1
|
Topaloğlu Ören ED, Ünsal Avdal E, Polat G, Sofulu F, Düzgün G, Pamuk G. Experiences of women with gestational diabetes about fear of having diabetes in their babies: A qualitative study. Medicine (Baltimore) 2024; 103:e37755. [PMID: 38608114 PMCID: PMC11018210 DOI: 10.1097/md.0000000000037755] [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: 10/03/2023] [Accepted: 03/08/2024] [Indexed: 04/14/2024] Open
Abstract
Gestational Diabetes Mellitus is an important public health problem that often occurs during pregnancy. This study aimed to reveal the experiences of women with gestational diabetes regarding the fear of having diabetes in their babies. A qualitative research method was carried out with a phenomenological approach. The interviews had a semi-structured form and were recorded on an online/face-to-face voice recorder, and thematic content analysis was performed on the MAXQDA22. Following the inclusion criteria, 12 women with gestational diabetes from the 2 hospitals in the study were included, and in this way, the study reached saturation. As a result of the interviews, 4 main themes and one subtheme were obtained from coding. The main themes were "sugar baby," "risky child," "raising a fearful baby," and "problematic gene carrier." From the main theme of "problematic gene carrier," the subtheme of "pregnancies with problematic genes" was created. This research sheds light on the problems women with gestational diabetes experience with themselves and their babies, and how they deal with these problems. Women with gestational diabetes try to accept and cope with the diagnosis. This research shows that the women were worried about both themselves and their babies. Illuminating the experiences of women with gestational diabetes is part of an integrative care approach that will help increase quality care and treatment in endocrine clinics. More qualitative studies are needed to learn more about the experiences of women with gestational diabetes in endocrine clinics.
Collapse
Affiliation(s)
- Ekin Dila Topaloğlu Ören
- Izmir Katip Celebi University Faculty of Health Science, Department of Obstetrics and Gynecology Nursing, İzmir, Türkiye
| | - Elif Ünsal Avdal
- Izmir Katip Celebi University Faculty of Health Science, Department of Internal Medicine Nursing, İzmir, Türkiye
| | - Gökşen Polat
- Izmir Tinaztepe University Faculty of Health Science, Department of Internal Medicine Nursing, İzmir, Türkiye
| | - Funda Sofulu
- Izmir Katip Celebi University Faculty of Health Science, Department of Internal Medicine Nursing, İzmir, Türkiye
| | - Gönül Düzgün
- İzmir Tinaztepe University Faculty of Health Science, Department of First Aid and Emergency, İzmir, Türkiye
| | - Gülseren Pamuk
- Izmir Katip Celebi University School of Medicine, Department of Family Medicine, İzmir, Türkiye
| |
Collapse
|
2
|
Düzgün G, Polat G, Ünsal Avdal E. Perspective on insulin use in gestational diabetes: A phenomenological study. Medicine (Baltimore) 2023; 102:e35831. [PMID: 38065916 PMCID: PMC10713104 DOI: 10.1097/md.0000000000035831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 10/06/2023] [Indexed: 12/18/2023] Open
Abstract
Gestational diabetes mellitus (GDM) is characterized by carbohydrate metabolism intolerance during pregnancy in individuals with normal blood glucose levels before pregnancy. The first-line treatment for GDM is nutrition and exercise, and insulin therapy is initiated when these are insufficient. Pregnant women who are started on insulin often think that they use drugs that may be harmful to the baby. Therefore, this study aimed to examine the perspectives of women diagnosed with gestational diabetes on insulin use using a phenomenological approach. Qualitative research was conducted using phenomenological patterns. The interviews were recorded on an online/face-to-face voice recorder in a semi-structured form, and thematic content analysis was performed using MAXQDA22. Based on the inclusion criteria of the 2 hospitals specific to the study, 15 patients were included, and the study reached saturation. Three main themes and 2 subthemes were obtained from the coding. The main themes were derived from, "fear," "baby protector," and "last remedy" coding. Pregnant women diagnosed with GDM can define gestational diabetes because of the training provided. Because the pregnancy period is sensitive, pregnant women delay control and insulin application for the health of their babies. Moreover, they sometimes experience pain during the injection, and believe that it may harm their babies.
