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Tschirhart H, Landeen J, Yost J, Nerenberg KA, Sherifali D. Perceptions of diabetes distress during pregnancy in women with type 1 and type 2 diabetes: a qualitative interpretive description study. BMC Pregnancy Childbirth 2024; 24:232. [PMID: 38570742 PMCID: PMC10988880 DOI: 10.1186/s12884-024-06370-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 02/25/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Diabetes distress is commonly seen in adults with pre-existing diabetes and is associated with worsened glycemic management and self-management practices. While a majority of women report increased stress during pregnancy, it is unknown how women with type 1 or type 2 diabetes experience diabetes distress during this unique and transitional time. PURPOSE This study aimed to understand the experiences and perceptions of diabetes distress in women with pre-existing diabetes during pregnancy. METHODS A qualitative study using an interpretive description approach was conducted. In-depth, one to one interviewing was used to capture rich descriptions of the pregnancy experience. Nested, stratified, and theoretical sampling was used to recruit 18 participants with type 1 and type 2 diabetes from the quantitative strand of this mixed methods study. Constant comparative analysis was used to inductively analyze the data and develop themes. FINDINGS Four themes, each with several subthemes, emerged under the main finding of "Diabetes Distress": 1) Worry for Baby's Health - "What's this going to do to the baby?"' 2) Feeling Overwhelmed with Diabetes Management-"It just seemed unattainable"; 3) Living with Diabetes - "There's no way out" and 4) Cycle of Diabetes Distress. CONCLUSIONS The findings from this study identify the sources and experiences of diabetes distress during pregnancy in women with pre-existing diabetes. Diabetes distress often presents as cyclical and multifaceted during pregnancy, with elements of fear for the unborn baby, difficulties with diabetes management, and having negative lived experiences of diabetes. Further work is needed to develop appropriate screening tools for pregnancy and interventions to mitigate diabetes distress. Diabetes educators are well-positioned provide emotional support and person-centred self-management education to individuals with diabetes.
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Affiliation(s)
- Holly Tschirhart
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Canada.
| | - Janet Landeen
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Jennifer Yost
- M. Louise Fitzpatrick College of Nursing, Villanova University, Pennsylvania, USA
| | - Kara A Nerenberg
- Departments of Medicine, Obstetrics & Gynecology, and Community Health Sciences, University of Calgary, Calgary, Canada
| | - Diana Sherifali
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Canada
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Schiller T, Gassner T, Winter Shafran Y, Knobler H, Schiller O, Kirzhner A. Prenatal Breastfeeding Counseling Intervention in Women with Pre-Gestational Diabetes Mellitus-A Randomized Controlled Trial. Healthcare (Basel) 2024; 12:406. [PMID: 38338291 PMCID: PMC10855396 DOI: 10.3390/healthcare12030406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 01/31/2024] [Accepted: 02/02/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Data on breastfeeding rates and targeted interventions in women with pre-gestational diabetes mellitus are inconclusive. The aim of the study was to evaluate breastfeeding rates up to one year postpartum and whether targeted counseling towards the end of pregnancy can impact breastfeeding rates and duration. An additional goal was to evaluate whether counseling affected women's perceptions regarding breastfeeding. METHODS Women with pre-gestational diabetes mellitus were cluster-randomized between 32 and 36 weeks of gestation, either to face-to-face instruction with a certified lactation consultant or to receive written information on breastfeeding. Thirty-eight women without diabetes served as controls and were given written information on breastfeeding. All women filled out a questionnaire regarding intended breastfeeding duration, exclusivity, and perceptions, before intervention and at three, six, and twelve months post-partum. RESULTS Fifty-two women with pre-gestational diabetes mellitus consented to participate. All completed the questionnaires, 26 in each group. At three, six, and twelve months postpartum, rates of any breastfeeding were around 60%, 50%, and 30%, respectively. Approximately one-third breastfed exclusively in each group at three and six months. No significant difference in breastfeeding rates was noted between face-to-face instruction, written information, and controls. End-of-pregnancy counseling improved confidence in breastfeeding knowledge and confidence in being able to manage blood glucose. CONCLUSIONS Breastfeeding rates in pre-gestational diabetes mellitus were comparable to those of women without diabetes and were unchanged by mode of instruction at the end of pregnancy. However, targeted diabetes-oriented breastfeeding instruction at the end of pregnancy improved knowledge and confidence among women with pre-gestational diabetes mellitus.
