Search Results (83)

There is little qualitative research on the support needed by workers with type 1 diabetes to effectively self-manage at work and maintain work ability. In this UK study, 21 workers with type 1 diabetes participated in semi-structured interviews. The interviews were transcribed and analysed using interpretive phenomenological analysis and then characterised under the Psychosocial Flags Framework. Findings highlighted several obstacles to maintaining self-management, including systemic workplace issues (black flags), individual attitudes and beliefs (yellow flags), and workplace issues (blue flags). Participants generally lacked confidence in voicing their needs, emphasising a requirement for a more supportive, inclusive workplace culture. This indicates a need for employers to foster an environment where workers with T1D feel comfortable seeking support without penalty. Addressing unhelpful perceptions of T1D seems key to this, making increased knowledge and awareness crucial for the harmonious integration of T1D with work. But delivering effective interventions may be challenging, since they must account for the complex biopsychosocial interplay of obstacles to work ability that this qualitative investigation emphasises. Full article

Background: Parents of children with type 1 diabetes play a key role in managing their child’s self-management, which can be stressful and burdensome. High involvement can lead to reactions such as emotional, cognitive, and physical exhaustion in parents. Understanding parents’ psychosocial impact due to their child’s disease is crucial for the family’s overall well-being. The purpose of this study was to describe stress and burden experienced by parents in families with children living with type 1 diabetes. Methods: This study utilized a qualitative approach, analyzing interviews with 16 parents of children aged 10 to 17 years living with T1D through qualitative content analysis. The data collection occurred between January and February 2025. Results: Managing a child’s Type 1 diabetes can be tough on family relationships, affecting how partners interact, intimacy, and sibling relationships. The constant stress and worry might leave parents feeling exhausted, unable to sleep, and struggling to think clearly, on top of the pain of losing a normal everyday life. The delicate balance between allowing a child with type 1 diabetes to be independent and maintaining control over their self-management renders these challenges even more demanding for the parents. Conclusions: Parents’ experiences highlight the need for robust support systems, including dependable school environments, trustworthy technical devices, reliable family and friends, and accessible healthcare guidance. These elements are essential not only for the child’s health and well-being but also for alleviating the emotional and practical burdens parents face. Full article

Background/Objectives: Type 2 diabetes (T2D) prevalence is rising worldwide. Despite numerous efforts to address the condition, many initiatives fall short due to limited consumer engagement. Involving people with lived experience in healthcare design is increasingly recognized as an effective strategy for improving diabetes management. Aim: To understand the unmet needs of people with T2D in self-managing their condition through the establishment of a Consumer Reference Group (CRG). Methods: The CRG was established using a standardized approach advised by Monash Partners, with specific terms of reference for consumer engagement. A face-to-face training workshop was conducted to develop consumers’ capacity to co-design T2D interventions. Two focus groups were held to explore consumers’ unmet needs and propose potential solutions. An inductive thematic analysis was performed. Results: Ten adults (three females/seven males; 58–78 years old) with T2D participated. Four main themes emerged: (1) misinformation; (2) limited guidance; (3) challenges in self-management; and (4) gaps in prevention and screening. Participants reported difficulties in maintaining motivation, balancing T2D management with other life commitments, and addressing mental health concerns. They reported feeling misinformed and inadequately supported by healthcare professionals and diabetes organizations, often relying on conflicting sources of information. Participants from culturally and linguistically diverse (CALD) backgrounds noted a lack of tailored dietary information. Proposed solutions included better training for primary care providers, reinforcing the role of diabetes nurse educators, expanding mental health support, and collaborating with CALD communities to provide culturally appropriate dietary information. Conclusions: These insights are critical for developing consumer-driven interventions that are responsive to the real-world needs of people living with T2D. Full article