Collapse
Affiliation(s)
- Gönül Düzgün
- Health Services Vocational School First Aid and Emergency Program, Izmir Tinaztepe University, Buca/Izmir, Turkey
| | - Gökşen Polat
- Health Services Vocational School First Aid and Emergency Program, Izmir Tinaztepe University, Buca/Izmir, Turkey
| | - Elif Ünsal Avdal
- Faculty of Health Sciences, Department of Nursing, Internal Medical Nursing Izmir Katip Celebi University, Izmir, Turkey
| |
Collapse
|
3
|
Al Nadhiri M, Al Hashmi I, Alaloul F, Al Omari O. Adherence to gestational diabetes mellitus (GDM) management plan among pregnant women in Oman: Predictors, barriers, and motivating factors. Diabetes Metab Syndr 2023; 17:102766. [PMID: 37146357 DOI: 10.1016/j.dsx.2023.102766] [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: 11/07/2022] [Revised: 04/10/2023] [Accepted: 04/13/2023] [Indexed: 05/07/2023]
Abstract
OBJECTIVES This study examined the predictors, the barriers, and the motivating factors of adherence to the gestational diabetes mellitus (GDM) management plan among Arab pregnant women with GDM. METHODS This cross-sectional study was conducted in the Antenatal Clinics of three major tertiary hospitals in Oman. Total of 164 Arab pregnant women with GDM were recruited using a convenience sampling technique. The measurement scales included Diabetes Self-Management Questionnaire- Revised, Diabetes Management Self-Efficacy Scales, and Social Support Survey. Multiple-choice questions were used to assess barriers to and motivators of adherence. The analytical tools included multiple linear regression and descriptive statistics. RESULTS Findings from stepwise regression analysis revealed three models with three significant predictors, including self-efficacy, previous history of GDM, and the type of GDM management. The major barriers to adherence were family, especially kids' responsibilities, time constraints, home responsibilities, and working status. Moreover, participants indicated their concern about maternal and neonatal GDM-related complications and husband encouragement as the main motivating factors for adherence. CONCLUSIONS and Clinical Relevance: Our findings suggest that antenatal healthcare providers should implement strategies that enhance self-efficacy and engage families in health education programs. The study also recommends collaboration between health policy makers in the Ministries of Health, Consumer Protection Agency, and the Ministries of Municipality to ensure the availability of healthy food choices in the public areas. Additionally, flexible working conditions and an environment conducive to a healthy and active lifestyle should be made available to pregnant women with GDM.
Collapse
Affiliation(s)
- Marwa Al Nadhiri
- Al Kodh 66, Sultan Qaboos University Hospital, Muscat, Oman, 123.
| | - Iman Al Hashmi
- Al Kodh 66, College of Nursing, Sultan Qaboos University, Muscat, Oman, 123.
| | - Fawwaz Alaloul
- Al Kodh 66, College of Nursing, Sultan Qaboos University, Muscat, Oman, 123.
| | - Omar Al Omari
- Al Kodh 66, College of Nursing, Sultan Qaboos University, Muscat, Oman, 123.
| |
Collapse
|
4
|
Salimi HR, Jalili S, Griffiths MD, Alimoradi Z. Fear of hypoglycemia and its predictive factors among diabetic pregnant women. Prim Care Diabetes 2023; 17:68-72. [PMID: 36460590 DOI: 10.1016/j.pcd.2022.11.009] [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: 08/20/2022] [Revised: 11/24/2022] [Accepted: 11/26/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The purpose of the present study was to investigate the fear of hypoglycemia (FoH) and its predictors among diabetic pregnant women. STUDY DESIGN Cross-sectional conducted between January to August 2022. METHODS In the present study, 250 diabetic pregnant women from Qazvin province participated. Demographic and fertility characteristics, FoH, adherence to treatment, self-efficacy, anxiety and depression were assessed. Data were analyzed using univariable and multivariable linear regression models. RESULTS The participants' mean age was 31.02 years (SD=4.72). The FoH mean score was 32.88 (out of 72). Based on the multivariable linear regression model, having a history of hypoglycemia (β = 0.44, p < 0.001), lower education (β = 0.17, p = 0.001), being treated with insulin (β = 0.22, p < 0.001), being treated with both insulin and diet (β = 0.16 p = 0.003), being of younger age (β = -0.13, p = 0.008), and depression (β = 0.16, p = 0.002) were independent predictors of FoH among pregnant women. CONCLUSION Diabetic pregnant women experience FoH, particularly those with a history of hypoglycemia. Therefore, providing education and counseling concerning hypoglycemia, complications, and necessary measures for this group of diabetic pregnant women are needed along with those who are younger, less educated, and have comorbid mental health conditions.
