ORCID Profile
0000-0002-0075-828X
Current Organisation
Deakin University Geelong - Waterfront Campus
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: Cambridge University Press (CUP)
Date: 17-07-2022
DOI: 10.1017/S0033291720002251
Abstract: Over the past 15 years, there has been substantial growth in web-based psychological interventions. We summarize evidence regarding the efficacy of web-based self-directed psychological interventions on depressive, anxiety and distress symptoms in people living with a chronic health condition. We searched Medline, PsycINFO, CINAHL, EMBASE databases and Cochrane Database from 1990 to 1 May 2019. English language papers of randomized controlled trials (usual care or waitlist control) of web-based psychological interventions with a primary or secondary aim to reduce anxiety, depression or distress in adults with a chronic health condition were eligible. Results were assessed using narrative synthases and random-effects meta-analyses. In total 70 eligible studies across 17 health conditions [most commonly: cancer ( k = 20), chronic pain ( k = 9), arthritis ( k = 6) and multiple sclerosis ( k = 5), diabetes ( k = 4), fibromyalgia ( k = 4)] were identified. Interventions were based on CBT principles in 46 (66%) studies and 42 (60%) included a facilitator. When combining all chronic health conditions, web-based interventions were more efficacious than control conditions in reducing symptoms of depression g = 0.30 (95% CI 0.22–0.39), anxiety g = 0.19 (95% CI 0.12–0.27), and distress g = 0.36 (95% CI 0.23–0.49). Evidence regarding effectiveness for specific chronic health conditions was inconsistent. While self-guided online psychological interventions may help to reduce symptoms of anxiety, depression and distress in people with chronic health conditions in general, it is unclear if these interventions are effective for specific health conditions. More high-quality evidence is needed before definite conclusions can be made.
Publisher: Wiley
Date: 05-02-2019
DOI: 10.1111/DME.14199
Abstract: Optimal diabetes management requires daily selfmanagement. While little time is spent with health professionals, they can have a substantial impact on how a person manages and feels about living with diabetes. The aim of this qualitative study was to explore what people with diabetes wish their health professionals understood about living with diabetes. Thematic analysis was conducted of responses to a single open‐ended question, ‘What do you wish your health professional understood about living with diabetes?’, which was part of the Diabetes MILES‐2 survey, assessing the psychological and behavioural aspects of living with type 1 or type 2 diabetes in Australian adults. In total, 1316 responses (56% response rate) were collected, with 1190 responses included for analysis (54% from respondents with type 1 diabetes, 46% from those with type 2 diabetes). Seven major themes emerged respondents wished their health professional understood: 1) the potential barriers to diabetes management 2) that it is ‘easier said than done’ 3) the social/emotional impact 4) that they want, need and deserve more 5) that judgements, assumptions and negative perspective are not helpful 6) more about diabetes and 7) that the respondent is the expert in his/her diabetes. Other comments suggested satisfactory experiences with health professionals, highlighting that some respondents had no wish for their health professional to understand more. This study highlights that, although some adults with diabetes are satisfied with their health professionals’ understanding of living with diabetes, many report unmet needs and perceive a lack of person‐centred care from their health professionals.
Publisher: Wiley
Date: 16-01-2022
DOI: 10.1111/DME.14772
Abstract: Women with prior gestational diabetes have nearly 10 times the risk of developing type 2 diabetes. Postpartum screening for type 2 diabetes is recommended for early diagnosis and management, yet uptake is low. This work updates a previous systematic review and advances it through the application of the Theoretical Domains Framework (TDF) to synthesise personal‐level factors impacting type 2 diabetes screening and the Capability, Opportunity, Motivation‐Behaviour model (COM‐B), to develop messaging recommendations for use in clinical practice and screening promotion interventions. We searched seven academic databases from September 2017 (prior review) to April 2021, reference lists and grey literature. Two reviewers independently screened articles against inclusion criteria (qualitative studies exploring factors impacting postpartum diabetes screening, any language) and extracted data. Using an inductive‐deductive model, we coded determinants to the TDF and mapped onto the COM‐B model. We identified 38 eligible papers from 34 studies ( N = 1291 participants). Most (71%) reported s le sizes of N ≥ 16. The ratio of barriers to enablers was three to one. Eight key TDF domains were identified. Evidence‐based recommendations include addressing knowledge, risk perception, fear of diabetes diagnosis, low prioritisation of personal health and fatalism. The risk of bias was low and confidence in findings was moderate to high. A limitation was conceptual overlap between TDF domains, which we addressed via the study procedure. The theoretical categorisation of determinants enables the development of messaging and interventions at the personal level, to promote women's uptake of postpartum type 2 diabetes screening.
Publisher: Elsevier BV
Date: 08-2020
Publisher: Wiley
Date: 04-02-2020
DOI: 10.1111/DME.14196
Abstract: Over the past 25 years, there has been significant acknowledgement of the importance of assessing the impact of diabetes on quality of life. Yet, despite the development of several diabetes-specific quality of life measures, the challenges we faced in 1995 remain. There is little consensus on the definition of quality of life because of the complexity and subjectivity of the concept. General quality of life comprises several domains of life, and these are highly in idualized. Assessing the impact of diabetes on these life domains adds to the complexity. While comprehensive diabetes-specific quality-of-life measures typically increase respondent burden, brief questionnaires may not capture all relevant/important domains. Today, the lack of resolution of these challenges may explain why the impact of diabetes on quality of life is not systematically assessed in research or clinical care. Few researchers report detailed rationales for assessment, there is often a mismatch between the concept of interest and the measure selected, and data are misinterpreted as assessing the impact of diabetes on quality of life when, in reality, related but distinct constructs have been assessed, such as diabetes distress, treatment satisfaction or health status. While significant efforts are being made to increase routine monitoring of psychological well-being and understand the lived experience, no guidelines currently recommend routine clinical assessment of diabetes-specific quality of life, and there is no consensus on which questionnaire(s) to use. The gaps identified in this review need urgent attention, starting with recognition that assessment of diabetes-specific quality of life is as important as biomedical markers, if we are to improve the lives of people with diabetes.
