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- Linden, Karolina, 1982, et al.
(författare)
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Person-centred web-based support in pregnancy and early motherhood for women with Type 1 Diabetes Mellitus : a randomized controlled trial
- 2018
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Ingår i: Diabetic Medicine. - : Wiley-Blackwell. - 0742-3071 .- 1464-5491. ; 5:2, s. 232-241
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To report results from and explore use of a multicentre, parallel-group, unblinded, randomized controlled trial testing the effectiveness in terms of well-being and diabetes management of a person-centred, web-based support programme for women with Type 1 diabetes, in pregnancy and postpartum.Methods: Between 2011 and 2014, 174 pregnant women with Type 1 diabetes were randomly allocated (1:1) to web-based support and standard care (intervention group, n=83), or standard care (control group, n=91). The web-based support consisted of evidence-based information; a self-care diary for monitoring of daily activities; and peer support in a discussion forum. The primary outcomes (mean difference, measured at 6 months after childbirth) were well-being and diabetes management.Results: No differences were found with regard to the primary outcome measure scores for general well-being [1.04 (95% CI -1.28 to 3.37); P= 0.68] and self-efficacy of diabetes management [0.076 (95% CI -0.123 to 0.275); P= 0.75], after adjustment for baseline differences in the insulin administration method, nor with regard to the secondary outcome measures.Conclusions: At 6 months after childbirth, the web-based support plus standard care was not superior to standard care in terms of general well-being or self-efficacy of diabetes management. This might be explained by the low number of participants who had a high activity level. Few simultaneously active participants in the web-based programme and stressors in motherhood and diabetes postpartum were the main barriers to its use. Further intervention studies that offer web-based support are needed, with lessons learned from the present study.
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- Linden, Karolina, 1982, et al.
(författare)
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A woman-centered web-support program during pregnancy and early motherhood for women with type 1 diabetes
- 2014
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Ingår i: The International Confederation of Midwives. ICM 30th Triennial Congress. 1-5 June 2014 Prague, Czech Republic.
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Konferensbidrag (refereegranskat)abstract
- Background: Midwives have the responsibility to strengthen normal birth and promote breastfeeding; this challenge also includes women with chronic illness, such as type 1 diabetes. The transition to motherhood in pregnant women with type 1 diabetes is influenced by their constant struggle to achieve normoglycemia and negative feelings such as stress, anxiety and hopelessness are present. Aim: To describe the design of a woman-centered web-support for pregnant women and new mothers with type 1 diabetes. Method: A web-support has been developed using participatory design. A research project management group had the responsibility of steering the project forward. Different stakeholders including, midwifery, medical, nursing and target group expertise participated in the development. The web-support is implemented through a randomized controlled trial. Result: The developed web-support consists of three parts: 1) Specific information about pregnancy, childbirth, and early motherhood in relation to type 1 diabetes, where the challenge is to balance the core values of normal childbearing with diabetes related issues. 2) A self-care diary, including a device for documenting and evaluating blood glucose levels, insulin doses, food intake and physical activities. This enables the woman to keep in control of her own health. 3) A forum for peer support through communication between women and mothers in pregnancy and early motherhood. This enables sharing of similar experiences and of strategies to handle daily life. Clinical relevance: Well-being in terms of joy of childbearing, birth and motherhood could be achieved by addressing diabetes related health risks and complications in a manner that emphasizes the normality of being pregnant, giving birth and breastfeeding. A balancing act between focusing on potential risks and normal pregnancy related processes.
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- Linden, Karolina, 1982, et al.
(författare)
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Study protocol for evaluating a web-support program with a control group for pregnant women and new mothers with type 1 diabetes mellitus.
- 2013
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Ingår i: 7th International DIP Symposium - Diabetes, Hypertension, Metabolic syndrome & Pregnancy. Florence, Italy, March 13-16, 2013.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background In the struggle to achieve normoglycemia during pregnancy, women with type 1 diabetes mellitus (T1D) alternate between mastering their situation and feeling enslaved. Caregivers not only have the responsibility of optimising the women’s biological probability of delivering healthy children, but also of supporting them during their transition to motherhood. In order to establish breastfeeding and simultaneously control blood glucose, the mothers require extended post-partum support. The aim was to describe the study design of an on-going randomized controlled trial evaluating a web-support program for pregnant women and new mothers with T1D. Methods The developed web-based support is being implemented through a randomized controlled trial in which women with T1D in early pregnancy are randomized to either web-based support in addition to usual care (IG) or usual care (CG). A sample size of 160 is required based on the two primary outcomes: a general wellbeing scale (W-BQ12) and a diabetes empowerment scale (SWE-DES) to reach a statistical power of 80% with a significance level of 0.05. Results The web-support consists of evidence-based information, person-centred self-care diaries and an online social community. Outcomes will be measured in early pregnancy (baseline), about five weeks before expected partus and at two and six months after partus. Conclusion The unique contribution of this project is the development of a specially designed web application for mothers with T1D which is expected to increase the women’s personal resources, including knowledge, and thereby strengthen their autonomy during pregnancy, breastfeeding and early motherhood.
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