Collapse
Affiliation(s)
- Hamid Reza Salimi
- Social Determinants of Health Research Center, Research Institute for prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
| | - Sahar Jalili
- Students' Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran.
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK.
| | - Zainab Alimoradi
- Social Determinants of Health Research Center, Research Institute for prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
| |
Collapse
|
5
|
Misita D, Yamamoto JM, Yuan Y, Donovan LE, Bell RC, Jarman M. An exploration of differences in infant feeding practices among women with and without diabetes in pregnancy: A mixed-methods study. Diabet Med 2021; 38:e14635. [PMID: 34265117 DOI: 10.1111/dme.14635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 06/17/2021] [Accepted: 07/07/2021] [Indexed: 11/29/2022]
Abstract
AIMS (1) To determine the likelihood of full breastfeeding at 3 months postpartum in women with and without diabetes in pregnancy (DiP); (2) to explore the associations between diabetes management practices and infant feeding practices in those who had DiP and (3) to examine women's experiences of feeding their infants after having DiP. METHODS The quantitative study used data from Alberta Pregnancy Outcomes and Nutrition (APrON) cohort study. Participants who had DiP (n = 62) were matched 1:3 to participants without DiP for pre-pregnancy BMI, parity, mode of delivery and pre-term birth. Infant feeding questionnaires, prospective breastfeeding diaries and medical chart data were analysed to determine likelihood of fully breastfeeding at 3 months postpartum. For the qualitative study, interviews were conducted with postpartum women who had DiP to explore the experiences of infant feeding. Interviews were thematically analysed, and the results were compared between women who were categorized as 'full breast feeders' or 'mixed feeders'. RESULTS The odds of fully breastfeeding were 50% lower in women with DiP than women without DiP (OR: 0.50, 95% CI 0.25-0.99, p = 0.04). Qualitative interviews identified that although all women showed resilience in the face of infant feeding challenges, those who were fully breastfeeding reported seeking out external infant feeding supports, for example, classes or Doula's. Mixed Feeders perceived there was a lack of infant feeding information and support given to them prior to giving birth. CONCLUSION Women with DiP may require additional prenatal and postnatal infant feeding support to be better prepared to overcome feeding challenges they may face.
Collapse
Affiliation(s)
- Dragana Misita
- Department of Agricultural, Food and Nutritional Sciences, Division of Human Nutrition, University of Alberta, Edmonton, AB, Canada
| | - Jennifer M Yamamoto
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada
- Department of Medicine, Division of Endocrinology and Metabolism, Cummings School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Yan Yuan
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Lois E Donovan
- Department of Medicine, Division of Endocrinology and Metabolism, Department of Obstetrics and Gynecology, Cummings School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Rhonda C Bell
- Department of Agricultural, Food and Nutritional Sciences, Division of Human Nutrition, University of Alberta, Edmonton, AB, Canada
| | - Megan Jarman
- Department of Agricultural, Food and Nutritional Sciences, Division of Human Nutrition, University of Alberta, Edmonton, AB, Canada
| |
Collapse
|
6
|
Power T, Wilson D, East L, Cashman B, Wannell J, Jackson D. Indigenous women's experiences of diabetes in pregnancy: A thematic synthesis. Collegian 2021. [DOI: 10.1016/j.colegn.2021.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
7
|
Autrey LK, Anderson CW. Applying Anthropology: A Mission-Essential Skill for Culturally Competent Healthcare. Mil Med 2021; 186:9-10. [PMID: 32869080 DOI: 10.1093/milmed/usaa208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 07/10/2020] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - Colonel Warner Anderson
- Uniformed Services University of the Health Sciences Department of Military Emergency Medicine 4301 Jones Bridge Road Bethesda, MD 20814
| |
Collapse
|
8
|