Publisher: Springer Science and Business Media LLC
Date: 23-03-2022
Publisher: Wiley
Date: 26-09-2022
DOI: 10.1111/DME.14944
Abstract: To explore the association between the use of glycaemic technologies and person‐reported outcomes (PROs) in adults with type 1 diabetes (T1D). We included T1D and technology publications reporting on PROs since 2014. Only randomised controlled trials and cohort studies that used validated PRO measures (PROMs) were considered. T1D studies reported on a broad range of validated PROMs, mainly as secondary outcome measures. Most studies examined continuous glucose monitoring (CGM), intermittently scanned CGM (isCGM), and the role of continuous subcutaneous insulin infusion (CSII), including sensor‐augmented CSII and closed loop systems. Generally, studies demonstrated a positive impact of technology on hypoglycaemia‐specific and diabetes‐specific PROs, including reduced fear of hypoglycaemia and diabetes distress, and greater satisfaction with diabetes treatment. In contrast, generic PROMs (including measures of health/functional status, emotional well‐being, depressive symptoms, and sleep quality) were less likely to demonstrate improvements associated with the use of glycaemic technologies. Several studies showed contradictory findings, which may relate to study design, population and length of follow‐up. Differences in PRO findings were apparent between randomised controlled trials and cohort studies, which may be due to different populations studied and/or disparity between trial and real‐world conditions. PROs are usually assessed as secondary outcomes in glycaemic technology studies. Hypoglycaemia‐specific and diabetes‐specific, but not generic, PROs show the benefits of glycaemic technologies, and deserve a more central role in future studies as well as routine clinical care.
Publisher: JMIR Publications Inc.
Date: 23-02-2020
DOI: 10.2196/15007
Abstract: Health professionals have expressed unmet needs, including lacking the skills, confidence, training, and resources needed to properly attend to the psychological needs of people with diabetes. Informed by needs assessments, this study aimed to develop practical, evidence-based resources to support health professionals to address the emotional needs of adults with type 1 or type 2 diabetes. We developed a new handbook and toolkit informed by formative evaluation, including literature reviews, stakeholder consultation and review, and a qualitative study. In the qualitative study, health professionals participated in interviews after reading sections of the handbook and toolkit. The literature review uncovered that psychological problems are common among adults with diabetes, but health professionals lack resources to provide related support. We planned and drafted resources to fill this unmet need, guided by stakeholder consultation and an Expert Reference Group (ERG). Before finalizing the resources, we implemented feedback received from stakeholders (ERG, health professionals, academics, and people with diabetes). The resulting resources were the practical, evidence-based Diabetes and Emotional Health handbook and toolkit. A total of 19 health professionals took part in the qualitative study about the handbook and toolkit. They viewed the resources favorably, felt empowered to support people with diabetes experiencing psychological problems, and felt motivated to share the resources with others. Some gave ex les of how they had used the handbook in clinical practice. A perceived highlight was the inclusion of a process model outlining 7 steps for identifying and supporting people with emotional problems: the 7 A’s model. With funding from the National Diabetes Services Scheme (NDSS), more than 2400 copies of Diabetes and Emotional Health have been distributed. It is freely available on the Web. The NDSS is an initiative of the Australian Government administered with the assistance of Diabetes Australia. The new evidence-based resources are perceived by stakeholders as effective aids to assist health professionals in providing emotional support to adults with diabetes. The 7 A’s model may have clinical utility for routine monitoring of other psychological and health-related problems, as part of person-centered clinical care.
Publisher: Wiley
Date: 08-09-2022
DOI: 10.1111/DME.14945
Abstract: Racial and ethnic disparities exist in gestational diabetes prevalence and risk of subsequent type 2 diabetes mellitus (T2DM). Postpartum engagement in healthy behaviours is recommended for prevention and early detection of T2DM, yet uptake is low among women from erse cultural backgrounds. Greater understanding of factors impacting postpartum health behaviours is needed. Applying the Theoretical Domains Framework (TDF) and Capability , Opportunity , Motivation‐Behaviour (COM‐B) model, our aim was to synthesise barriers to and enablers of postpartum health behaviours among women from erse cultural backgrounds with prior GDM and identify relevant intervention components. Databases, reference lists and grey literature were searched from September 2017 to April 2021. Two reviewers screened articles independently against inclusion criteria and extracted data. Using an inductive–deductive model, themes were mapped to the TDF and COM‐B model. After screening 5148 citations and 139 full texts, we included 35 studies ( N = 787 participants). The main ethnicities included Asian (43%), Indigenous (15%) and African (11%). Barriers and enablers focused on Capability (e.g. knowledge), Opportunity (e.g. competing demands, social support from family, friends and healthcare professionals, culturally appropriate education and resources) and Motivation (e.g. negative emotions, perceived consequences and necessity of health behaviours, social/cultural identity). Five relevant intervention functions are identified to link the barriers and enablers to evidence‐based recommendations for communications to support behaviour change. We provide a conceptual model to inform recommendations regarding the development of messaging and interventions to support women from erse cultural backgrounds in engaging in healthy behaviours to reduce risk of T2DM.
