The mother–daughter guilt dynamic: effects of type 1 diabetes during life transitions

Rasmussen, Bodil; Dunning, Trisha; Cox, Helen; O’Connell, Bev

doi:10.1111/j.1365-2702.2008.02342.x

Cited by 15 publications

(19 citation statements)

References 28 publications

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“…Preparing for and going through pregnancy thus requires close attention to a strict diabetes management regimen and detailed planning of everyday activities. Daily life is characterised by exaggerated feelings of responsibility and perceived demands from the baby, creating constant worry, self-blame, guilt and fear of being a ‘burden’ to others and pressure to provide the best conditions to enable delivery of a healthy baby [10-12]. …”

Section: Introductionmentioning

confidence: 99%

Transition to motherhood in type 1 diabetes: design of the pregnancy and postnatal well-being in transition questionnaires

Rasmussen

Dunning

Hendrieckx

et al. 2013

BMC Pregnancy Childbirth

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BackgroundLife transitions are associated with high levels of stress affecting health behaviours among people with Type 1 diabetes. Transition to motherhood is a major transition with potential complications accelerated by pregnancy with risks of adverse childbirth outcomes and added anxiety and worries about pregnancy outcomes. Further, preparing and going through pregnancy requires vigilant attention to a diabetes management regimen and detailed planning of everyday activities with added stress on women. Psychological and social well-being during and after pregnancy are integral for good pregnancy outcomes for both mother and baby. The aim of this study is to establish the face and content validity of two novel measures assessing the well-being of women with type 1 diabetes in their transition to motherhood, 1) during pregnancy and 2) during the postnatal period.MethodsThe approach to the development of the Pregnancy and Postnatal Well-being in T1DM Transition questionnaires was based on a four-stage pre-testing process; systematic overview of literature, items development, piloting testing of questionnaire and refinement of questionnaire. The questionnaire was reviewed at every stage by expert clinicians, researchers and representatives from consumer groups. The cognitive debriefing approach confirmed relevance of issues and identified additional items.ResultsThe literature review and interviews identified three main areas impacting on the women’s postnatal self-management; (1) psychological well-being; (2) social environment, (3) physical (maternal and fetal) well-being. The cognitive debriefing in pilot testing of the questionnaire identified that immediate postnatal period was difficult, particularly when the women were breastfeeding and felt depressed.ConclusionsThe questionnaires fill an important gap by systematically assessing the psychosocial needs of women with type 1 diabetes during pregnancy and in the immediate postnatal period. The questionnaires can be used in larger data collection to establish psychometric properties. The questionnaires potentially play a key role in prospective research to determine the self-management and psychological needs of women with type 1 diabetes transitioning to motherhood and to evaluate health education interventions.

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Section: Introductionmentioning

confidence: 99%

Transition to motherhood in type 1 diabetes: design of the pregnancy and postnatal well-being in transition questionnaires

Rasmussen

Dunning

Hendrieckx

et al. 2013

BMC Pregnancy Childbirth

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“…The relationship between managing psychosocial stress and diabetes control makes people with diabetes particularly vulnerable to a variety of expectations and reactions from others (Kralik et al. 2006, Rasmussen et al. 2007b, 2008, Kay et al.…”

Section: Introductionmentioning

confidence: 99%

Young adults’ management of Type 1 diabetes during life transitions

Rasmussen

Ward

Jenkins

et al. 2011

Journal of Clinical Nursing

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“…This is reinforced by Rasmussen et al. (24), who found that mothers felt guilty and often blamed themselves for the development of their daughters’ diabetes. Being positioned as a partner and resource, and as someone who informs the diabetes team, might produce a feeling of being important and valuable to the child’s health outcome.…”

Section: Resultsmentioning

confidence: 98%

Parents’ discursive resources: Analysis of discourses in Swedish, Danish and Norwegian health care guidelines for children with diabetes type 1

Boman

Borup

Povlsen

et al. 2011

Scandinavian Journal of Caring Sciences

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The incidence of diabetes type 1 in children, the most common metabolic disorder in childhood, increases worldwide, with highest incidence in Scandinavia. Having diabetes means demands in everyday life, and the outcome of the child's treatment highly depends on parents' engagement and involvement. The aim of this study was to explore and describe discourses in health care guidelines for children with diabetes type 1, in Sweden, Norway and Denmark during 2007-2010, with a focus on how parents were positioned. As method a Foucauldian approach to discourse analysis was applied, and a six-stage model was used to perform the analysis. The findings shows a Medical, a Pedagogic and a Public Health discourse embedded in the hegemonic Expert discourse. The Expert discourse positioned parents as dependent on expert knowledge, as recipients of education, as valuable and responsible for their child's health through practicing medical skills. This positioning may place parents on a continuum from being deprived of their own initiatives to being invited to take an active part and could result in feelings of guilt and uncertainty, but also of security and significance. From this study we conclude that guidelines rooted in the Expert discourse may reduce opportunities for parents' voices to be heard and may overlook their knowledge. By broadening the selection of authors of the guidelines to include patients and all professionals in the team, new discourses could emerge and the parents' voice might be more prominent.

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The mother–daughter guilt dynamic: effects of type 1 diabetes during life transitions

Cited by 15 publications

References 28 publications

Transition to motherhood in type 1 diabetes: design of the pregnancy and postnatal well-being in transition questionnaires

Transition to motherhood in type 1 diabetes: design of the pregnancy and postnatal well-being in transition questionnaires

Young adults’ management of Type 1 diabetes during life transitions

Parents’ discursive resources: Analysis of discourses in Swedish, Danish and Norwegian health care guidelines for children with diabetes type 1

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