Guo J, Long Q, Li J, Wang X, Li Y, Jiang S, Sun M, Wiley J, Chen JL. Barriers and facilitators of self-monitoring of blood glucose engagement among women with gestational diabetes mellitus in China: A mixed-methods study. Midwifery 2020; 90:102797. [PMID: 32755742 DOI: 10.1016/j.midw.2020.102797] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 07/06/2020] [Accepted: 07/17/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Self-monitoring of blood glucose (SMBG) is a crucial tool for maintaining glycemic control in women with gestational diabetes mellitus (GDM). However, to date, little is known about the current status of SMBG engagement among women with GDM in China. OBJECTIVE To describe the current status of SMBG engagement among women with GDM in China and identify its barriers and facilitators. DESIGN AND SETTING A mixed-methods design was conducted, comprising a cross-sectional survey and semi-structured interviews. The research data were collected in two tertiary hospitals in Hunan province, China. PARTICIPANTS A total of 323 women with GDM completed the survey from March 2018 to October 2018, and 11 of them participated in the interviews. FINDING In total, 35.6% of the participants actively engaged in SMBG. The participants who had an advanced maternal age (95% CI 0.253-0.947), did not own glucose meters (95% CI 0.054-0.364), did not receive SMBG-related information from health professionals (95% CI 0.232-.987), or received less SMBG information in general (95% CI 0.137-0.52) were less likely to engage in SMBG. Insufficient SMBG information and low awareness of SMBG were also summarized as the main barriers in the interview findings. Facilitators of SMBG engagement included SMBG-related social support (95% CI 1.573-6.135) and health concerns related to themselves and the unborn infant. CONCLUSION About one-third of Chinese women with GDM engaged in SMBG. An accurate and complete description of how SMBG should be performed is needed from health professionals. Strategies to obtain more SMBG-related social support and a greater emphasis on health concerns are recommended to increase SMBG engagement among women with GDM in China.
Collapse
Affiliation(s)
- Jia Guo
- Xiangya School of Nursing, Central South University, Changsha, Hunan, PR China.
| | - Qing Long
- Xiangya School of Nursing, Central South University, Changsha, Hunan, PR China.
| | - Junrong Li
- Second Xiangya Hospital,Central South University, Changsha, Hunan, PR China.
| | - Xin Wang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, PR China.
| | - Yixuan Li
- Third Xiangya Hospital, Central South University, Changsha, Hunan, PR China.
| | - Shan Jiang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, PR China.
| | - Mei Sun
- Xiangya School of Nursing, Central South University, Changsha, Hunan, PR China; Hunan Women's Research Association, Changsha, Hunan, 410013, PR China.
| | - James Wiley
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA, USA.
| | - Jyu-Lin Chen
- School of Nursing, University of California, San Francisco, CA, USA.
| |
Collapse
|
9
|
Henderson JN, Carson LD, Tomette A, Hass A, King K. Diabetes-by-Proxy: Virtual Embodiment of Disease by Oklahoma Choctaw Parents of Children with Type 1 Diabetes. Med Anthropol Q 2020; 35:25-42. [PMID: 32524666 DOI: 10.1111/maq.12581] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 03/24/2020] [Accepted: 03/26/2020] [Indexed: 11/26/2022]
Abstract
Childhood type 1 diabetes is increasing globally and requires meticulous at-home care due to risks for fatal outcomes if glucose levels are not continuously and correctly monitored. Type 1 diabetes research has focused on metabolism and stress measurements confirming high parental worry levels. However, research on caregivers' management strategies has lagged. We show parents' intense, all-encompassing work to preempt a disastrous drop in their child's glucose as a stress-path to the virtual embodiment of their child's condition. That is, parents acquire diabetes-by-proxy. Our findings derive from four and half years of ethnographic research with the same 19 families in the Choctaw Nation of Oklahoma. These parents were exceptionally engaged as caregivers and distressed by the potentially fatal outcome of type 1 diabetes mismanagement. Diabetes-by-proxy names the parents' experience and validates clinical attention to them as they cope with their crucial caregiving commitment.