Publisher: Wiley
Date: 27-10-2021
DOI: 10.1111/DME.14727
Abstract: Hypoglycaemic episodes and fear of hypoglycaemia can be burdensome for adults with type 1 diabetes. This study explored support needs relating to hypoglycaemia among adults with type 1 diabetes living in Denmark, Germany, the Netherlands and the United Kingdom. Respondents participated in a web‐based qualitative study involving four open‐ended questions that asked what they wished other people understood about hypoglycaemia and what other people could do differently to support them with hypoglycaemia. Responses were analyzed using reflexive thematic analysis. Participants were 219 adults with type 1 diabetes (mean ± SD age 39 ± 13 years mean ± SD diabetes duration 20 ± 14 years). They described unmet needs relating to: (1) Clinical support , involving access to new diabetes technologies, training on hypoglycaemia prevention, personalised care and psychological support (2) Practical support , involving family and friends better supporting them with hypoglycaemia management and prevention (3) Education for other people , involving others becoming more informed about hypoglycaemia and (4) An appreciation of the burden , involving others recognizing the experience and impact of episodes, and the burden of living with the risk of hypoglycaemia. Adults with type 1 diabetes report several unmet support needs relating to hypoglycaemia. Service delivery should be person‐centred and prioritise the in idual's support needs. Clinical conversations are needed to identify the in idual's support needs and develop tailored support plans. People with diabetes and their family members should be offered hypoglycaemia‐specific education and training.
Publisher: BMJ
Date: 08-2021
DOI: 10.1136/BMJDRC-2021-002322
Abstract: Achieving glycemic targets and optimizing quality of life (QoL) are important goals of type 1 diabetes care. Hypoglycemia is a common barrier to achieving targets and can be associated with significant distress. However, the impact of hypoglycemia on QoL is not fully understood. The aim of this study was to explore how adults with type 1 diabetes are impacted by hypoglycemia in areas of life that are important to their overall QoL. Participants responded to a web-based qualitative survey involving a novel ‘Wheel of Life’ activity. Responses were analyzed using reflexive thematic analysis. The final s le included 219 adults with type 1 diabetes from Denmark, Germany, the Netherlands, and the UK. They had a mean±SD age of 39±13 years and diabetes duration of 20±14 years. Participants identified eight areas of life important to their overall QoL, including relationships and social life, work and studies, leisure and physical activity, everyday life, sleep, sex life, physical health, and mental health. Participants reported emotional, behavioral, cognitive, and social impacts of hypoglycemia within domains. Across domains, participants described interruptions, limited participation in activities, exhaustion, fear of hypoglycemia, compensatory strategies to prevent hypoglycemia, and reduced spontaneity. The findings emphasize the profound impact of hypoglycemia on QoL and diabetes self-care behaviors. Diabetes services should be aware of and address the burden of hypoglycemia to provide person-centered care. Clinicians could ask in iduals how hypoglycemia affects important areas of their lives to better understand the personal impact and develop tailored management plans.
Publisher: Wiley
Date: 06-08-2021
DOI: 10.1111/DME.14666
Abstract: To summarize and critically appraise the recent qualitative evidence regarding the impact of hypoglycaemia on the quality of life of family members of adults with type 1 or type 2 diabetes. Four databases were searched systematically (MEDLINE, PsycINFO, CINAHL and Cochrane Library), and results were screened for eligibility. Article quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research. Data were extracted, coded and analysed using thematic analysis. The systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) and Enhancing transparency in reporting of qualitative research (ENTREQ) guidelines. Eight qualitative studies were included in the final review. The majority of participants were partners or spouses of adults with type 1 diabetes. Thematic synthesis resulted in six analytical themes: ‘Hypoglycaemia alters everyday life, reducing freedoms and increasing disruptions’, ‘Hypoglycaemia has an adverse impact on sleep’, ‘Hypoglycaemia negatively changes the relationship with the person with diabetes’, ‘Hypoglycaemia negatively impacts emotional well‐being’, ‘The detection, prevention, and treatment of hypoglycaemia consumes time and energy’ and ‘Family members have unmet needs for informational and emotional support regarding hypoglycaemia’. Across the six analytical themes, family members described how hypoglycaemia has a severe negative impact on different aspects of their lives, including daily living, personal relationships and emotional well‐being. Family members experience the impact of hypoglycaemia as a major recurrent challenge in their lives. The unmet needs of family members need further attention in research and clinical practice.
Publisher: Wiley
Date: 27-12-2019
DOI: 10.1111/DME.14205
Abstract: Almost 100 years since the discovery of insulin, hypoglycaemia remains a barrier for people with type 1 diabetes to achieve and maintain blood glucose at levels which prevent long-term diabetes-related complications. Although hypoglycaemia is primarily attributable to the limitations of current treatment and defective hormonal counter-regulation in type 1 diabetes, the central role of psycho-behavioural factors in preventing, recognizing and treating hypoglycaemia has been acknowledged since the early 1980s. Over the past 25 years, as documented in the present review, there has been a substantial increase in psycho-behavioural research focused on understanding the experience and impact of hypoglycaemia. The significant contributions have been in understanding the impact of hypoglycaemia on a person's emotional well-being and aspects of life (e.g. sleep, driving, work/social life), identifying modifiable psychological and behavioural risk factors, as well as in developing psycho-behavioural interventions to prevent and better manage (severe) hypoglycaemia. The impact of hypoglycaemia on family members has also been confirmed. Structured diabetes education programmes and psycho-behavioural interventions with a focus on hypoglycaemia have both been shown to be effective in addressing problematic hypoglycaemia. However, the findings have also revealed the complexity of the problem and the need for a personalized approach, taking into account the in idual's knowledge of, and emotional/behavioural reactions to hypoglycaemia. Evidence is emerging that people with persistent and recurrent severe hypoglycaemia, characterized by deeply entrenched cognitions and lack of concern around hypoglycaemia, can benefit from tailored cognitive behavioural therapy.
