Parental perceptions and management strategies for otitis media in Greenland

Otitis media (OM) in Greenland is a substantial problem and the country prevalence is among the highest in the world. However, little is known about how Greenlandic Inuit parents perceive and manage everyday life with children suffering from OM. We hypothesize that having a child with OM has consequences for the families that go beyond the advice and treatment offered in primary health care.

We conducted a qualitative study based on semi-structured interviews and focus groups with parents to children suffering from OM. The interviews took place in three different Greenlandic regions; the capital Nuuk and two smaller towns in West and East Greenland. Access to specialized health care differs among the regions, creating an underlying difference on the limitations of referral and thereby level of care. We conducted the data analysis using Systematic Text Condensation.

In total, 27 parents participated in the study. Although most parents perceived OM as a result of genetic or environmental dispositions, individual perceptions and cultural beliefs of causal associations between behavior and OM co-existed with the general understanding of medical explanation models. This created a sense of guilt among the parents. Some parents felt in control of managing the disease of the child and used medically well-established strategies. Others felt frustrated and considered contact to the health clinics as futile, thereby managing the disease by 'waiting it out'. Emerging themes were shame and stigma related to the symptoms of OM, which led to social isolation as a consequence for several of the families.

Our results indicate that Greenlandic Inuit families are impacted by OM in a complex and severe manner. Guilt, shame and social isolation were predominant themes influencing the everyday life of the affected families. Perceptions and management strategies go beyond the scope of the medical explanation models which poses a potential challenge for the parents' experiences with the present treatment offer. The results underline the need to develop a broader approach to prevention and treatment for OM - both at the clinical level as well as part of public health promotion at the community level.