Juggling type 1 diabetes and pregnancy in rural Australia
- King, Rosemary, Wellard, Sally
- Authors: King, Rosemary , Wellard, Sally
- Date: 2009
- Type: Text , Journal article
- Relation: Midwifery Vol. 25, no. 2 (2009), p. 126-133
- Full Text:
- Reviewed:
- Description: Objective: to explore the experiences of women with type 1 diabetes, living in rural Australia, while preparing for pregnancy and childbirth. Additionally, we aimed to describe the women's engagement with, and expectations of, health-care providers during this period, and subsequently highlight potential service and informational gaps. Design: qualitative research using a collective case-study design; seven women with type 1 diabetes who had given birth within the previous 12 months participated in in-depth interviews about their experiences of pregnancy and birth. Data were analysed thematically. Setting: The experience of type 1 diabetes, preconception preparation and pregnancy among rural Australian women was explored, including interactions with health professionals. Participants: seven women aged between 26 and 35 years agreed to be interviewed. The woman had one or two children and had given birth within the past 12 months. Findings: rigid narrow control of blood glucose levels before conception and during pregnancy created unfamiliar body responses for women, with hypoglycaemic symptoms disappearing or changing. For example, some women mentioned developing tunnel vision or numbness and tingling around their lips and tongue as different symptoms of hypoglycaemia. Women needed information and support to differentiate between what might be normal or abnormal bodily processes associated with pregnancy, diabetes, or both. The women's preparation for conception and pregnancy was reliant on the level of available expertise and advice. Participants' experiences were coloured by their limited access and interactions with expert health professionals. Conclusion: women with type 1 diabetes experienced significant hardship during their pregnancy, including a higher incidence of hypoglycaemic episodes, a loss of hypoglycaemic symptom recognition and weight gain. These difficulties were compounded by a scarcity of available information to support the management of their pregnancy and a lack of availability of experienced health professionals. Implications for practice: national and international consensus guidelines emphasise the importance of preconception and pregnancy care for women with type 1 diabetes. Close clinical supervision and the development of closer co-operation and partnership between the women and health-care providers before conception and during pregnancy may improve outcomes for these women and their babies. Building confidence in professional care requires increased access to specialist services, increased levels of demonstrated knowledge and expertise and better general community access to information about preparation for pregnancy and birth among women who have type 1 diabetes. © 2007 Elsevier Ltd. All rights reserved.
- Authors: King, Rosemary , Wellard, Sally
- Date: 2009
- Type: Text , Journal article
- Relation: Midwifery Vol. 25, no. 2 (2009), p. 126-133
- Full Text:
- Reviewed:
- Description: Objective: to explore the experiences of women with type 1 diabetes, living in rural Australia, while preparing for pregnancy and childbirth. Additionally, we aimed to describe the women's engagement with, and expectations of, health-care providers during this period, and subsequently highlight potential service and informational gaps. Design: qualitative research using a collective case-study design; seven women with type 1 diabetes who had given birth within the previous 12 months participated in in-depth interviews about their experiences of pregnancy and birth. Data were analysed thematically. Setting: The experience of type 1 diabetes, preconception preparation and pregnancy among rural Australian women was explored, including interactions with health professionals. Participants: seven women aged between 26 and 35 years agreed to be interviewed. The woman had one or two children and had given birth within the past 12 months. Findings: rigid narrow control of blood glucose levels before conception and during pregnancy created unfamiliar body responses for women, with hypoglycaemic symptoms disappearing or changing. For example, some women mentioned developing tunnel vision or numbness and tingling around their lips and tongue as different symptoms of hypoglycaemia. Women needed information and support to differentiate between what might be normal or abnormal bodily processes associated with pregnancy, diabetes, or both. The women's preparation for conception and pregnancy was reliant on the level of available expertise and advice. Participants' experiences were coloured by their limited access and interactions with expert health professionals. Conclusion: women with type 1 diabetes experienced significant hardship during their pregnancy, including a higher incidence of hypoglycaemic episodes, a loss of hypoglycaemic symptom recognition and weight gain. These difficulties were compounded by a scarcity of available information to support the management of their pregnancy and a lack of availability of experienced health professionals. Implications for practice: national and international consensus guidelines emphasise the importance of preconception and pregnancy care for women with type 1 diabetes. Close clinical supervision and the development of closer co-operation and partnership between the women and health-care providers before conception and during pregnancy may improve outcomes for these women and their babies. Building confidence in professional care requires increased access to specialist services, increased levels of demonstrated knowledge and expertise and better general community access to information about preparation for pregnancy and birth among women who have type 1 diabetes. © 2007 Elsevier Ltd. All rights reserved.