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Affiliation(s)
- Tal Schiller
- Department of Diabetes, Endocrinology and Metabolism, Kaplan Medical Center, Rehovot 7661041, Israel
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9160401, Israel
| | - Tali Gassner
- Department of Diabetes, Endocrinology and Metabolism, Kaplan Medical Center, Rehovot 7661041, Israel
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9160401, Israel
| | - Yael Winter Shafran
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9160401, Israel
- Obstetric and Gynecology Department, Kaplan Medical Center, Faculty of Medicine, Rehovot 7661041, Israel
| | - Hilla Knobler
- Department of Diabetes, Endocrinology and Metabolism, Kaplan Medical Center, Rehovot 7661041, Israel
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9160401, Israel
| | - Ofer Schiller
- Pediatric Cardiac Intensive Care Unit, Schneider Children’s Medical Center of Israel, Petah Tikva 4941492, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Alena Kirzhner
- Department of Diabetes, Endocrinology and Metabolism, Kaplan Medical Center, Rehovot 7661041, Israel
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9160401, Israel
- Department of Medicine A, Kaplan Medical Center, Faculty of Medicine, Rehovot 7661041, Israel
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Nicolazzi L, Gilbert L, Horsch A, Quansah DY, Puder JJ. Trajectories and associations of symptoms of mental health and well-being with insulin resistance and metabolic health in women with gestational diabetes. Psychoneuroendocrinology 2024; 160:106919. [PMID: 38091918 DOI: 10.1016/j.psyneuen.2023.106919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 11/17/2023] [Accepted: 12/05/2023] [Indexed: 01/02/2024]
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is characterized by increased insulin resistance and carries perinatal and long-term risks for the mother and her offspring. There is a link between perinatal depression or anxiety and GDM. Mental health problems are associated with higher insulin resistance and could explain the underlying association between GDM and depression or anxiety symptoms. We investigated the trajectories and associations between symptoms of mental health and well-being with insulin resistance and metabolic health in women with GDM. METHODS This study included the control group (n = 106) of a randomized controlled trial in women with GDM that were followed-up during pregnancy and up to 1-year postpartum. We measured symptoms of mental health (Edinburgh Postnatal Depression Scale (EPDS), Anxiety subscale of the Hospital Anxiety and Depression Scale (HADS-A), well-being (The World Health Organization Well-Being Index (WHO-5)) and metabolic health, including insulin resistance variables (HOMA-insulin resistance (IR) and Matsuda Index of insulin sensitivity) as well as weight during pregnancy and in the postpartum. RESULTS Participants' pre pregnancy weight and BMI were 69.7 kg ± 16.1 and 25.9 kg/m2 ± 5.5 respectively. HOMA-IR was higher during pregnancy compared to 6-8 weeks postpartum and increased between 6-8 weeks and 1-year postpartum (all p < 0.05). Matsuda index decreased between 6-8 weeks and 1-year postpartum (p < 0.001). EPDS scores decreased between pregnancy and both 6-8 weeks and 1-year postpartum (all p < 0.05). HADS-A scores did not change between pregnancy and the postpartum. WHO-5 scores improved significantly from pregnancy and both 6-8 weeks and 1-year postpartum (p < 0.001). Correlation coefficients within outcome at the three different time points were high for metabolic measures and ranged between 0.94 and 0.96 for weight, from 0.77 to 0.89 for HOMA-IR and 0.64 for the Matsuda index (all p < 0.001). Mental health and well-being variables were moderately correlated in all three time points including r = 0.36-0.55 for the EPDS (p < 0.001), r = 0.58 for HADS (p < 0.001), and r = 0.43-0.52 for the WHO-5 (p < 0.01). After adjustment for age and pre-pregnancy BMI, Matsuda index was negatively associated with EPDS scores and positively associated to WHO-5 scores at 6-8 weeks postpartum. No other association between insulin resistance and mental health or well-being outcomes were found. CONCLUSION While insulin resistance fluctuated with values being lowest in the early postpartum and increasing thereafter, both depression and well-being scores decreased between pregnancy and the postpartum and did not change in the postpartum period. Intraindividual variability was larger for mental health and well-being than for metabolic health outcomes at different time points, indicating a higher plasticity for mental health and well-being outcomes that could be acted upon. We found only few associations between mental health and well-being and metabolic health outcomes.
