Midwives’views and experiences of providing healthy eating advice to pregnant women:a qualitative content analysis of semi-structured interviews

Objective:To explore midwives’views on how they provide healthy eating education to pregnant women after attending a healthy eating education workshop/webinar.Methods:A qualitative descriptive approach was utilized.Semi-structured interviews were conducted to explore the views and experiences of midwives on providing healthy eating education for pregnant women.A purposive sample of six midwives was interviewed face-to-face,and one was conducted by telephone interview.Data were analyzed through qualitative conventional content analysis.Results:Midwives described their views and experiences of factors that impacted their role in providing healthy eating educa-tion.They identified three categories:perceived role of midwi ves,health literacy,and model of care.Conclusions:Knowledge and confidence of midwives improved after attending the workshop/webinar on healthy eating education.Findings suggested that midwives perceived their role as important in providing nutrition education.However,time and resources were highlighted as challenges when providing healthy eating education for pregnant women.The availability of health literacy and model of care were significant factors in enabling midwives to adequately provide this education.Midwives acknowledged a need for further education in areas of vegan diet,cultural food preferences for ethnic minority groups,and regular updates on national healthy eating guidelines.

Education programs for people living with chronic pain:a scoping review

Objective:The aim of this scoping review was to provide evidence for health practitioners to improve patient education practice for chronic pain management.Methods:A scoping review was guided by Arksey and O’Malley’s(2005)1 five-stage framework,investigated contemporary patient education programs(2007–2018)for chronic pain management in education content,formats of delivery,and tools used for evaluation.Content analysis and description were used for the outcome report.Results:Seven quantitative studies were included.Education content consisted of General information,Cognitive behavior therapy(CBT),Self-management,and Pain neurophysiology(PN).Education delivery formats varied from workbook to workbook,face-toface,online,when given for a group or individual or in a combined way.In total,19 tools were reported for the evaluation of the education programs.Conclusions:There is a variety in the education content and the delivery formats.The majority of programs showed effectiveness in patients’chronic pain management based on their selected evaluation tools.This review showed that patient education programs can be useful in chronic pain management.The effectiveness of patient education programs focuses on the improved patients’physical function and quality of life rather than the cessation of pain only.

Diabetes Self-Care Activities and Glycaemic Control among Adults with Type 2 Diabetes in Sri Lanka: A Cross-Sectional Study

The prevalence of Type 2 Diabetes Mellitus (T2DM) and its complications continue to rise across the globe including Sri Lanka. Diabetes Self-care activities (DSCA) are promising behaviors to reduce complications and to achieve good glycaemic control. There is a lack of data regarding DSCA and its association with glycaemic control among adults with T2DM in Sri Lanka. A descriptive cross-sectional study was conducted among purposively selected adults with T2DM (n = 300) in a teaching hospital, Sri Lanka to determine the association between DSCA and glycaemic control. Apre-tested interviewer-administered questionnaire which includes socio-demographic, diabetes-related information and Summary of Diabetes Self-care activities questionnaire was used to collect data. Data were analyzed by using descriptive statistics and Chi-square test. General diet (Healthy eating plan) (OR = 3.04, 95% CI = 1.04 - 8.88, p = 0.034), Physical activities (OR = 2.26, 95% CI = 1.29 - 3.97, p = 0.004), Medication adherence (OR = 2.87, 95% CI = 1.24 - 6.64, p = 0.011) were significantly associated with HbA1c. Medication adherence was significantly associated with poor fasting blood sugar (FBS) (OR = 1.90, 95% CI = 1.07 - 3.37, p = 0.028). The findings highlight the need for health professionals to implement health education programs on diabetes self-care activities for adults with T2DM to enhance their adherence to DSCA, as well as to maintain glycemic control.

Cognitive Behavior Therapy for Heart Failure Patients with Depression

The purpose of this systematic review was to examine the effectiveness of cognitive behavior therapy (CBT) in minimizing the depressive symptoms and improving quality of life in heart failure (HF) patients with depression. This systematic review was conducted in accordance with the Joanna Briggs Institute methodology for systematic reviews of effectiveness evidence. This review only considered randomized controlled trial, assessing the effectiveness of CBT as a treatment for depression in adults (aged above 18) with HF, compared with usual care, which may include medications. This systematic review includes five RCTs involving 379 HF patients with depression (CBT = 192;Control = 187). Two RCTs compared CBT versus usual care using BDI, and no statistically significant differences were observed in reduction of depression after three months of the intervention (MD ?0.92, 95% CI ?1.89 to ?0.05) (p = 0.06). However, a significant difference of depression level was identified between CBT and control groups in a meta-analysis of two RCTs after 6-months of intervention measured by Hamilton Depression Scale (HAM-D) (MD ?3.34, 95% CI ?5.00 to ?1.68) (p = 0.0001) with moderate heterogeneity (I2 = 43%). Quality of life was assessed at three months between intervening groups undergoing CBT and the control group with usual care in two RCTs. A statistically significant improvement was observed in the Minnesota Living with Heart Failure Questionnaire (MLHFQ) in the CBT group compared with usual care (MD ?9.44, 95% CI ?13.02 to ?5.87) (p < 0.0001). The key finding of this review is that CBT is likely to be helpful in improving the depressive symptoms and quality of life in HF patients with depression. Moreover, long-term continued CBT sessions may help in minimizing the depression level and improving the QoL.