Publisher: Wiley
Date: 05-02-2021
DOI: 10.1111/DME.14524
Abstract: To compare the acceptability, reliability and validity of five contemporary diabetes‐specific quality of life (QoL) scales among adults with type 1 diabetes in the United Kingdom and Australia. Adults with type 1 diabetes (UK = 1139, Australia = 439) completed a cross‐sectional, online survey including ADDQoL‐19, DCP, DIDP, DSQOLS and Diabetes QoL‐Q, presented in randomised order. After completing each scale, participants rated it for clarity, relevance, ease of completion, length and comprehensiveness. We examined scale acceptability (scale completion and user ratings), response patterns, structure (exploratory and confirmatory factor analyses) and validity (convergent, concurrent, ergent and known groups). To assess cross‐country reproducibility, analyses conducted on the UK dataset were replicated in the Australian dataset. Findings were largely consistent between countries. All scales were acceptable to participants: ≥90% completing all items, and ≥80% positive user ratings, except for DSQOLS’ length. Scale structure was not supported for the DCP. Overall, in terms of acceptability and psychometric evaluation, the DIDP was the strongest performing scale while the ADDQoL‐19 and Diabetes QoL‐Q scales also performed well. These findings suggest that the recently developed brief (7 items), neutrally worded DIDP scale is acceptable to adults with type 1 diabetes and has the strongest psychometric performance. However, questionnaire selection should always be considered in the context of the research aims, study design and population, as well as the wider published evidence regarding both the development and responsiveness of the scales.
Publisher: BMJ
Date: 02-2022
DOI: 10.1136/BMJOPEN-2021-051651
Abstract: Hypoglycaemia is a frequent adverse event and major barrier for achieving optimal blood glucose levels in people with type 1 or type 2 diabetes using insulin. The Hypo-RESOLVE (Hypoglycaemia—Redefining SOLutions for better liVEs) consortium aims to further our understanding of the day-to-day impact of hypoglycaemia. The Hypo-METRICS (Hypoglycaemia—MEasurement, ThResholds and ImpaCtS) application (app) is a novel app for smartphones. This app is developed as part of the Hypo-RESOLVE project, using ecological momentary assessment methods that will minimise recall bias and allow for robust investigation of the day-to-day impact of hypoglycaemia. In this paper, the development and planned psychometric analyses of the app are described. The three phases of development of the Hypo-METRICS app are: (1) establish a working group—comprising diabetologists, psychologists and people with diabetes—to define the problem and identify relevant areas of daily functioning (2) develop app items, with user-testing, and implement into the app platform and (3) plan a large-scale, multicountry study including interviews with users and psychometric validation. The app includes 7 modules (29 unique items) assessing: self-report of hypoglycaemic episodes (during the day and night, respectively), sleep quality, well-being/cognitive function, social interactions, fear of hypoglycaemia/hyperglycaemia and work roductivity. The app is designed for use within three fixed time intervals per day (morning, afternoon and evening). The first version was released mid-2020 for use (in conjunction with continuous glucose monitoring and activity tracking) in the Hypo-METRICS study an international observational longitudinal study. As part of this study, semistructured user-experience interviews and psychometric analyses will be conducted. Use of the novel Hypo-METRICS app in a multicountry clinical study has received ethical approval in each of the five countries involved (Oxford B Research Ethics Committee, CMO Region Arnhem-Nijmegen, Ethikkommission der Medizinischen Universität Graz, Videnskabsetisk Komite for Region Hovedstaden and the Comite Die Protection Des Personnes SUD Mediterranne IV). The results from the study will be published in peer review journals and presented at national and international conferences. NCT04304963 .
Publisher: Wiley
Date: 07-10-2021
DOI: 10.1111/DME.14706
Abstract: To conduct a systematic review of published studies reporting on the longitudinal impacts of hypoglycaemia on quality of life (QoL) in adults with type 2 diabetes. Database searches with no restrictions by language or date were conducted in MEDLINE, Cochrane Library, CINAHL and PsycINFO. Studies were included for review if they used a longitudinal design (e.g. cohort studies, randomised controlled trials) and reported on the association between hypoglycaemia and changes over time in patient‐reported outcomes related to QoL. In all, 20 longitudinal studies published between 1998 and 2020, representing 50,429 adults with type 2 diabetes, were selected for review. A descriptive synthesis following Synthesis Without Meta‐analysis guidelines indicated that self‐treated symptomatic hypoglycaemia was followed by impairments in daily functioning along with elevated symptoms of generalised anxiety, diabetes distress and fear of hypoglycaemia. Severe hypoglycaemic events were associated with reduced confidence in diabetes self‐management and lower ratings of perceived health over time. Frequent hypoglycaemia was followed by reduced energy levels and diminished emotional well‐being. There was insufficient evidence, however, to conclude that hypoglycaemia impacted sleep quality, depressive symptoms, general mood, social support or overall diabetes‐specific QoL. Longitudinal evidence in this review suggests hypoglycaemia is a common occurrence among adults with type 2 diabetes that impacts key facets in the physical and psychological domains of QoL. Nonetheless, additional longitudinal research is needed—in particular, studies targeting erse forms of hypoglycaemia, more varied facets of QoL and outcomes assessed using hypoglycaemia‐specific measures.
Publisher: Wiley
Date: 07-10-2022
DOI: 10.1111/DME.14708
Abstract: An emerging group of people with type 1 diabetes are not waiting for commercial solutions, choosing to manage their condition with open‐source artificial pancreas systems (APS). Our aim was to explore their perspectives on the future of APS. Semi‐structured telephone interviews were conducted (in Australia, October 2018 to January 2019) with 23 adults with type 1 diabetes currently using open‐source APS. Interviews were recorded, transcribed and analysed thematically. Participants described five key features of open‐source APS they value: compatibility, user‐led design, customisability, ability to evolve faster and community‐driven. They attributed the success of the open‐source APS movement to benefits they derive from these features: choice, solutions that meet their needs, ownership, staying one step ahead and real‐time support. They expressed hope that future commercial products and healthcare would benefit from their learnings and from collaboration with the open‐source APS community. Participants believed that there will always be a place for the open‐source community. It will continue to build on and advance commercial products, respond to user needs, offering a higher degree of control and customisation than afforded by commercial products and generating optimism for the future. Participants desired that future commercial diabetes technologies would be inspired by the open‐source community and developed collaboratively with people with diabetes.