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Affiliation(s)
- Ludmila Nicolazzi
- Department of Medicine, Internal Medicine service, Lausanne University Hospital, Lausanne, Switzerland.
| | - Leah Gilbert
- Obstetric service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland.
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Switzerland; Neonatalogy Service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland.
| | - Dan Yedu Quansah
- Obstetric service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland.
| | - Jardena J Puder
- Obstetric service, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland.
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Toledo‐Chavarri A, Delgado J, Rodríguez‐Martín B. Perspectives of women living with type 1 diabetes regarding preconception and antenatal care: A qualitative evidence synthesis. Health Expect 2023; 27:e13876. [PMID: 37909855 PMCID: PMC10726142 DOI: 10.1111/hex.13876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 08/21/2023] [Accepted: 09/08/2023] [Indexed: 11/03/2023] Open
Abstract
INTRODUCTION Pregnant women with type 1 diabetes may have an increased risk of complications for both the baby and themselves. Educational programmes, preconception planning, strict glycemic control and comprehensive medical care are some of the antenatal interventions that have been proposed to improve the outcomes of pregnant women with type 1 diabetes. While some evidence-based recommendations about antenatal care are included in clinical practice guidelines (CPGs), the views, and experiences of women with type 1 diabetes about these interventions are not well known. AIM To understand and synthesize the perceptions of women with type 1 diabetes about the interventions before pregnancy. METHOD A qualitative evidence synthesis (QES) was carried out with a framework analysis guided by the Cochrane Qualitative and Implementation Methods Group approach. Three online databases (Medline, Embase and Web of Science) were searched. We included qualitative articles that were published from 2011 to 2021 and which were available in English or Spanish. FINDINGS Ten references met the inclusion criteria of the study and were included. Three main themes were identified: (a) acceptability of antenatal care, (b) feasibility and implementation consideration and (c) equity and accessibility difficulties. CONCLUSION Continuity of care, coordination between health professionals and services, and a more holistic approach are the key aspects women say need to be considered for more acceptable, feasible and equitable preconception and antenatal care. PATIENT OR PUBLIC CONTRIBUTION This QES was carried out as part of the CPGs on diabetes mellitus type 1, carried out as part of the Spanish Network of Health Technology Assessment Agencies. In this CPG, the representatives of the patient associations are Francisco Javier Darias Yanes, from the Association for Diabetes of Tenerife, who has participated in all the phases of the CPG; Aureliano Ruiz Salmón and Julián Antonio González Hernández (representatives of the Spanish Diabetes Federation (FEDE) who have participated as collaborator and external reviewer, respectively.
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Affiliation(s)
- Ana Toledo‐Chavarri
- Canary Islands Health Research Institute Foundation, (FIISC)TenerifeSpain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS)MadridSpain
- Research Network on Health Services in Chronic Diseases (REDISSEC)Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS)Spain
| | - Janet Delgado
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS)MadridSpain
- Department of Philosophy IUniversity of Granada, Campus Universitario de Cartuja CPGranadaSpain
| | - Beatriz Rodríguez‐Martín
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS)Spain
- Department of Nursing, Physiotherapy and Occupational TherapyFaculty of Health Sciences, University of Castilla‐La ManchaTalavera de la Reina (Toledo)Spain
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Elsamani Y, Mejia C, Kajikawa Y. Employee well-being and innovativeness: A multi-level conceptual framework based on citation network analysis and data mining techniques. PLoS One 2023; 18:e0280005. [PMID: 36608048 PMCID: PMC9821520 DOI: 10.1371/journal.pone.0280005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 12/19/2022] [Indexed: 01/07/2023] Open
Abstract
This study proposes a multilevel conceptual framework for a deeper understanding of the relationship between employee well-being and innovativeness. We overview 49 years of well-being research [1972-2021] and 54 years of research on innovativeness [1967-2021] to uncover 24 dominant themes in well-being and ten primary topics in innovativeness research. Citation network analysis and text semantic similarity were used to develop a conceptual framework featuring 21 components and three levels: individual, organizational, and market. These components consist of constructs, domains, and factors that can influence or be influenced by employee well-being and innovativeness either directly or indirectly. This is the first study to use citation network analysis and data mining techniques to investigate the relationship between employee well-being and innovativeness. This novel framework can aid organizations in identifying more holistic and efficient strategies for fostering innovativeness and enhancing the well-being of their workforce. It can also assist in developing new theories and serve as a roadmap for future research. We discuss the research limitations and theoretical and practical implications and propose three research themes that future studies may address.
