1
|
Rasmussen B, Nankervis A, Skouteris H, McNamara C, Nagle C, Steele C, Bruce L, Holton S, Wynter K. Psychosocial wellbeing among new mothers with diabetes: Exploratory analysis of the postnatal wellbeing in transition questionnaire. SEXUAL & REPRODUCTIVE HEALTHCARE 2019; 22:100457. [PMID: 31442748 DOI: 10.1016/j.srhc.2019.100457] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 06/14/2019] [Accepted: 08/06/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The Postnatal Wellbeing in Transition (PostTrans) Questionnaire assesses psychosocial wellbeing among women transitioning to motherhood while managing pre-existing diabetes. Face and content validity have been previously reported; however the PostTrans questionnaire has 51 items which imposes a substantial burden on respondents. The aim of this study was exploratory analysis of the PostTrans questionnaire to investigate whether a reduction in the number of items was statistically supported, and whether clinically meaningful subscales could be derived. METHODS A prospective cohort of women with type 1 or type 2 diabetes was recruited from three metropolitan hospitals in Melbourne, Australia. Women completed surveys across three postnatal time points. Data were pooled for the analysis. Suitability for factor analysis was confirmed and exploratory Principal Components Analysis with oblique rotation was conducted. RESULTS The number of responses in the pooled dataset was 117. The reduced PostTrans scale has 27 items and six factors, which together explain 68.7% of the variance. The subscales assess: feeling as if one is coping with diabetes and the infant; feeling anxious and guilty about diabetes; feeling supported by family; sensitivity to the opinions of others; prioritising self-care; and health professional support. CONCLUSION The number of items in the PostTrans Questionnaire was reduced from 51 to 27 items. Six meaningful subscales emerged, which can help health professionals identify and address areas in which women with diabetes are experiencing psychosocial difficulties. The revised scale provides a feasible instrument to be tested for psychometric properties in a larger sample.
Collapse
Affiliation(s)
- Bodil Rasmussen
- School of Nursing and Midwifery, Deakin University, Geelong Waterfront Campus, 1 Geringhap Street, Geelong 3220, Australia; Centre for Quality and Patient Safety Research - Western Health Partnership, Sunshine Hospital, Furlong Road, St Albans 3021, Victoria, Australia.
| | - Alison Nankervis
- Departments of Diabetes and Endocrinology, Royal Melbourne and Women's Hospitals, Melbourne 3050, Victoria, Australia.
| | - Helen Skouteris
- Monash Centre for Health Research & Implementation, Faculty of Medicine, Nursing and Health Sciences, School of Public Health & Preventive Medicine, Level 1, 43-51 Kanooka Grove, Clayton, Locked Bag 29, Clayton 3168, Victoria, Australia.
| | - Catharine McNamara
- School of Nursing and Midwifery, Deakin University, Geelong Waterfront Campus, 1 Geringhap Street, Geelong 3220, Australia; Diabetes Education, Mercy Hospital for Women, 163 Studley Road, Heidelberg 3084, Victoria, Australia.
| | - Cate Nagle
- Centre for Nursing and Midwifery Research, James Cook University, 1 James Cook Drive, Townsville 4811, Queensland, Australia; Townsville Hospital and Health Service, 100 Angus Drive, Townsville 4811, Queensland, Australia.
| | - Cheryl Steele
- Diabetes Education Services, Sunshine Hospital, Furlong Road, St Albans 3021, Victoria, Australia.
| | - Lauren Bruce
- Monash Centre for Health Research & Implementation, Faculty of Medicine, Nursing and Health Sciences, School of Public Health & Preventive Medicine, Level 1, 43-51 Kanooka Grove, Clayton, Locked Bag 29, Clayton 3168, Victoria, Australia.
| | - Sara Holton
- School of Nursing and Midwifery, Deakin University, Geelong Waterfront Campus, 1 Geringhap Street, Geelong 3220, Australia; Centre for Quality and Patient Safety Research - Western Health Partnership, Sunshine Hospital, Furlong Road, St Albans 3021, Victoria, Australia.