Publisher: Wiley
Date: 23-06-2023
DOI: 10.1111/JOCN.16806
Abstract: Unmet supportive care needs (SCN) refer to perceived gaps in the support parents want to manage caregiving activities for children with chronic health conditions (CHC) and the support received. This review aims to systematically identify the unmet SCN of families with children living with five common paediatric CHC and characterise the assessment tools used to measure SCN. Systematic review methodology with narrative synthesis of data. Reporting followed the PRISMA statement guidelines. Literature searches were conducted in electronic databases Medline complete, PsycINFO, CINHAL and EMBASE to retrieve relevant articles published between 1990 and July 2022. Eligible studies involved (i) children aged 0–18 years diagnosed with either of cancer, congenital heart disease (CHD), diabetes, asthma, renal disease and (ii) assessment of unmet SCN. Studies involving children with genetic or developmental conditions were excluded. The methodological quality of studies was assessed using JBI assessment tool. Of 6223 articles screened, 34 papers were included (25 quantitative, 5 qualitative and 4 mixed design). Most papers explored unmet needs of families with cancer ( n = 26). The remaining articles concerned CHD ( n = 5), asthma ( n = 2) and mixed CHC ( n = 1, renal failure, and diabetes). Information (e.g. treatment, lifestyle, etc.) and health care (e.g. emotional support, practical services, etc.) were the most common unmet need domains across health conditions. A variety of methods and need assessments h ered comparisons between studies both across and within CHC. Irrespective of illness, addressing unmet informational or health care needs may help to optimise outcomes and care for children and families living with common CHC. There was considerable variation in reporting styles, study design and need assessments both within and across conditions. Health care professionals must routinely evaluate the type, quality and quantity of psychoeducation and support that families of children with CHC want and receive. Providing nurses with more effective strategies to assess child and family needs across a broad range of domains may help to increase understanding of where further support for families is required. There was no patient or public contribution to this study as it involved a systematic review of existing literature.
Publisher: Wiley
Date: 23-08-2023
DOI: 10.1111/DME.15195
Abstract: To examine the psychometric properties of the Diabetes Management Experiences Questionnaire (DME‐Q). Adapted from the validated Glucose Monitoring Experiences Questionnaire, the DME‐Q captures satisfaction with diabetes management irrespective of treatment modalities. The DME‐Q was completed by adults with type 1 diabetes as part of a randomized controlled trial comparing hybrid closed loop (HCL) to standard therapy. Most psychometric properties were examined with pre‐randomization data ( n = 149) responsiveness was examined using baseline and 26‐week follow‐up data ( n = 120). Pre‐randomization, participants' mean age was 44 ± 12 years, 52% were women. HbA1c was 61 ± 11 mmol/mol (7.8 ± 1.0%), diabetes duration was 24 ± 12 years and 47% used an insulin pump prior to the trial. A forced three‐factor analysis revealed three expected domains, that is, ‘Convenience’, ‘Effectiveness’ and ‘Intrusiveness’, and a forced one‐factor solution was also satisfactory. Internal consistency reliability was strong for the three subscales ( range = 0.74–0.84) and ‘Total satisfaction’ = 0.85). Convergent validity was demonstrated with moderate correlations between DME‐Q ‘Total satisfaction’ and diabetes distress (PAID: r s = −0.57) and treatment satisfaction (DTSQ r s = 0.58). Divergent validity was demonstrated with a weak correlation with prospective/retrospective memory (PRMQ: r s = −0.16 and − 0.13 respectively). Responsiveness was demonstrated, as participants randomized to HCL had higher ‘Effectiveness’ and ‘Total satisfaction’ scores than those randomized to standard therapy. The 22‐item DME‐Q is a brief, acceptable, reliable measure with satisfactory structural and construct validity, which is responsive to intervention. The DME‐Q is likely to be useful for evaluation of new pharmaceutical agents and technologies in research and clinical settings.
Publisher: JMIR Publications Inc.
Date: 29-09-2023
DOI: 10.2196/42100
Publisher: Wiley
Date: 27-02-2018
DOI: 10.1111/DME.13594
Publisher: Elsevier BV
Date: 10-2017
DOI: 10.1016/J.DIABRES.2017.07.005
Abstract: Screening for depression is recommended internationally. The World Health Organization's 5-item Well-being Index (WHO-5) is used clinically to screen for depression but its empirical suitability for this purpose is not well documented. We investigated the psychometric properties of the WHO-5 and its suitability for identifying likely depression in Australian adults with diabetes. The Diabetes MILES - Australia study dataset provided a s le of N=3249 who completed the WHO-5 (positively-worded 5-item measure of emotional well-being) and the PHQ-9 (9-item measure of depressive symptoms). Analyses were conducted for the full s le, and separately by diabetes type and treatment (type 1, non-insulin-treated type 2, and insulin-treated type 2 diabetes). Construct (convergent and factorial) validity and reliability of the WHO-5 were examined. ROC analyses were used to examine the sensitivity and specificity of the WHO-5 as a depression screening instrument, comparing two commonly used WHO-5 cut-off values (≤7 and <13) with the PHQ-9. For the whole s le, the WHO-5 demonstrated satisfactory internal consistency reliability (α=0.90) and convergent validity with the PHQ-9 (r=-0.73, p<0.001). Confirmatory factor analysis partially supported factorial validity: Χ These findings support use of a WHO-5 cut-point of <13 to identify likely depression in Australian adults with diabetes, regardless of type/treatment.
