of life, as supporting family and relatives in the home country entails a lifelong commitment that can erode both their relationship with their husband as well as their own health.

Keywords: marriage migration; domestic violence; women’s health and wellbeing 

Abstract [sv]

Bakgrund:

Denna avhandling i vårdvetenskap använder Betty Neumans Nursing teori för att möjliggöra en mer djupgående kunskap om kvinnors hälsa i sammanhanget äktenskapsmigration. Globaliseringen har gett nya möjligheter till äktenskaplig migration, till exempel för thailändska kvinnor att flytta till västländer för att förbättra sitt liv och välbefinnande. Västerländska män tycks erbjuda ekonomisk trygghet och bättre levnadsförhållanden men är ökad välmående och hälsa verkligen vad äktenskapsmigration innebär?

Syfte:

Det övergripande syftet med detta avhandlingsprojekt var att undersöka vad som bidrar till hälsa och välbefinnande för thailändska kvinnor som bor i Sverige.

Metod:

Semistrukturerade individuella intervjuer genomfördes med 40 kvinnor. Innehållsanalys användes i studie I och IV, fenomenografi i studie II och critical incidents metodologi i studie III för att analysera data.

Resultat:

De flesta intervjuade kom till Sverige med en dröm om att få ett bättre liv.       Studie I: Drömmen uppfylldes dock mer sällan, eftersom 18 av 40 intervjuade upplevde intimt partnervåld i sina nära relationer. Studie II: Thailändska kvinnor har ett transnationellt familjeansvar baserat på traditionella kulturella normer och värderingar och buddhistisk religion som består av plikter mot familj och släktingar: att vara en god dotter, att vara en omtänksam mamma, att vara en vänlig släkting, att vara en generös person och att sträva efter ökad välfärd för släkt och familj. Studie III: Kvinnorna rapporterade 438 kritiska hälsoincidenter inom fem huvudområden: Psykologiska, sociokulturella, fysiologiska, andliga dilemman samt åldrandet. Dessa dilemman bidrog till återkommande hälsokonsekvenser vilka kan relateras till rollen som västerländsk fru. Studie IV: Enligt de intervjuade kvinnornas beskrivningar är deras viktigaste mål i livet att bibehålla sin relation med en västerländsk man som de menar är vägen mot att nå välstånd och välbefinnande. Enligt de intervjuade behövde de kulturella skillnaderna i paret kontinuerligt förhandlas och omformuleras och med hjälp av delade vardagsbekymmer, delad omsorg och bibehållet lugn kunde relationen vidmakthållas. En av de 40 intervjuade valde en mer västerländsk livsstil där en ensamstående kvinna kan välja ett mer oberoende och självständigt liv och på så sätt i bästa fall bidra till ett utökat välbefinnande och hälsa. 

Slutsats:

Kunskap utifrån tvärvetenskaplig forskning kan bidra till ökad medvetenhet om utsatta gruppers begränsade tillgång av hälsa och välfärd. Äktenskapsmigration leder ofta till en speciellt utsatt position, vilken har stor inverkan på kvinnors hälsa. Det transnationella familjeansvaret som ofta följer med vid immigration bidrar till negativa effekter på kvinnors livskvalitet, eftersom att stödja familj och släktingar i hemlandet är ett livslångt engagemang som kan tära på såväl relationen till maken som kvinnans individuella hälsa. 