Perceptions of people with Type 2 diabetes about self-management and the efficacy of community based services
- Wellard, Sally, Rennie, Sheree, King, Rosemary
- Authors: Wellard, Sally , Rennie, Sheree , King, Rosemary
- Date: 2008
- Type: Text , Journal article
- Relation: Contemporary nurse : a journal for the Australian nursing profession Vol. 29, no. 2 (2008), p. 218-226
- Full Text:
- Description: Self-management has become a key strategy for managing the health care of people with diabetes. This study explored issues people with type 2 diabetes experienced in their self-management practices and access to regional community based services. Using a qualitative interpretative design data was collected from four participants who were interviews about their perceptions of facilitators, barriers and issues they encountered in their diabetes care in a regional setting. The findings indicate difficulties participants experienced in gaining access to quality services in regional areas, including long waiting times, difficulties making appointments, and their perception that healthcare professionals fail to acknowledge patients self-management knowledge and practices. Additionally, participants reported food choices affected their family relationships and experience of social stigma. These issues compromised their self-management decisions. The findings support other studies that show a need for health professionals to develop strategies to improve community based services for people with type 2 diabetes and to increase public awareness of the scope of diabetes management.
- Authors: Wellard, Sally , Rennie, Sheree , King, Rosemary
- Date: 2008
- Type: Text , Journal article
- Relation: Contemporary nurse : a journal for the Australian nursing profession Vol. 29, no. 2 (2008), p. 218-226
- Full Text:
- Description: Self-management has become a key strategy for managing the health care of people with diabetes. This study explored issues people with type 2 diabetes experienced in their self-management practices and access to regional community based services. Using a qualitative interpretative design data was collected from four participants who were interviews about their perceptions of facilitators, barriers and issues they encountered in their diabetes care in a regional setting. The findings indicate difficulties participants experienced in gaining access to quality services in regional areas, including long waiting times, difficulties making appointments, and their perception that healthcare professionals fail to acknowledge patients self-management knowledge and practices. Additionally, participants reported food choices affected their family relationships and experience of social stigma. These issues compromised their self-management decisions. The findings support other studies that show a need for health professionals to develop strategies to improve community based services for people with type 2 diabetes and to increase public awareness of the scope of diabetes management.
Regional special care nursery environments : Navigating the role of mother
- Knox, Kate, Wellard, Sally, King, Rosemary
- Authors: Knox, Kate , Wellard, Sally , King, Rosemary
- Date: 2007
- Type: Text , Conference paper
- Relation: Paper presented at 9th National Rural Health Conference, Albury, New South Wales : 7th-10th March 2007
- Full Text:
- Description: Premature birth presents challenges for most mothers assuming a parenting role with their infant. Living in rural and regional areas provides additional hardship due to isolation, distances and limited support services. The predominant focus of research in the area of premature birth has been on the survival of infants. There has been limited investigation of the experiences of women with infants in special care nurseries (SCNs), in regional Australia. The ways in which mothers ‘navigate their way’, physically and emotionally, in SCN environments was the focus of this study. Using a qualitative interpretive design data were collected through in-depth interviews with mothers and analysed thematically. Women related a dislocation in their lives as a result of their infant’s hospitalisation. The nursery space and the various ways space was used to marginalise or sanction mothers was revealed and resulted in women adopting conflicting roles throughout this time. These findings provide direction for developing more supportive environments for parents relying on SCNs for the care of their infant. This study provides new insight into the experiences of women and their environmental sensitivity within SCN settings. Findings will increase regional midwives’ understanding of mothers’ interpretations of the neonatal nursery environment. Insights into maternal perspectives will assist in the provision of better family-centred care and improved outcomes for the vulnerable families of premature infants.
- Description: 2003005864
- Authors: Knox, Kate , Wellard, Sally , King, Rosemary
- Date: 2007
- Type: Text , Conference paper
- Relation: Paper presented at 9th National Rural Health Conference, Albury, New South Wales : 7th-10th March 2007
- Full Text:
- Description: Premature birth presents challenges for most mothers assuming a parenting role with their infant. Living in rural and regional areas provides additional hardship due to isolation, distances and limited support services. The predominant focus of research in the area of premature birth has been on the survival of infants. There has been limited investigation of the experiences of women with infants in special care nurseries (SCNs), in regional Australia. The ways in which mothers ‘navigate their way’, physically and emotionally, in SCN environments was the focus of this study. Using a qualitative interpretive design data were collected through in-depth interviews with mothers and analysed thematically. Women related a dislocation in their lives as a result of their infant’s hospitalisation. The nursery space and the various ways space was used to marginalise or sanction mothers was revealed and resulted in women adopting conflicting roles throughout this time. These findings provide direction for developing more supportive environments for parents relying on SCNs for the care of their infant. This study provides new insight into the experiences of women and their environmental sensitivity within SCN settings. Findings will increase regional midwives’ understanding of mothers’ interpretations of the neonatal nursery environment. Insights into maternal perspectives will assist in the provision of better family-centred care and improved outcomes for the vulnerable families of premature infants.
- Description: 2003005864
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