Background/Objectives: Nurse practitioners (NPs) play a pivotal role in delivering medical care, leveraging their specialized training and broader range of authorities than registered nurses, as approved by the Ministry of Health. Since 2009, Israel has expanded NP training to include diverse specialties such as palliative care, geriatrics, diabetes, surgery, and health policy. Introducing a new professional role into the health system is a complex, resource-intensive process that requires collaboration across stakeholders. Globally, NPs are recognized for preventing hospitalizations and achieving improved care outcomes, with high patient satisfaction. However, in Israel, NPs’ perceptions of their role and contributions remain underexplored. This study aims to assess NPs’ role perception, contributions to the health system, and attitudes toward their professional development in palliative and geriatric care. Methods: The mixed-methods study included 26 in-depth interviews with palliative and geriatric NPs and an online survey of 89 NPs (29 in geriatrics and 60 in palliative care). Results: Most NPs are women (84%), Israeli natives (69%), and Jewish (64%). More than half (53%) have 1–4 years of experience as practitioners, and 71% are employed full time. Regarding their work environment, the NPs feel that their supervisors and patients are appreciative of their work and that they are considered professional authorities. The qualitative findings also point to several challenges in their work: (1) The NPs’ status vis-à-vis medical staff and patients is insufficiently established; (2) the NPs lack practical and theoretical learning over time; (3) there is a shortage of positions; and (4) there is a sense of high work and emotional load and difficulty in implementing palliative care within the health system. With regard to their training, 58% of NPs were satisfied with the course, while 71% felt it lacked content. Looking forward, 76% of the NPs believed that over the next five years, the NP role would expand significantly, and 88% would recommend that other nurses become NPs. Conclusions: To maximize NPs’ potential, the study recommends clarifying their role, expanding authorities, aligning training with professional demands, and fostering trust between NPs and the medical establishment. Branding efforts and emotional support for NPs, especially in palliative care, are essential to enhance their integration and effectiveness in the health system. Full article

People who suffer from body integrity dysphoria (BID) feel a strong need to be disabled. The most common desire is for amputation or paralysis. Objectives: This study aims to gather the opinion of experts on which types of disabilities are included in BID, which therapies are useful and whether those affected should be supported in obtaining a disability. Methods: A questionnaire with 62 items and a flow chart were developed and sent to experts who have published work with regard to BID. Participants: 22 experts from 11 countries, mostly with an academic title and with an average age of 48.5 years, responded. Results: As expected, amputations and paralysis were clearly attributed to BID, other disabilities (toothlessness, incontinence, diabetes) received rather uncertain or negative scores. On average, those affected were not classified as mentally or psychiatrically ill. Neurological misconnection was considered the most likely cause. Experts did not think it was helpful to inform the health system or even the police about the desire to be disabled. Almost all experts supported the surgical solution of amputation by doctors. All participants believed that BID patients are aware of the limitations imposed by the desired disability. Finally, a flow chart is presented for diagnosis and therapy. Conclusions: The experts assume that the surgical solution is currently acceptable if it has been proven that the BID-affected person does not suffer from another mental disorder, there is a high level of suffering due to BID, other therapies have not been of any use and it is clear that the quality of life will actually increase as a result of achieving the disability. Full article

Background and Objectives: Three respiratory syncytial virus (RSV) vaccines have been recently made available for older adults. Understanding the principal characteristics of the first vaccine-takers can pave the way for a successful vaccination campaign. The objective of this study was to explore the sociodemographic and clinical characteristics of the first Italian users of an adjuvanted RSV vaccine and their attitudes towards RSV and vaccination. Materials and Methods: This cross-sectional study was conducted in 2024 in Liguria (Italy). Individuals aged ≥60 years with no contraindications to the adjuvanted vaccine RSVPreF3 OA were eligible. Following vaccination, subjects filled in a questionnaire, which comprised items on sociodemographic and clinical characteristics, attitudes towards RSV and RSV vaccination and a vaccination trust indicator (VTI). Results: A total of 453 vaccinees completed the survey. Their mean age was 74.9 ± 8.0 years, and 50.6% were males. Nine of ten (89.2%) individuals had ≥1 co-morbidity, of which cardiovascular conditions (70.4%), respiratory diseases (27.6%) and diabetes (18.5%) were the most common. Uptake of the routine vaccines was high: 91.2% and 98.7% received the 2023/2024 season influenza and ≥2 COVID-19 vaccines, respectively. The most common reasons for the current RSV vaccination were general practitioner advice (43.9%), followed by the willingness to be protected against (20.8%) and feelings of being at risk (16.6%) of RSV. The average VTI score was 91.5%, suggesting high trust in vaccines. More positive attitudes towards RSV vaccination were observed (p < 0.01) among subjects who received more COVID-19 vaccine doses, whose reasons for the current RSV vaccination were the willingness to be protected or to be in good health and the feeling of being at risk for RSV. Conclusions: The first Italian users of the novel RSVPreF3 OA vaccine were represented by high-risk individuals with a comparatively high prevalence of co-morbidities, high uptake of the seasonal respiratory vaccines and high trust in immunization. Full article