Publisher: Wiley
Date: 04-08-2019
DOI: 10.1111/DME.14067
Abstract: Hypoglycaemia affects many people with Type 2 diabetes using insulin and other glucose-lowering therapies. This systematic review examined the impact of severe hypoglycaemia (episodes requiring external assistance) on psychological outcomes (e.g. emotional well-being, health status and quality of life) in adults with Type 2 diabetes. MEDLINE Complete, PsycINFO and CINAHL databases were searched for peer-reviewed empirical studies, published in English, reporting the occurrence and severity of hypoglycaemia and its relationship with patient-reported outcomes (PROs) in adults with Type 2 diabetes. Data were extracted from published reports and analysed. Of 3756 potentially relevant abstracts, 29 studies met the inclusion criteria. Most reported cross-sectional data and s le sizes varied widely (N = 71 to 17 563). Although definitions of mild and severe hypoglycaemia were largely consistent between studies, additional non-standard categorizations (e.g. moderate, very severe) were apparent and recall periods varied. Overall, severe hypoglycaemia was associated with increased fear of hypoglycaemia and decreased emotional well-being, health status and diabetes-specific quality of life. Effect sizes show that the association with fear of hypoglycaemia was stronger than with general health status. Notwithstanding the limitations of the empirical studies, these findings indicate that severe hypoglycaemia in adults with Type 2 diabetes (insulin- and non-insulin-treated) is associated with impaired psychological outcomes. Healthcare professionals should address the psychological impact of severe hypoglycaemia during clinical consultations, to support in iduals to minimize exposure to, and the psychological consequences of, severe hypoglycaemia.
Publisher: Springer Science and Business Media LLC
Date: 29-05-2023
DOI: 10.1007/S12519-023-00730-W
Abstract: The aim of this study was to identify similarities and differences in the unmet supportive care needs (USCN) of families of children with major chronic health conditions (CHCs) using a universal need assessment tool. A cross-sectional online survey involving parents of children with congenital heart disease (CHD), type 1 diabetes mellitus (T1D), cancer, and asthma diagnosed within the last 5 years recruited via social media and support organizations. Thirty-four items assessing the USCN across six domains (care needs, physical and social needs, informational needs, support needs, financial needs, child-related emotional needs) were responded to on a 4-point Likert scale [no need (1) to high need (4)]. Descriptive statistics identified the level of need, and linear regressions identified factors associated with higher need domain scores. Due to small numbers, the asthma group was excluded from comparisons across CHCs. One hundred and ninety-four parents completed the survey (CHD: n = 97, T1D: n = 50, cancer: n = 39, and asthma: n = 8). Parents of children with cancer were most likely to report at least one USCN (92%), followed by parents of children with T1D (62%). The five most commonly reported USCN across CHCs were drawn from four domains: child-related emotional, support, care, and financial. Three need items were included in the top five needs for all conditions. A higher USCN was associated with a greater frequency of hospital visits and the absence of parental support. Using a universal need assessment tool, this is one of the first studies to characterize USCN in families of children diagnosed with common CHCs. While proportions endorsing different needs varied across conditions, the most endorsed needs were similar across the illness groups. This suggests that support programs or services could be shared across different CHCs.
Publisher: Wiley
Date: 12-04-2021
DOI: 10.1111/DME.14565
Abstract: To examine whether frequency, perceived severity and fear of hypoglycaemia are independently associated with diabetes‐specific quality of life in adolescents with type 1 diabetes. Cross‐sectional self‐reported data on demographics, frequency and perceived severity of both self‐treated and severe hypoglycaemia, fear of hypoglycaemia (Hypoglycaemia Fear Survey—Child version) and diabetes‐specific quality of life (Pediatric Quality of Life Diabetes Module PedsQL‐DM) were obtained from the project ‘Whose diabetes is it anyway?’. Hierarchical regression analyses were performed for the total scale and recommended summary scores of the PedsQL‐DM as dependent variables independent variables were entered in the following steps: (1) age, gender and HbA 1c , (2) frequency of hypoglycaemia, (3) perceived severity of hypoglycaemia and (4) fear of hypoglycaemia. Adolescents (12–18 years n = 96) completed questionnaires. In the first three steps, female gender ( p 0.05), higher HbA 1c ( p 0.05), higher frequency of severe hypoglycaemia ( p 0.05) and higher perceived severity of severe ( p 0.05) and self‐treated hypoglycaemia ( p 0.001) were significantly associated with lower diabetes‐specific quality of life ( β ranging from 0.20 to 0.35). However, in the final model only fear of hypoglycaemia was significantly associated with QoL ( p 0.001). Adolescents with greater fear reported lower diabetes‐specific quality of life, with 52% explained variance. This pattern was observed across subdomains of diabetes‐specific quality of life. Fear of hypoglycaemia was the only factor independently associated with diabetes‐specific quality of life, whereas frequency and perceived severity of hypoglycaemia were not. These findings highlight the importance of awareness and assessment of fear of hypoglycaemia in clinical practice.
Publisher: JMIR Publications Inc.