Collapse
Affiliation(s)
- J Neil Henderson
- American Indian Diabetes Prevention Center, University of Oklahoma Health Sciences Center.,Duluth campus Memory Keepers Medical Discover Team, University of Minnesota Medical School
| | - Linda D Carson
- American Indian Diabetes Prevention Center, University of Oklahoma Health Sciences Center
| | - Alisa Tomette
- American Indian Diabetes Prevention Center, University of Oklahoma Health Sciences Center.,Duluth campus Memory Keepers Medical Discover Team, University of Minnesota Medical School
| | - Amanda Hass
- Duluth campus Memory Keepers Medical Discover Team, University of Minnesota Medical School
| | - Kama King
- American Indian Diabetes Prevention Center, University of Oklahoma Health Sciences Center
| |
Collapse
|
10
|
Maugest L, McGovern EM, Mazalovic K, Doulazmi M, Apartis E, Anheim M, Bourdain F, Benchetrit E, Czernecki V, Broussolle E, Bonnet C, Falissard B, Jahanshahi M, Vidailhet M, Roze E. Health-Related Quality of Life Is Severely Affected in Primary Orthostatic Tremor. Front Neurol 2018; 8:747. [PMID: 29379467 PMCID: PMC5775514 DOI: 10.3389/fneur.2017.00747] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 12/27/2017] [Indexed: 12/17/2022] Open
Abstract
Background Primary orthostatic tremor (POT) is a movement disorder characterized by unsteadiness upon standing still due to a tremor affecting the legs. It is a gradually progressive condition with limited treatment options. Impairments in health-related quality of life (HQoL) seem to far exceed the physical disability associated with the condition. Methods A multi-center, mixed-methodology study was undertaken to investigate 40 consecutive patients presenting with POT to four movement disorder centers in France. HQoL was investigated using eight quantitative scales and a qualitative study which employed semi-structured interviews. Qualitative data were analyzed with a combination of grounded-theory approach. Results Our results confirm that HQoL in POT is severely affected. Fear of falling was identified as the main predictor of HQoL. The qualitative arm of our study explored our initial results in greater depth and uncovered themes not identified by the quantitative approach. Conclusion Our results illustrate the huge potential of mixed methodology in identifying issues influencing HQoL in POT. Our work paves the way for enhanced patient care and improved HQoL in POT and is paradigmatic of this modern approach for investigating HQoL issues in chronic neurological disorders.
Collapse
Affiliation(s)
- Lucie Maugest
- Département de Neurologie, EA 4184, Hôpital universitaire de Dijon, Dijon, France
| | - Eavan M McGovern
- Department of Neurology, St Vincent's University Hospital, Dublin, Ireland.,School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
| | - Katia Mazalovic
- Département de Médecine générale, Faculté de Médecine, Université de Bourgogne, Dijon, France
| | - Mohamed Doulazmi
- Sorbonne Universités, UPMC Univ Paris 06, UMR8256, INSERM, CNRS, Institut de Biologie Paris Seine, Adaptation Biologique et Vieillissement, Paris, France
| | - Emmanuelle Apartis
- Département de Neurophysiologie, Hôpital de Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Mathieu Anheim
- Département de Neurologie, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, Strasbourg, France.,Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), Illkirch-Graffenstaden, France.,Université de Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Frédéric Bourdain
- Département de Neurologie, Centre médico-chirurgical Foch, Suresnes, France
| | - Eve Benchetrit
- Département de Neurologie, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Virginie Czernecki
- Département de Neurologie, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Emmanuel Broussolle
- Département de Neurologie, Service de Mouvements anormaux, Hôpital Neurologique et Neurochirurgical Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France.,Université de Lyon, Université Lyon I, Faculté de Médecine Lyon Sud Charles Mérieux, Institut des Sciences Cognitives Marc Jeannerod, CNRS UMR 5229, Lyon, France
| | - Cecilia Bonnet
- Département de Neurologie, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Bruno Falissard
- CESP, Univ. Paris-Sud, Université Paris-Saclay, UVSQ, INSERM U1178, Paris, France
| | - Marjan Jahanshahi
- Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, The National Hospital for Neurology and Neurosurgery, University College London, London, United Kingdom
| | - Marie Vidailhet
- Département de Neurologie, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France.,UMR S 975, CNRS UMR 7225, ICM, Sorbonne Universités, UPMC Université Paris, Paris, France
| | - Emmanuel Roze
- Département de Neurologie, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France.,UMR S 975, CNRS UMR 7225, ICM, Sorbonne Universités, UPMC Université Paris, Paris, France
| |
Collapse
|
11
|