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Affiliation(s)
- Yousif Elsamani
- Department of Innovation Science, School of Environment & Society, Tokyo Institute of Technology, Tokyo, Japan
- * E-mail: ,
| | - Cristian Mejia
- Department of Innovation Science, School of Environment & Society, Tokyo Institute of Technology, Tokyo, Japan
| | - Yuya Kajikawa
- Department of Innovation Science, School of Environment & Society, Tokyo Institute of Technology, Tokyo, Japan
- Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan
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Mirzakhani K, Khadivzadeh T, Faridhosseini F, Ebadi A. Development and psychometric evaluation of the High-Risk Pregnancy Well-Being Index in Mashhad: a methodological study. Reprod Health 2022; 19:218. [PMID: 36457135 PMCID: PMC9714023 DOI: 10.1186/s12978-022-01529-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 11/04/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Assessment of well-being in high-risk pregnancy (HRP) is the key to achieve positive maternal and fetal outcomes. Although there are a wide range of instruments for well-being assessment, none of them is comprehensive for well-being assessment in HRP. The present study aimed at the development and psychometric evaluation of the High-Risk Pregnancy Well-Being Index (HRPWBI). METHODS This methodological study was conducted using the Waltz's four-step method. The dimensions of well-being in HRP were determined based on a conceptual model and the blueprint and the item pool of HRPWBI were developed. Then, the face and the content validity were assessed and item analysis was performed. Construct validity was also assessed through exploratory factor analysis with principal component analysis on the data obtained from 376 women with HRP in Mashhad, Iran. Finally, internal consistency, test-retest stability, sensitivity, and interpretability of HRPWBI were assessed. RESULTS The scale- content validity index (SCVI) of HRPWBI was 0.91. In factor analysis, 33 items were loaded on seven factors which explained 53.77% of the total variance. Internal consistency, relative stability, absolute stability, sensitivity, and interpretability of HRPWBI were confirmed with a Cronbach's alpha of 0.84, a test-retest intraclass correlation coefficient of 0.97, a standard error of measurement of 0.92, a minimal detectable change of 8.09, and a minimal important change of 2.92, respectively. CONCLUSION HRPWBI is a valid and reliable instrument for well-being assessment among women with HRP. It can be used to assess well-being and the effects of well-being improvement interventions on well-being among women with HRP.