| | - Karen Wynter
- School of Nursing and Midwifery, Deakin University, Geelong Waterfront Campus, 1 Geringhap Street, Geelong 3220, Australia; Centre for Quality and Patient Safety Research - Western Health Partnership, Sunshine Hospital, Furlong Road, St Albans 3021, Victoria, Australia.
| |
Collapse
|
2
|
Linden K, Sparud-Lundin C, Adolfsson A, Berg M. Well-Being and Diabetes Management in Early Pregnant Women with Type 1 Diabetes Mellitus. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:E836. [PMID: 27556476 PMCID: PMC4997522 DOI: 10.3390/ijerph13080836] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 08/15/2016] [Accepted: 08/18/2016] [Indexed: 12/16/2022]
Abstract
This paper explores well-being and diabetes management in women with type 1 diabetes mellitus (DM) in early pregnancy and investigates associations among perceived well-being, diabetes management, and maternal characteristics. Questionnaires were answered by 168 Swedish women. Correlation analyses were conducted with Spearman's correlation coefficient (rs). The women reported relatively high scores of self-efficacy in diabetes management (SWE-DES-10: 3.91 (0.51)) and self-perceived health (excellent (6.5%), very good (42.3%), good (38.7%), fair (11.3%) and poor (1.2%)). Moderate scores were reported for general well-being (WBQ-12: 22.6 (5.7)) and sense of coherence (SOC-13: 68.9 (9.7), moderate/low scores for hypoglycemia fear (SWE-HFS 26.6 (11.8)) and low scores of diabetes-distress (SWE-PAID-20 27.1 (15.9)). A higher capability of self-efficacy in diabetes management showed positive correlations with self-perceived health (rs = -0.41, p < 0.0001) and well-being (rs = 0.34, p < 0.0001) as well as negative correlations with diabetes distress (rs = -0.51, p < 0.0001) and hypoglycemia worries (rs = -0.27, p = 0.0009). Women with HbA1c levels of ≤48 mmL/mol scored higher in the subscales "goal achievement" in SWE-DES (p = 0.0028) and "comprehensibility" in SOC (p = 0.016). Well-being and diabetes management could be supported by strengthening the women's capability to achieve glycemic goals and their comprehensibility in relation to the treatment. Further studies are needed to test this.
Collapse
Affiliation(s)
- Karolina Linden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden.
- Centre for Person-Centred Care (GPCC), University of Gothenburg, 405 30 Gothenburg, Sweden.
| | - Carina Sparud-Lundin
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden.
- Centre for Person-Centred Care (GPCC), University of Gothenburg, 405 30 Gothenburg, Sweden.
| | - Annsofie Adolfsson
- School of Health Sciences, Örebro University, 701 82 Örebro, Sweden.
- Faculty of Health Sciences, Department of Nursing Science, Vestfold University College of Southeast Norway, 3603 Kongsberg, Norway.
| | - Marie Berg
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden.
- Centre for Person-Centred Care (GPCC), University of Gothenburg, 405 30 Gothenburg, Sweden.
| |
Collapse
|
3
|
Wołowicz-Ruszkowska A. How Polish Women With Disabilities Challenge the Meaning of Motherhood. PSYCHOLOGY OF WOMEN QUARTERLY 2015. [DOI: 10.1177/0361684315600390] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In this qualitative study, I offer a feminist reflection on motherhood from the perspectives of 25 women with various types of physical and sensory disabilities. Disability was treated not only as an individual experience but also as a social construct. I conducted 25 non-standardised narrative interviews with women with various types of physical disabilities. Using grounded theory method, with a particular emphasis on symbolic interactionism, I identified three important themes from the non-standardised narrative interviews: the effects of insufficient health care on pregnant women, the lack of acceptance and support for mothers, and a welfare system inadequate to the needs of mothers. These themes affect the way Polish women with disabilities experience motherhood. Findings highlight the different ways that mothers with disabilities challenge the prevailing normative categories of gender and disability and, in so doing, demythologise and delegitimise the traditional Polish model of motherhood. While this study points to needed reforms in Poland to support women with disabilities, it also reveals a model of motherhood based on interdependence and mutual care. The women with disabilities in this study identify new possibilities for all families.