Chamberlain CR, Wilson AN, Amir LH, O'Dea K, Campbell S, Leonard D, Ritte R, Mulcahy M, Eades S, Wolfe R. Low rates of predominant breastfeeding in hospital after gestational diabetes, particularly among Indigenous women in Australia. Aust N Z J Public Health 2017; 41:144-150. [PMID: 28110518 DOI: 10.1111/1753-6405.12629] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 07/01/2016] [Accepted: 09/01/2016] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES To investigate rates of 'any' and 'predominant' breastfeeding in hospital among Indigenous and non-Indigenous women with and without gestational diabetes mellitus (GDM). METHODS A retrospective study of singleton infants born from July 2007 to December 2010 at Cairns Hospital, Australia, following GDM pregnancy, using linked hospital and birth data (n=617 infants), with a subsample of medical record reviews (n=365 infants). Aggregate data were used to compare to breastfeeding rates among infants born following non-GDM pregnancy (n=7,894 infants). RESULTS More than 90% of all women reported any breastfeeding before hospital discharge. About 80% of women without GDM reported predominant breastfeeding. Despite significant increases over time (p<0.0001), women with GDM were less likely to predominantly breastfeed (OR 0.32, 95%CI 0.27-0.38, p<0.0001); with lower rates among Indigenous women (53%) compared with non-Indigenous (60%) women (OR 0.78, 0.70-0.88, p<0.0001); and women having a caesarean birth or pre-term infant. CONCLUSIONS Rates of predominant in-hospital breastfeeding were lower among women with GDM, particularly among Indigenous women and women having a caesarean or pre-term birth. IMPLICATIONS Strategies are needed to support predominant in-hospital breastfeeding among women with GDM.
Collapse
Affiliation(s)
- Catherine R Chamberlain
- Indigenous Health Equity Unit, School of Population and Global Health, University of Melbourne, Victoria.,Aboriginal Health Domain, Baker IDI Heart and Diabetes Institute, Victoria
| | - Alyce N Wilson
- Indigenous Health Equity Unit, School of Population and Global Health, University of Melbourne, Victoria
| | - Lisa H Amir
- Judith Lumley Centre, La Trobe University, Victoria
| | - Kerin O'Dea
- Centre for Population Health Research, School of Health Sciences, University of South Australia
| | - Sandra Campbell
- Apunipima Cape York Health Council, Queensland.,Centre for Chronic Disease Prevention, Cairns Institute, James Cook University, Queensland
| | - Dympna Leonard
- Centre for Chronic Disease Prevention, Cairns Institute, James Cook University, Queensland
| | - Rebecca Ritte
- Indigenous Health Equity Unit, School of Population and Global Health, University of Melbourne, Victoria
| | | | - Sandra Eades
- Aboriginal Health Domain, Baker IDI Heart and Diabetes Institute, Victoria
| | - Rory Wolfe
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Victoria
| |
Collapse
|
12
|
Ge L, Wikby K, Rask M. 'Is gestational diabetes a severe illness?' exploring beliefs and self-care behaviour among women with gestational diabetes living in a rural area of the south east of China. Aust J Rural Health 2016; 24:378-384. [PMID: 27087496 DOI: 10.1111/ajr.12292] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2016] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE This study explores beliefs about illness and health and self-care behaviour among women with gestational diabetes living in a rural area of the south east of China. DESIGN A qualitative exploratory study using semi-structured interviews and qualitative content analysis. SETTING A hospital located in the outskirts of a city in the south east of China. PARTICIPANTS Seventeen women with gestational diabetes in 34-38th pregnant weeks. RESULTS The beliefs about gestational diabetes among the women in the present study were found to be bidirectional. Some of them feared the illness and its negative influence on health, while others believed that it was not a severe illness and disbelieved the diagnosis of gestational diabetes. They related their illness and health to the individual, social and natural factors. They mainly sought help from the professional sector, but did not fully comply with the professionals' advice. Diet control and exercise were their main self-care measures, but none of them self-monitored their blood glucose. They demonstrated their misunderstanding about diet control and self-monitoring of blood glucose. CONCLUSIONS This study highlighted the serious lack of knowledge, lower level of risk awareness and poor self-care behaviour among women in this group. Health professionals were found to be the most important source of knowledge about gestational diabetes for these women. The influence of Chinese culture was demonstrated. Gestational diabetes among these women can most likely be improved by training the health professionals and by health education involving individuals, families and the rural communities.
Collapse
Affiliation(s)
- Li Ge
- Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.,Nursing College of Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Kerstin Wikby
- Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
| | - Mikael Rask
- Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
| |
Collapse
|