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Affiliation(s)
- Kobra Mirzakhani
- grid.411583.a0000 0001 2198 6209Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran ,grid.411583.a0000 0001 2198 6209Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Talat Khadivzadeh
- grid.411583.a0000 0001 2198 6209Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran ,grid.411583.a0000 0001 2198 6209Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farhad Faridhosseini
- grid.411583.a0000 0001 2198 6209Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abbas Ebadi
- grid.411521.20000 0000 9975 294XBehavioral Sciences Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran ,Research Center for Life & Health Sciences & Biotechnology of the Police, Direction oh Health, Rescue & Treatment, Police Headquarter, Tehran, Iran
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Price SAL. Mental Health During Pregnancy and Postpartum in Mothers With Type 1 Diabetes. Diabetes Care 2022; 45:1027-1028. [PMID: 35561134 DOI: 10.2337/dci22-0007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Sarah A L Price
- Department of Medicine, University of Melbourne, Parkville, Victoria, Australia.,Department of Obstetric Medicine, Royal Women's Hospital, North Melbourne, Victoria, Australia.,Department of Diabetes and Endocrinology, Royal Melbourne Hospital, Parkville, Victoria, Australia
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de Wolff MG, Rom AL, Johansen M, Broberg L, Midtgaard J, Tabor A, Hegaard HK. Worries among pregnant Danish women with chronic medical conditions - A cross sectional study with data from the Copenhagen pregnancy cohort. SEXUAL & REPRODUCTIVE HEALTHCARE 2021; 29:100623. [PMID: 33984666 DOI: 10.1016/j.srhc.2021.100623] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/16/2021] [Accepted: 04/07/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Pregnancy is a time of uncertainty and worries are common. Pregnant women with somatic chronic medical conditions (SCMC) are at higher risk of adverse pregnancy outcomes and perinatal mental illness than women without SCMC. We aimed to describe the degree and content of worries in early pregnancy among Danish women with SCMC compared with women without SCMC. STUDY DESIGN We conducted a cross-sectional study with self-reported questionnaires answered by 28,794 women from 2012─2019 during 1st trimester at a large university hospital in Denmark. MAIN OUTCOME MEASURES We used the Cambridge Worry Scale (CWS). The outcomes of interest were the prevalence of major worry at item level (n/%) and the total CWS score (mean/SEM) as expression of the degree and content of worries. Univariate and multivariable regression analysis were performed. RESULTS Women with SCMC reported a significantly higher total CWS score (aMD 1.50, 95% CI: 1.20-1.80). Women with SCMC were significantly more likely to report major worry in relation to own health (aOR 2.72, 95% CI: 2.43-3.08), the baby's health (aOR 1.40 95% CI 1.31-1.52), the process of giving birth (aOR 1.12, 95% CI: 1.04-1.21), the possibility of preterm labor (aOR 1.44, 95% CI: 1.28-1.63), and miscarriage (aOR 1.34, 95% CI: 1.24-1.43). CONCLUSION Women with SCMC reported higher overall degree of worry during early pregnancy and an increased risk of major worry in relation to own health, pregnancy complications and giving birth. In antenatal care, these worries should be addressed by clinicians.
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Affiliation(s)
- Mie Gaarskjaer de Wolff
- Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark; The Research Unit for Women's and Children's Health, The Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark; University of Copenhagen, Faculty of Health and Medical Sciences, Department of Clinical Medicine, Blegdamsvej 3, 2200 Copenhagen N, Denmark.
| | - Ane Lilleøre Rom
- Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark; The Research Unit for Women's and Children's Health, The Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark; Department of Clinical Research, University of Southern Denmark, Winsløwparken 19, 3, 5000 Odense, Denmark.
| | - Marianne Johansen
- Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark; Center for Pregnancy and Heart Disease, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark.
| | - Lotte Broberg
- Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark; The Research Unit for Women's and Children's Health, The Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark; University of Copenhagen, Faculty of Health and Medical Sciences, Department of Clinical Medicine, Blegdamsvej 3, 2200 Copenhagen N, Denmark.
| | - Julie Midtgaard
- The University Hospitals Center for Health Research, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark; Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Øster Farimagsgade 5, P.O.B 2099, 1014 Copenhagen K, Denmark.
| | - Ann Tabor
- University of Copenhagen, Faculty of Health and Medical Sciences, Department of Clinical Medicine, Blegdamsvej 3, 2200 Copenhagen N, Denmark; Center of Fetal Medicine and Pregnancy, Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark.
| | - Hanne Kristine Hegaard
- Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark; The Research Unit for Women's and Children's Health, The Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark; University of Copenhagen, Faculty of Health and Medical Sciences, Department of Clinical Medicine, Blegdamsvej 3, 2200 Copenhagen N, Denmark.