Nyckelord: Äktenskapmigration; våld i hemmet; kvinnors hälsa och välmående

Place, publisher, year, edition, pages
Västerås: Mälardalen University , 2021.
Series
Mälardalen University Press Dissertations, ISSN 1651-4238 ; 339
Keywords [en]
marriage migration; domestic violence; women’s health and wellbeing 
Keywords [sv]
Äktenskapmigration; våld i hemmet; kvinnors hälsa och välmående
National Category
Nursing
Research subject
Care Sciences
Identifiers
URN: urn:nbn:se:mdh:diva-55373ISBN: 978-91-7485-514-2 (print)OAI: oai:DiVA.org:mdh-55373DiVA, id: diva2:1576631
Public defence
2021-12-03, C1-007 och Ministry of Public Health (och online via Zoom), Mälardalens högskola/Ministry of Public Health, Eskilstuna/Bangkok, 09:00 (English)
Opponent
Supervisors
Available from: 2021-11-17 Created: 2021-07-01 Last updated: 2024-06-26Bibliographically approved
List of papers
1. Illuminating health aspects for immigrant Thai women in Swedish transnational marriages
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2024 (English)In: BMC Women's Health, E-ISSN 1472-6874, Vol. 24, no 1, article id 337Article in journal (Refereed) Published
Abstract [en]

Background: Women who are migrants experience discrimination and face major risks, including sexual exploitation, trafficking, and violence, which affect their health and well-being. This study explored critical health incidents experienced by immigrant Thai women in marriage migration. Methods: A qualitative explorative approach with in-depth interviews was used. Forty immigrant Thai women who currently or previously had a Swedish spouse were recruited for the study. An inductive critical incident technique was used to collect and analyze the data as the first step. In a second deductive step, the Newman system model was used to categorize health dilemmas. Results: The women reported 438 critical health incidents in five main areas. Psychological health dilemmas included emotional abuse, feeling overwhelmed due to family responsibilities and the stress of leaving family behind. Sociocultural health dilemmas included transnational family duties or not performing family duties. Physiological health dilemmas included experiencing physical violence and environmental, domestic or work accidents. Developmental health dilemmas included failing health, difficulties upholding the duties expected of a spouse in the target culture and caring for an elderly husband. Spiritual health dilemmas included critical incidents in which the women perceived themselves to have failed in their hopes and duties as a wife, which intensified their dependence on faith, particularly the Buddhist concept of karma. Conclusion: Professionals in health and welfare practices in Thailand together with professionals in Western countries who work with women in marriage migration situations need to recognize the psychological, sociocultural, physiological, developmental, and spiritual health dilemmas experienced by these women. Furthermore, civil organizations that meet Thai women in foreign countries, such as Buddhist cultural associations, would benefit from the multicultural knowledge revealed by the present study. This knowledge can facilitate healthcare and welfare support for women in marriage migration situations. 

Place, publisher, year, edition, pages
BioMed Central Ltd, 2024
Keywords
Critical incident technique, International marriages, Well-being, Women’s health, Adult, Emigrants and Immigrants, Female, Health Status, Humans, Marriage, Middle Aged, Qualitative Research, Southeast Asian People, Spouses, Stress, Psychological, Sweden, Thailand, aged, anxiety, Article, educational status, emotional abuse, family duties, health, health care personnel, human, immigrant, interview, knowledge, life expectancy, lifestyle and related phenomena, partner violence, pension, qualitative analysis, responsibility, semi structured interview, social support, sociodemographics, transnational marriages, ethnology, mental stress, migrant, psychology, Southeast Asian, spouse
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:mdh:diva-67902 (URN)10.1186/s12905-024-03071-6 (DOI)001244829300001 ()38867221 (PubMedID)2-s2.0-85195996868 (Scopus ID)
Available from: 2024-06-26 Created: 2024-06-26 Last updated: 2024-07-03Bibliographically approved
2. Perceptions of transnational family responsibilities' effects on subjective health and wellness - voices of Thai immigrant women
Open this publication in new window or tab >>Perceptions of transnational family responsibilities' effects on subjective health and wellness - voices of Thai immigrant women
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2020 (English)In: International Journal of Migration, Health and Social Care, ISSN 1747-9894, E-ISSN 2042-8650, Vol. 16, no 3, p. 225-240Article in journal (Refereed) Published
Abstract [en]