Objective: This study aimed to characterize the sociodemographic and clinical profiles of Portuguese patients with type 2 diabetes mellitus (T2DM) and to assess their self-care practices, treatment adherence, motivation, and satisfaction with social support. Methods: A cross-sectional observational study was conducted at an endocrinology unit in northern Portugal from January 2021 to December 2022. The sample included 303 adult patients with T2DM who provided informed consent. Data were collected using a structured questionnaire addressing sociodemographic, clinical, and self-care aspects. Validated scales were used to assess diabetes knowledge, self-care activities, treatment adherence, motivation, and social support. Results: Of the 303 patients enrolled, with a median age of 67 years, 51.2% were female and 68.2% retired. Clinical measures showed a median systolic blood pressure of 135 mmHg, abdominal circumference of 104.6 cm, and BMI of 29.3 kg/m². Self-care practices were suboptimal, with only 25.1% of patients consistently following a healthy diet, and 31% engaged in weekly physical activity. Although treatment adherence was generally high, issues like forgetfulness were reported. Satisfaction with social support varied, with 30% of patients feeling isolated. Conclusions: The study identifies significant gaps in diet and physical activity adherence among T2DM patients. There is a need for targeted educational interventions and enhanced support systems to improve self-care and treatment outcomes. Personalized care strategies addressing educational, motivational, and social support factors are crucial to better managing T2DM and improving patient well-being. Full article

In total, 3274 adults (65.2% females) from six European countries were included in this cross-sectional analysis using data from the baseline assessment of the Feel4Diabetes study. Anthropometric, sociodemographic, dietary and behavioral data were assessed, and the existence of metabolic syndrome (MetS) was recorded. Beverage consumption patterns (BCPs) were derived via principal component analysis. Three BCPs were derived explaining 39.5% of the total variation. BCP1 was labeled as “Alcoholic beverage pattern”, which loaded heavily on high consumption of beer/cider, wine and other spirits; BCP2 was labeled as “High in sugars beverage pattern” that was mainly characterized by high consumption of soft drinks with sugar, juice containing sugar and low consumption of water; and BCP3 was labeled as “Healthy beverage pattern” that was mainly characterized by high consumption of water, tea, fruit juice freshly squeezed or prepacked without sugar and low consumption of soft drinks without sugar. After adjusting for various confounders, BCP2 was positively associated with elevated triglycerides (p = 0.001), elevated blood pressure (p = 0.001) elevated fasting glucose (p = 0.008) and the existence of MetS (p = 0.006), while BCP1 was inversely associated with reduced HDL-C (p = 0.005) and BCP3 was inversely associated with elevated blood pressure (p = 0.047). The establishment of policy actions as well as public health nutritional education can contribute to the promotion of a healthy beverage consumption. Full article