Date: 31-10-2020
Abstract: utomated insulin delivery (AID) systems have been shown to be safe and effective in reducing hyperglycemia and hypoglycemia but are not universally available, accessible, or affordable. Therefore, user-driven open-source AID systems are becoming increasingly popular. his study aims to investigate the motivations for which people with diabetes (types 1, 2, and other) or their caregivers decide to build and use a personalized open-source AID. cross-sectional web-based survey was conducted to assess personal motivations and associated self-reported clinical outcomes. f 897 participants from 35 countries, 80.5% (722) were adults with diabetes and 19.5% (175) were caregivers of children with diabetes. Primary motivations to commence open-source AID included improving glycemic outcomes (476/509 adults, 93.5%, and 95/100 caregivers, 95%), reducing acute (443/508 adults, 87.2%, and 96/100 caregivers, 96%) and long-term (421/505 adults, 83.3%, and 91/100 caregivers, 91%) complication risk, interacting less frequently with diabetes technology (413/509 adults, 81.1% 86/100 caregivers, 86%), improving their or child’s sleep quality (364/508 adults, 71.6%, and 80/100 caregivers, 80%), increasing their or child’s life expectancy (381/507 adults, 75.1%, and 84/100 caregivers, 84%), lack of commercially available AID systems (359/507 adults, 70.8%, and 79/99 caregivers, 80%), and unachieved therapy goals with available therapy options (348/509 adults, 68.4%, and 69/100 caregivers, 69%). Improving their own sleep quality was an almost universal motivator for caregivers (94/100, 94%). Significant improvements, independent of age and gender, were observed in self-reported glycated hemoglobin (HbA sub c /sub ), 7.14% (SD 1.13% 54.5 mmol/mol, SD 12.4) to 6.24% (SD 0.64% 44.7 mmol/mol, SD 7.0 i P /i & .001), and time in range (62.96%, SD 16.18%, to 80.34%, SD 9.41% i P /i & .001). hese results highlight the unmet needs of people with diabetes, provide new insights into the evolving phenomenon of open-source AID technology, and indicate improved clinical outcomes. This study may inform health care professionals and policy makers about the opportunities provided by open-source AID systems. > R2-10.2196/15368
Publisher: Wiley
Date: 02-02-2021
DOI: 10.1111/DME.14521
Abstract: To assess differences in knowledge and beliefs about pregnancy in women with diabetes. Questions were from the Australian ‘ Contraception, Pregnancy & Women's Health’ survey. Women (18–50 years) were eligible if pregnant or planning pregnancy. Knowledge and beliefs items were adapted from the Reproductive Health and Behaviours Questionnaire. Compared to women with type 2 diabetes ( n = 103), women with type 1 diabetes ( n = 526) had higher scores for knowledge about pregnancy in diabetes (type 1 diabetes 9.8 ± 2.4 vs. type 2 diabetes 7.7 ± 3.1), beliefs about benefits (type 1 diabetes 18.4 ± 2.2 vs. type 2 diabetes 17.2 ± 3.3), cues‐to‐action (type 1 diabetes 2.7 ± 1.4 vs. type 2 diabetes 1.5 ± 1.3) and self‐efficacy (type 1 diabetes 22.6 ± 5.5 vs. type 2 diabetes 20.2 ± 6.1 (all p 0.001) regarding preparing for pregnancy. Major knowledge gaps were the need for higher dose folate compared to women without diabetes and uncertainty about breastfeeding recommendations. Women with type 1 diabetes believed more strongly in the benefits of ‘close to target’ glucose levels prior to pregnancy and using contraception to prevent unplanned pregnancy they also felt more confident to access pre‐pregnancy care and to wait for optimal glycaemia before pregnancy. Women with type 2 diabetes were less aware of contraceptive choices, and risks associated with hyperglycaemia before or early in pregnancy. The findings highlighted main gaps in knowledge and beliefs about planning for pregnancy. Especially in type 2 diabetes, there is a need for evidence‐based messaging and strategies addressing these gaps, to raise understanding to prepare for future pregnancies.
Publisher: Wiley
Date: 09-10-2023
DOI: 10.1111/DME.15231
Publisher: Wiley
Date: 08-11-2019
DOI: 10.1111/DME.14165
Publisher: Springer Science and Business Media LLC
Date: 02-02-2021
DOI: 10.1007/S00125-021-05382-X
Abstract: It is generally accepted that hypoglycaemia can negatively impact the quality of life (QoL) of people living with diabetes. However, the suitability of patient-reported outcome measures (PROMs) used to assess this impact is unclear. The aim of this systematic review was to identify PROMs used to assess the impact of hypoglycaemia on QoL and examine their quality and psychometric properties. Systematic searches (MEDLINE, EMBASE, PsycINFO, CINAHL and The Cochrane Library databases) were undertaken to identify published articles reporting on the development or validation of hypoglycaemia-specific PROMs used to assess the impact of hypoglycaemia on QoL (or domains of QoL) in adults with diabetes. A protocol was developed and registered with PROSPERO (registration no. CRD42019125153). Studies were assessed for inclusion at title/abstract stage by one reviewer. Full-text articles were scrutinised where considered relevant or potentially relevant or where doubt existed. Twenty per cent of articles were assessed by a second reviewer. PROMS were evaluated, according to COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines, and data were extracted independently by two reviewers against COSMIN criteria. Assessment of each PROM’s content validity included reviewer ratings ( N = 16) of relevance, comprehensiveness and comprehensibility: by researchers ( n = 6) clinicians ( n = 6) and adults with diabetes ( n = 4). Of the 214 PROMs used to assess the impact of hypoglycaemia on QoL (or domains of QoL), eight hypoglycaemia-specific PROMS were identified and subjected to full evaluation: the Fear of Hypoglycemia 15-item scale the Hypoglycemia Fear Survey the Hypoglycemia Fear Survey version II the Hypoglycemia Fear Survey-II short-form the Hypoglycemic Attitudes and Behavior Scale the Hypoglycemic Confidence Scale the QoLHYPO questionnaire and the Treatment-Related Impact Measure-Non-severe Hypoglycemic Events (TRIM-HYPO) questionnaire. Content validity was rated as ‘inconsistent’, with most as ‘(very) low’ quality, while structural validity was deemed ‘unsatisfactory’ or 'indeterminate'. Other measurement properties (e.g. reliability) varied, and evidence gaps were apparent across all PROMs. None of the identified studies addressed cross-cultural validity or measurement error. Criterion validity and responsiveness were not assessed due to the lack of a ‘gold standard’ measure of the impact of hypoglycaemia on QoL against which to compare the PROMS. None of the hypoglycaemia-specific PROMs identified had sufficient evidence to demonstrate satisfactory validity, reliability and responsiveness. All were limited in terms of content and structural validity, which restricts their utility for assessing the impact of hypoglycaemia on QoL in the clinic or research setting. Further research is needed to address the content validity of existing PROMs, or the development of new PROM(s), for the purpose of assessing the impact of hypoglycaemia on QoL. CRD42019125153
Publisher: American Physical Society (APS)
Date: 15-03-2021
Publisher: Wiley
Date: 09-2021
DOI: 10.1111/DME.14676
Abstract: The prevalence of sexual dysfunctions in people with diabetes is still debated and understudied in women. This study examines the prevalence of sexual dysfunction in men and women with type 1 or type 2 diabetes (T1D or T2D) and the associations with clinical and psychological variables. Adults with diabetes ( n = 756) completed an online survey including questions on sexual functioning (adapted Short Sexual Functional Scale), general emotional well‐being (WHO‐5), symptoms of anxiety (GAD‐7) and diabetes distress (PAID‐20). One third of participants reported a sexual dysfunction. Men reported erectile dysfunction (T1D: 20% T2D: 33%), and orgasmic dysfunction (T1D: 22% T2D: 27%). In men, sexual dysfunction was independently associated with, older age (OR = 1.05, p = 0.022), higher waist circumference (OR = 1.04 p 0.001) and longer duration of diabetes (OR = 1.04 p = 0.007). More men with sexual dysfunction reported diabetes distress (20% vs. 12%, p = 0.026). Women reported decreased desire (T1D: 22% T2D: 15%) and decreased arousal (T1D: 9% T2D: 11%). More women with sexual dysfunction reported diabetes distress (36% vs. 21%, p = 0.003), impaired emotional well‐being (36% vs. 25%, p = 0.036) and anxiety symptoms (20% vs. 11%, p = 0.026). Sexual dysfunctions are common in both men and women with diabetes. In men, sexual dysfunctions were associated with clinical factors. More women with sexual dysfunction reported low emotional well‐being and anxiety symptoms compared to women without sexual dysfunction. For both men and women, sexual dysfunctions were associated with diabetes distress.