Collapse
|
4
|
Woolley M, Jones C, Davies J, Rao U, Ewins D, Nair S, Joseph F. Type 1 diabetes and pregnancy: a phenomenological study of women's first experiences. PRACTICAL DIABETES 2015. [DOI: 10.1002/pdi.1914] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Maria Woolley
- Department of Obstetrics; Countess of Chester Hospital NHS Foundation Trust; Chester UK
| | - Colin Jones
- Faculty of Health & Applied Social Sciences; Liverpool John Moores University; Liverpool UK
| | - Joanne Davies
- Department of Obstetrics; Countess of Chester Hospital NHS Foundation Trust; Chester UK
| | - Usha Rao
- Department of Obstetrics; Countess of Chester Hospital NHS Foundation Trust; Chester UK
| | - David Ewins
- Department of Diabetes and Endocrinology; Countess of Chester Hospital NHS Foundation Trust; Chester UK
| | - Sunil Nair
- Department of Diabetes and Endocrinology; Countess of Chester Hospital NHS Foundation Trust; Chester UK
| | - Frank Joseph
- Department of Diabetes and Endocrinology; Countess of Chester Hospital NHS Foundation Trust; Chester UK
| |
Collapse
|
5
|
Singh H, Murphy HR, Hendrieckx C, Ritterband L, Speight J. The challenges and future considerations regarding pregnancy-related outcomes in women with pre-existing diabetes. Curr Diab Rep 2013; 13:869-76. [PMID: 24013963 PMCID: PMC3836194 DOI: 10.1007/s11892-013-0417-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Ineffective management of blood glucose levels during preconception and pregnancy has been associated with severe maternal and fetal complications in women with pre-existing diabetes. Studies have demonstrated that preconception counseling and pre-pregnancy care can dramatically reduce these risks. However, pregnancy-related outcomes in women with diabetes continue to be less than ideal. This review highlights and discusses a variety of patient, provider, and organizational factors that can contribute to these suboptimal outcomes. Based on the findings of studies reviewed and authors' clinical and research experiences, recommendations have been proposed focusing on various aspects of care provided, including improved accessibility to effective preconception and pregnancy-related care and better organized clinic consultations that are sensitive to women's diabetes and pregnancy needs.
Collapse
Affiliation(s)
- Harsimran Singh
- Department of Psychiatry & Neurobehavioral Sciences, Division of Behavioral Health and Technology, University of Virginia School of Medicine, 310 Old Ivy Way, Suite 102, Charlottesville, VA 22903, USA, Phone: (434) 924 5988 (for Dr. Ritterband)
- ; Phone: (434) 982 1022 (for Dr. Singh, Corresponding author)
| | - Helen R. Murphy
- Metabolic Research Laboratories and NIHR Cambridge Biomedical Centre, Level 4, Institute of Metabolic Science Box 289 Addenbrookes Hospital, Cambridge, CB2 0QQ, UK. Phone: +44 (0) 1223 769079
| | - Christel Hendrieckx
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Australia – Vic, 570 Elizabeth Street, Melbourne 3000, Australia. Phone: +61 (0) 3 8648 1860 (for Dr. Hendrieckx), Phone: +61(0) 3 8648 1850 (for Dr. Speight)
- Centre for Mental Health and Wellbeing Research, School of Psychology, Deakin University, 221 Burwood Highway, Burwood, Australia
| | - Lee Ritterband
- Department of Psychiatry & Neurobehavioral Sciences, Division of Behavioral Health and Technology, University of Virginia School of Medicine, 310 Old Ivy Way, Suite 102, Charlottesville, VA 22903, USA, Phone: (434) 924 5988 (for Dr. Ritterband)
| | - Jane Speight
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Australia – Vic, 570 Elizabeth Street, Melbourne 3000, Australia. Phone: +61 (0) 3 8648 1860 (for Dr. Hendrieckx), Phone: +61(0) 3 8648 1850 (for Dr. Speight)
- Centre for Mental Health and Wellbeing Research, School of Psychology, Deakin University, 221 Burwood Highway, Burwood, Australia
- AHP Research, Uxbridge, UK
| |
Collapse
|
6
|