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Ong ZX, Dowthwaite L, Perez Vallejos E, Rawsthorne M, Long Y. Measuring Online Wellbeing: A Scoping Review of Subjective Wellbeing Measures. Front Psychol 2021; 12:616637. [PMID: 33790835 PMCID: PMC8006413 DOI: 10.3389/fpsyg.2021.616637] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 02/05/2021] [Indexed: 01/07/2023] Open
Abstract
With the increasing importance of the internet to our everyday lives, questions are rightly being asked about how its' use affects our wellbeing. It is important to be able to effectively measure the effects of the online context, as it allows us to assess the impact of specific online contexts on wellbeing that may not apply to offline wellbeing. This paper describes a scoping review of English language, peer-reviewed articles published in MEDLINE, EMBASE, and PsychInfo between 1st January 2015 and 31st December 2019 to identify what measures are used to assess subjective wellbeing and in particular to identify any measures used in the online context. Two hundred forty studies were identified; 160 studies were removed by abstract screening, and 17 studies were removed by full-text screening, leaving 63 included studies. Fifty-six subjective wellbeing scales were identified with 18 excluded and 38 included for further analysis. Only one study was identified researching online wellbeing, and no specific online wellbeing scale was found. Therefore, common features of the existing scales, such as the number and type of questions, are compared to offer recommendations for building an online wellbeing scale. Such a scale is recommended to be between 3 and 20 questions, using mainly 5-point Likert or Likert-like scales to measure at least positive and negative affect, and ideally life satisfaction, and to use mainly subjective evaluation. Further research is needed to establish how these findings for the offline world effectively translate into an online measure of wellbeing.
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Affiliation(s)
- Zhen Xin Ong
- School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Liz Dowthwaite
- Horizon Digital Economy Research Institute, University of Nottingham, Nottingham, United Kingdom
| | - Elvira Perez Vallejos
- National Institute of Health Research (NIHR) Biomedical Research Centre for Mental Health and Technology, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Mat Rawsthorne
- Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Yunfei Long
- School of Computer Science, University of Essex, Colchester, United Kingdom
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Mirzakhani K, Ebadi A, Faridhosseini F, Khadivzadeh T. Well-being in high-risk pregnancy: an integrative review. BMC Pregnancy Childbirth 2020; 20:526. [PMID: 32912254 PMCID: PMC7488451 DOI: 10.1186/s12884-020-03190-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 08/19/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND A prerequisite to the interventions for well-being improvement in high-risk pregnancy (HRP) is to make the concept clear, objective, and measurable. Despite the wealth of studies into the concept of well-being in HRP, there is no clear definition for it. This study aimed to explore the concept of well-being in HRP. METHODS This integrative review was conducted using the Whittemore and Knafl's approach. A literature search was done without any data limitation in dictionaries, thesauruses, encyclopedias, well-being-related textbooks, midwifery, psychology, and mental health journals, and Iranian and international databases. The most primary inclusion criterion was relevance to well-being in HRP. The full-texts of all these articles were assessed using the checklists of the Joanna Briggs Institute. Data were analyzed through the constant comparison method and were managed using the MAXQDA 10 software. Meaning units were identified and coded. The codes were grouped into subcategories and categories according to the attributes, antecedents, and consequences of well-being in HRP. RESULTS Thirty articles were included in the review, from which 540 codes were extracted. The codes were grouped into seven main attributes, eight main antecedents, and five main consequences of well-being in HRP. The four unique dimensions of well-being in HRP are physical, mental-emotional, social, and spiritual well-being. These dimensions differentiate well-being in HRP from well-being in low-risk pregnancy and in non-pregnancy conditions. CONCLUSION As a complex and multidimensional concept, well-being in HRP refers to the pregnant woman's evaluation of her life during HRP. It includes physical, hedonic, and eudaimonic components. The assessment of well-being in HRP should include all these components.
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Affiliation(s)
- Kobra Mirzakhani
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Life style institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
- Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Farhad Faridhosseini
- Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Talaat Khadivzadeh
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
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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.
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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.