Publisher: Wiley
Date: 09-09-2022
DOI: 10.1111/DME.14953
Abstract: To examine the prevalence and health risks of binge eating in people with diabetes. Self‐report data were analysed from a subs le ( n = 582 type 1 diabetes/735 type 2 diabetes) of Diabetes MILES – the Netherlands, an online survey. Prevalence of binge eating was compared across diabetes type and treatment and between participants with and without binges for eating styles, diabetes treatment and outcomes, weight, BMI and psychological comorbidity. Associations between binge eating, HbA 1c , BMI, diabetes distress were assessed using hierarchical linear regression analyses. 23% ( n = 308) of participants reported eating binges, with 16% at least monthly, and 6% at least weekly. Prevalence and frequency of binges did not differ across diabetes type or treatment. People reporting binges scored higher on dietary restraint, emotional and external eating and reported higher weight and BMI than those without binges. Only people with type 1 diabetes and eating binges had a higher HbA 1c . Hierarchical regression analyses demonstrated that binge eating was independently associated with higher HbA 1c ( β = 0.12, p =0.001), BMI ( β = 0.13, p 0.001) but not with diabetes distress. This study found binge eating to be associated with eating styles, BMI and HbA 1c . However, our cross‐sectional data do not allow for conclusions on causality. Future studies could further examine the directions of these associations and their clinical implications.
Publisher: JMIR Publications Inc.
Date: 07-06-2021
DOI: 10.2196/25409
Abstract: Automated insulin delivery (AID) systems have been shown to be safe and effective in reducing hyperglycemia and hypoglycemia but are not universally available, accessible, or affordable. Therefore, user-driven open-source AID systems are becoming increasingly popular. This study aims to investigate the motivations for which people with diabetes (types 1, 2, and other) or their caregivers decide to build and use a personalized open-source AID. A cross-sectional web-based survey was conducted to assess personal motivations and associated self-reported clinical outcomes. Of 897 participants from 35 countries, 80.5% (722) were adults with diabetes and 19.5% (175) were caregivers of children with diabetes. Primary motivations to commence open-source AID included improving glycemic outcomes (476/509 adults, 93.5%, and 95/100 caregivers, 95%), reducing acute (443/508 adults, 87.2%, and 96/100 caregivers, 96%) and long-term (421/505 adults, 83.3%, and 91/100 caregivers, 91%) complication risk, interacting less frequently with diabetes technology (413/509 adults, 81.1% 86/100 caregivers, 86%), improving their or child’s sleep quality (364/508 adults, 71.6%, and 80/100 caregivers, 80%), increasing their or child’s life expectancy (381/507 adults, 75.1%, and 84/100 caregivers, 84%), lack of commercially available AID systems (359/507 adults, 70.8%, and 79/99 caregivers, 80%), and unachieved therapy goals with available therapy options (348/509 adults, 68.4%, and 69/100 caregivers, 69%). Improving their own sleep quality was an almost universal motivator for caregivers (94/100, 94%). Significant improvements, independent of age and gender, were observed in self-reported glycated hemoglobin (HbA1c), 7.14% (SD 1.13% 54.5 mmol/mol, SD 12.4) to 6.24% (SD 0.64% 44.7 mmol/mol, SD 7.0 P .001), and time in range (62.96%, SD 16.18%, to 80.34%, SD 9.41% P .001). These results highlight the unmet needs of people with diabetes, provide new insights into the evolving phenomenon of open-source AID technology, and indicate improved clinical outcomes. This study may inform health care professionals and policy makers about the opportunities provided by open-source AID systems. RR2-10.2196/15368
Publisher: Mary Ann Liebert Inc
Date: 05-2022
Abstract: There is limited evidence supporting the recommendation that drivers with insulin-treated diabetes need to start journeys with glucose >90 mg/dL. Glucose levels of drivers with type 1 diabetes were monitored for 3 weeks using masked continuous glucose monitoring (CGM). Eighteen drivers (median [IQR] age 40 [35, 51] years 11 men) undertook 475 trips (duration 15 [13, 21] min). Hypoglycemia did not occur in any trip starting with glucose >90 mg/dL (92%
Publisher: JMIR Publications Inc.
Date: 23-08-2022
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for christel hendrieckx.