Rasmussen B, Hendrieckx C, Clarke B, Botti M, Dunning T, Jenkins A, Speight J. Psychosocial issues of women with type 1 diabetes transitioning to motherhood: a structured literature review. BMC Pregnancy Childbirth 2013; 13:218. [PMID: 24267919 PMCID: PMC4222685 DOI: 10.1186/1471-2393-13-218] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Accepted: 11/18/2013] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Life transitions often involve complex decisions, challenges and changes that affect diabetes management. Transition to motherhood is a major life event accompanied by increased risk that the pregnancy will lead to or accelerate existing diabetes-related complications, as well as risk of adverse pregnancy outcomes, all of which inevitably increase anxiety. The frequency of hyperglycaemia and hypoglycaemia often increases during pregnancy, which causes concern for the health and physical well-being of the mother and unborn child. This review aimed to examine the experiences of women with T1DM focusing on the pregnancy and postnatal phases of their transition to motherhood. METHODS The structured literature review comprised a comprehensive search strategy identifying primary studies published in English between 1990-2012. Standard literature databases were searched along with the contents of diabetes-specific journals. Reference lists of included studies were checked. Search terms included: 'diabetes', 'type 1', 'pregnancy', 'motherhood', 'transition', 'social support', 'quality of life' and 'psychological well-being'. RESULT Of 112 abstracts returned, 62 articles were reviewed in full-text, and 16 met the inclusion criteria. There was a high level of diversity among these studies but three common key themes were identified. They related to physical (maternal and fetal) well-being, psychological well-being and social environment. The results were synthesized narratively. CONCLUSION Women with type 1 diabetes experience a variety of psychosocial issues in their transition to motherhood: increased levels of anxiety, diabetes-related distress, guilt, a sense of disconnectedness from health professionals, and a focus on medicalisation of pregnancy rather than the positive transition to motherhood. A trusting relationship with health professionals, sharing experiences with other women with diabetes, active social support, shared decision and responsibilities for diabetes management assisted the women to make a positive transition. Health professionals can promote a positive transition to motherhood by proactively supporting women with T1DM in informed decision-making, by facilitating communication within the healthcare team and co-ordinating care for women with type 1 diabetes transitioning to motherhood.
Collapse
Affiliation(s)
- Bodil Rasmussen
- School of Nursing and Midwifery, Deakin University, 221 Burwood Highway, Burwood, Vic 3125, Australia
| | - Christel Hendrieckx
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Australia – Vic, 570 Elizabeth Street, Melbourne, VIC 3000, Australia
- Centre for Mental Health and Well-being Research, School of Psychology, Deakin University, 221 Burwood Highway, Burwood, Vic 3125, Australia
| | - Brydie Clarke
- School of Nursing and Midwifery, Deakin University, 221 Burwood Highway, Burwood, Vic 3125, Australia
| | - Mari Botti
- School of Nursing and Midwifery, Deakin University, 221 Burwood Highway, Burwood, Vic 3125, Australia
- Epworth Health Care, Centre for Clinical Research Nursing, Epworth, Australia
| | - Trisha Dunning
- School of Nursing and Midwifery, Deakin University, 221 Burwood Highway, Burwood, Vic 3125, Australia
- Deakin University, Waterfront, PO Box 281, Geelong, Vic 3220, Australia
| | - Alicia Jenkins
- Department of Medicine, St Vincent’s Hospital, 4th Floor Clinical, Science Building, Melbourne University, 29 Regent Street, Fitzroy, Vic 3065, Australia
| | - Jane Speight
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Australia – Vic, 570 Elizabeth Street, Melbourne, VIC 3000, Australia
- Centre for Mental Health and Well-being Research, School of Psychology, Deakin University, 221 Burwood Highway, Burwood, Vic 3125, Australia
- AHP Research, 16 Walden Way, Hornchurch, UK
| |
Collapse
|