Diabetic retinopathy (DR) remains the leading cause of blindness in the working-age population. Its progression causes gradual damage to corneal nerves, resulting in decreased corneal sensitivity (CS) and disruption of anterior-eye-surface homeostasis, which is clinically manifested by increased ocular discomfort and dry eye disease (DED). This study included 52 DR patients and 52 sex- and age-matched controls. Ocular Surface Disease Index (OSDI) survey, tear film-related parameters, CS, and in vivo corneal confocal microscopy (IVCM) of the subbasal plexus were performed. Furthermore, all patients underwent tear sampling for neurotrophin and cytokine analysis. OSDI scores were greater in DR patients than in controls (p = 0.00020). No differences in the Schirmer test score, noninvasive tear film-break-up time (NIBUT), tear meniscus or interferometry values, bulbar redness, severity of blepharitis or meibomian gland loss were found. In the DR group, both the CS (p < 0.001), and the scotopic pupil diameter (p = 0.00008) decreased. IVCM revealed reduced corneal nerve parameters in DR patients. The stage of DR was positively correlated with the OSDI (Rs = +0.51, 95% CI: + 0.35–+0.64, p < 0.001) and negatively correlated with IVCM corneal nerve parameters and scotopic pupillometry (Rs = −0.26, 95% CI: −0.44–−0.06, p = 0.0097). We found negative correlations between the OSDI and IVCM corneal innervation parameters. The DR group showed lower tear film-brain-derived neurotrophic factor (BDNF) levels (p = 0.0001) and no differences in nerve growth factor (NGF)-β, neurotrophin (NT)-4, vascular endothelial growth factor (VEGF), interleukin (IL)-1β, IL-4, IL-5, IL-6, or IL-12 concentrations. Tumor necrosis factor (TNF)-α, IL-2, IL-8, IL-10, granulocyte macrophage colony-stimulating factor (GM-CSF), and interferon (IFN)-γ levels were decreased among patients with DR. Corneal innervation defects have a direct impact on patients’ subjective feelings. The evolution of DR appears to be associated with corneal nerve alterations, emphasizing the importance of IVCM. Full article

Background: Parents of children with chronic conditions face challenges that go beyond basic care and parenting responsibilities. Parents’ experiences can be influenced by perceived stress, emotional experiences, feelings of helplessness, low sense of self-efficacy, anxiety and depression, reducing their quality of life. It is therefore not surprising that parents of children with chronic illnesses are more likely to experience stress, anxiety and depression than parents of healthy children. A prevalent chronic condition is type 1 diabetes. Methods: Parents (31 with children with type 1 diabetes diagnosis and 71 with children without chronic illness) were recruited to complete the measures of the Brief Symptom Inventory-18 (BSI-18), the Parent Health Locus of Control (PHLOC) and Parenting Sense of Competence (PSOC). Results: Significant differences in depression and internal locus of control were found; there was a positive correlation between internal LOC and efficacy in both samples; furthermore, there was a negative correlation between somatization and satisfaction in the experimental group. Conclusions: The ongoing experiences and challenges faced daily make parents perceive themselves as capable. Active involvement in supporting and managing the needs of child with type 1 diabetes could be a source of empowerment for the parent, contributing to the maintenance of their sense of competence. It is important, therefore, to consider the well-being and perception of the parent at a personal level, regardless of the child’s situation. Full article

Screen time among children in most European countries is notably high and is influenced by various sociodemographic and other factors. Our study aimed to explore the associations between parents’ sociodemographic characteristics, socioeconomic status, body mass index (BMI), physical activity, risk status for type 2 diabetes, and their children’s BMI, physical activity, and screen time. The data were sourced from the 2016 Feel4Diabetes study, involving 12,280 parents and 12,211 children aged 6–9 years (average age 8.21 years) in a cross-sectional study design. We used a logistic regression model to identify potential factors associated with children’s screen time. The results showed that mothers with tertiary education (OR = 0.64; 95%CI = 0.49–0.82; p < 0.001), the middle age group (45–54 years) (OR = 0.81 95%CI = 0.66–0.98; p = 0.033), and families with higher incomes (middle–OR = 0.85; 95%CI = 0.75–0.97; p = 0.014; high–OR = 0.8; 95%CI = 0.69–0.93; p = 0.003) were associated with a decreased chance of children spending more than 2 h/day in front of the screen. In contrast, maternal overweight/obesity (OR = 1.15; 95%CI = 1.03–1.29; p = 0.013) and lower physical activity in children were linked to an increased likelihood of more than 2 h of screen time per day. Our findings suggest that targeted interventions should be developed to mitigate excessive screen time, particularly focusing on low-income families and mothers with low educational levels. Full article