Purpose Globalisation provides new opportunities for immigrant women to supply financial benefits transnationally to uphold their families in their home countries. The purpose of this study is to explore the experiences of Thai immigrant women regarding transnational family responsibilities effects on their health and wellness. Design/methodology/approach Qualitative data were collected using semi-structured interviews with 40 Thai immigrant women, of which 34 described having transnational family responsibilities. The transcribed data were analysed using a phenomenographic approach. Findings The findings revealed five structural aspects of transnational family responsibilities of Thai immigrant women: being a dutiful daughter, being a caring mother, being a kind relative, being a "giving" person and striving for a wealthy life. The interviewees seldom encountered enough support from the spouse in handling their transnational family responsibilities. In general, a transnational marriage includes family responsibilities that are continuous and that often is the cause of migration. Practical implications This paper illuminates the transnational responsibilities of marriage migration and argues for women's rights of culturally congruent health care. Originality/value Traditionally Thai women's values are based on how they handle family responsibilities and acknowledging own health needs are not. These interviewees perceived doubled burden in terms of family responsibilities and workload in employed work, which contributed to poor health and wellness.

Place, publisher, year, edition, pages
EMERALD GROUP PUBLISHING LTD, 2020
Keywords
Phenomenography, Migration health, International marriages, Neuman systems model
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-51464 (URN)10.1108/IJMHSC-12-2019-0104 (DOI)000543449400001 ()2-s2.0-85086660659 (Scopus ID)
Available from: 2020-10-09 Created: 2020-10-09 Last updated: 2022-10-19Bibliographically approved
3. Multidimensional health goal a driving force in relationship management among Thai women in marriages migration
Open this publication in new window or tab >>Multidimensional health goal a driving force in relationship management among Thai women in marriages migration
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(English)Manuscript (preprint) (Other academic)
National Category
Nursing
Identifiers
urn:nbn:se:mdh:diva-55372 (URN)
Available from: 2021-07-01 Created: 2021-07-01 Last updated: 2022-10-17Bibliographically approved
4. Broken dreams of a better life in Sweden: Thai women’s lived experiences of intimate partner violence by Swedish men in international marriages
Open this publication in new window or tab >>Broken dreams of a better life in Sweden: Thai women’s lived experiences of intimate partner violence by Swedish men in international marriages
2018 (English)In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 11, no 1, p. 1-10Article in journal (Refereed) Published
Abstract [en]

Background: Intimate partner violence by men against women has detrimental effects on equality, health and integration. Migrated and ‘imported’ wives experience an increased risk of intimate partner violence. Objectives: The purpose of this study was to explore Thai immigrant women’s lived experiences of intimate partner violence in Sweden. Method: Semi-structured interviews based on the critical incident technique with specific questions about experiences of male-to-female intimate partner violence were used to collect data. The participants were Thai immigrant women who had lived in Sweden for more than five years. Qualitative content analysis was used to identify patterns and variations in the transcribed data material. Results: Eighteen interviewees reported psychological, physical, economic and/or sexual violence in their international marriages. These Thai women described being faithful and silent and reliable housewives. However, this did not keep them from being replaced and losing dignity as a result of intimate partner violence, including experiencing broken dreams and deception. Although their dreams were broken, they did not give up their efforts to achieve better lives in Sweden. Conclusions: The vulnerability of imported wives in international marriages needs to be further recognised by health and welfare agencies in Sweden, as elsewhere, to ensure that these women have equal access to human rights, welfare and health as other citizens. From a health promotion perspective, home-based health check-ups are needed to stop the exploitation of imported wives. In Thailand, information and education about the unrecognised negative conditions of the Mia farang role (Imported wife role) need to be disseminated.

National Category
Medical and Health Sciences
Research subject
Public Health Sciences
Identifiers
urn:nbn:se:mdh:diva-41285 (URN)10.1080/16549716.2018.1496889 (DOI)000440729600001 ()30073910 (PubMedID)2-s2.0-85051069200 (Scopus ID)
Available from: 2018-11-05 Created: 2018-11-05 Last updated: 2021-07-01Bibliographically approved

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