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Singh H, Ingersoll K, Gonder-Frederick L, Ritterband L. "Diabetes Just Tends to Take Over Everything": Experiences of Support and Barriers to Diabetes Management for Pregnancy in Women With Type 1 Diabetes. Diabetes Spectr 2019; 32:118-124. [PMID: 31168282 PMCID: PMC6528394 DOI: 10.2337/ds18-0035] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
To optimize clinical outcomes, women with type 1 diabetes are advised to consistently achieve blood glucose levels in their target range before becoming pregnant. However, following this recommendation can be clinically and psychologically challenging for patients. We explored women's experiences of pregnancy-related diabetes management and any barriers and support systems affecting their self-management. Fifteen semi-structured telephone interviews were conducted with a nationwide sample. Interviews focused on women's perceptions of barriers hindering pregnancy-related diabetes management and support systems facilitating their self-management. Audio recordings were analyzed using inductive thematic analysis. Results indicated significant impairment of psychological health and overall quality of life in women with type 1 diabetes who were pregnant or planning pregnancy. Most participants reported a lack of support and empathetic engagement from their health care team, which affected their clinical management. Guilt and concerns about high blood glucose levels, constant pressure to meet glucose targets, and difficult interactions with health care professionals were a few of the primary themes with regard to barriers to optimal management. Patient-centered programs that provide effective clinical and psychosocial support for women who are preparing for pregnancy with preexisting diabetes are urgently needed so that these women feel adequately supported and empowered to undertake pregnancy.
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Affiliation(s)
- Harsimran Singh
- Mary & Dick Allen Diabetes Center, Hoag Memorial Hospital Presbyterian, Newport Beach, CA
| | - Karen Ingersoll
- Center for Behavioral Health and Technology, Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA
| | - Linda Gonder-Frederick
- Center for Behavioral Health and Technology, Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA
| | - Lee Ritterband
- Center for Behavioral Health and Technology, Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA
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Edwards H, Speight J, Bridgman H, Skinner TC. The pregnancy journey for women with type 1 diabetes: a qualitative model from contemplation to motherhood. PRACTICAL DIABETES 2016. [DOI: 10.1002/pdi.2036] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Helen Edwards
- Diabetes Counselling Online; Adelaide South Australia Australia
| | - Jane Speight
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria; Melbourne Victoria
- Centre for Social and Early Emotional Development, School of Psychology; Victoria Australia
- AHP Research; Hornchurch UK
| | - Heather Bridgman
- Centre for Rural Health, School of Health Sciences, Faculty of Health; University of Tasmania; Launceston Tasmania Australia
| | - Timothy C Skinner
- School of Psychological and Clinical Sciences, Faculty of Engineering, Health, Science and the Environment; Charles Darwin University; Darwin Northern Territory Australia
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Breastfeeding practices in women with type 1 diabetes: A discussion of the psychosocial factors and policies in Sweden and Australia. Women Birth 2015; 28:71-5. [PMID: 25435074 DOI: 10.1016/j.wombi.2014.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Revised: 10/30/2014] [Accepted: 11/03/2014] [Indexed: 11/20/2022]
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Abstract
This study aims to provide a better understanding of the ability of mobile health tools to offer glycemic control for patients with type 1 diabetes mellitus. Data gained from research articles searched in PubMed, Ovid (Medline), and CINAHL from 2005 to 2013 focused on interventions introduced to a type 1 diabetic population. Articles were screened to identify interventions that examined mobile health tools effect on glycemic control using %A1C as a proxy. Fourteen articles were included in this study. Descriptive data, %A1C difference, and statistical significance, if available, were extracted for comparison. Five major categories were identified across the spectrum of interventions, including "Internet," "Mobile," "Mobile and Internet," "Phone," and "Videoconference and phone." Seven of the 14 articles reported statistically significant decreases in measured outcomes. Seven studies examine a single cohort, and 7 examined a double cohort. Eleven of the 14 authors (79%) reported success with their intervention. Twelve studies reported a decrease in %A1C values in their intervention groups. Initial results for glycemic control through these tools appear promising, though inconclusive. Additional measures of mobile health tool efficacy should be assessed more directly. More rigorous study methods are also needed to improve the reliability of results.
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Affiliation(s)
- Adam Peterson
- Department of Health Management and Informatics, School of Medicine, University of Missouri, Columbia, MO, USA
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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.
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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
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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.
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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
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