Emerging adulthood is a transitional stage with significant lifestyle changes, making it especially challenging for those living with type 1 diabetes mellitus. This systematic review synthesizes qualitative research to explore how emerging adulthood (18–29 years) influences lifestyle behaviors in individuals with type 1 diabetes mellitus. CINAHL, Cochrane Library, Global Health, Nursing & Allied Health Premium, PsycINFO, PubMed, Scopus, and WOS were searched for original qualitative studies addressing the lifestyle of 18–31-year-olds with type 1 diabetes mellitus, published between January 2010 and March 2021 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Thirty-five studies met the inclusion criteria and their findings were categorized into eight topics (emotions and feelings, nutrition, perceptions, risky behaviors, self-care, sleep, social relationships, and stigma) using meta-aggregation, as outlined in the Joanna Briggs Institute Manual for Evidence Synthesis. The spontaneity characteristic of emerging adulthood can undermine self-care. This is because new environments, schedules, and relationships encountered during this life stage often lead to the neglect of diabetes management, owing to the various social, academic, and occupational demands. This review highlights the necessity of creating health promotion strategies tailored to the unique lifestyle aspects of emerging adults with type 1 diabetes mellitus. Full article

Alexithymia is the inability to describe one’s own feelings and is being increasingly researched. According to contemporary psychodynamic theories, negative emotions cannot be adequately named and externalized, but remain trapped in the body. Recent research shows the connection of alexithymia with numerous somatic diseases. Diabetes mellitus type 2 and obesity represent great challenges in treatment, and the psychological profiles in these diseases are being studied more and more often. Therefore, alexithymia enters the focus of some research as a factor that could play a significant role in these diseases, namely as the one that makes a difference. The aim of this paper is a review of the literature with the purpose of understanding the current knowledge about the interconnection between alexithymia, obesity and type 2 diabetes mellitus. Full article

Promoting diet and physical activity is important for women with recent gestational diabetes mellitus (GDM) and their partners to reduce the risk of future type 2 diabetes (T2D). The study aimed to understand how motivation for changing diet and physical activity behaviors among women with recent GDM and their partners was experienced after participation in the Danish Face-it intervention. Fourteen couples’ interviews were conducted. Data analysis followed a reflexive thematic analysis. Guided by self-determination theory and interdependence theory, we identified four themes affecting couples’ motivation for health behavior change: (1) The need to feel understood after delivery; (2) adjusting health expectations; (3) individual and mutual preferences for health behaviors; and (4) the health threat of future T2D as a cue to action. We found that couples in general perceived the Face-it intervention as useful and motivating. Using couple interviews increased our understanding of how the women and partners influenced each other’s perspectives after a GDM-affected pregnancy and thus how targeting couples as opposed to women alone may motivate health behavior change. Full article

We aimed to determine the prevalence of Demodex spp. and bacterial infection in patients with blepharitis and also to investigate the relationship between culturable microorganisms and Demodex spp. in this study. The study included patients diagnosed with blepharitis (n = 128) and volunteers without ocular problems (n = 113). Eyelash sampling was performed by epilating eight lashes, which were then tested for Demodex spp. using a light microscope. The examination consisted of assessing the patient’s vision with and without ocular correction and tonus in both eyes and a careful examination of the anterior segment of both eyes. Bacterial identification was performed based on morphological, physiological, and biochemical methods. The prevalence of Demodex spp. was 8.0% in patients from the control group and all patients with blepharitis. Isolated forms of Demodex spp. were detected in all infested patients in the control group and in 58% of patients with blepharitis. A total of 35% of patients with blepharitis had from three to nine forms of Demodex spp., and 7% of patients with blepharitis had more than 10 mites in every field of vision. We found a statistically significant relationship between Demodex spp. infestation and the occurrence of eye dryness and sensations of burning and tearing, redness of the conjunctiva, feeling of a foreign body, loss of eyelashes, Meibomian gland dysfunction, and cylindrical dandruff. There were statistically significant relationships between Demodex sp. infestation and the presence of hyperopia, Meibomian cysts, chronic eyelid inflammation, and the use of eyeglasses. There was also a statistically significant relationship between the occurrence of Demodex spp. and seborrheic dermatitis and diabetes mellitus. Culturable microorganisms of the ocular surface were found in 8.7% of participants who were uninfested and in all patients infested with D. folliculorum. We isolated Staphylococcus aureus, Acinetobacter baumannii, Streptococcus pneumoniae, Klebsiella oxytoca, and Bacillus spp. from the conjunctival sac only in patients infested with D. folliculorum. This indicates an increased probability of colonization by pathogenic bacteria in patients with demodicosis. Therefore, patients infested with D. folliculorum should undergo a microbiological examination of conjunctival swabs. Full article