Food as both comfort and risk: perspectives on healthy eating among Swedish women with prediabetes.

Purpose The purpose of the study was to explore preventive behaviors and attitudes among mostly low-income, young Hispanic women with and without prediabetes. Methods In 2017, a convenience sample of women without diabetes aged 18 to 49 years (n = 214, 77.8% Hispanic) was recruited from the waiting room of a community health center to complete a 77-item questionnaire. Attitudes, risk perception, and recent lifestyle change were measured using a validated instrument, the Risk Perceptions Survey: Developing Diabetes. Chi-squared tests and multivariable binary logistic regression were conducted to assess the relationship between prediabetes diagnosis and attitude or lifestyle variables. Results Women diagnosed with prediabetes were more likely to report worry about diabetes and to perceive themselves at higher risk for developing diabetes in the next 10 years than women without a prior prediabetes diagnosis. There was no significant association between prediabetes diagnosis and recent adoption of lifestyle changes compared with those without prediabetes. After controlling for demographic characteristics and risk factors for type 2 diabetes, prediabetes diagnosis was significantly associated with elevated risk perception for developing diabetes if no lifestyle change is made but not with worry or risk perception for developing diabetes generally. Conclusions Prediabetes diagnosis is associated with heightened perception of diabetes risk but not lifestyle change compared to women without prediabetes in this low-income, predominantly Hispanic population. Prediabetes counseling efforts must emphasize evidence-based approaches for motivating preventive behaviors.

Our aim was to explore the reasoning and experiences of women when offered a self-sampling HPV test. This study implemented a qualitative study design and content analysis using an inductive approach. Data consisted of written narratives collected through open-ended questions from a total of 173 women. Women were included if they had been offered a self-sampling device since September 2021 and were southern Sweden residents. To achieve purposive sampling with maximum variation, attenders adhering to the screening programme, nonattenders (absent for at least two screening rounds), and women with cervical dysplasia were recruited. The content analysis generated seven categories: (1) unpleasant experience with a vaginal examination; (2) gratefulness and acceptability of self-sampling; (3) varied perception of one's capacity to perform self-sampling; (4) preference for cervical sampling by healthcare professionals; (5) anxiety and fear concerning a potential or detected HPV infection; (6) different risk assessments for acquiring an HPV infection; and (7) negative impact on mental well-being due to cervical dysplasia. The overarching theme became "the HPV self-sampling reduced practical and emotional barriers to attending the cervical cancer screening programme, but test results may create anxiety." Most women valued HPV self-sampling, although their confidence in performing it varied. Self-sampling can reduce the emotional and practical barriers to participation in cervical cancer screening. However, anxiety about cervical dysplasia or following a positive HPV test was noted, highlighting the need for healthcare professionals to provide personalised information to alleviate negative emotions.

Diabetes and Mental Health

ObjectivesGuidelines advocate goal setting for promoting lifestyle changes in cardiovascular disease (CVD) patients. This study investigates 1) preferences in health and life goal domains in CVD patients, 2) the impact of linking life goals to health goals on intention‐to‐change‐lifestyle and explores 3) socio‐demographic and health‐related variables influencing intention‐to‐change‐lifestyle.DesignOnline experimental study.MethodsPatients (N = 629, mean age 66.6; 39% female) were randomized to health‐goal‐group (HG) or life‐and‐health‐goal‐group (LHG). HG set a health goal, and LHG first established a life goal and then set a supporting health goal. Directly after goal setting, the primary outcome, intention‐to‐change‐lifestyle, was measured and analysed using logistic regression (high: 9–10 vs. lower: ≤8.5), as were the secondary outcomes.ResultsExercise goals were most frequently selected in LHG (66.0%) and HG (66.9%). Preference for selecting stress management was significantly higher in LHG (17.3%) than HG (9.3%), χ2(1) = 8.85, p = .003; OR = 2.05, 95%CI [1.27–3.30]. The direct effect of goal‐setting condition on intention‐to‐change‐lifestyle was non‐significant (OR = .98, 95%CI [.71–1.34], p = .88). In exploratory analyses, lower‐ and medium‐educated patients showed significantly higher intention when life and health goals were linked (OR = 2.55, 95%CI [1.03–6.27], p = .04, and OR = 2.47, 95%CI [1.15–5.30], p = .02, respectively). Perceived meaning in life was positively associated with intention.ConclusionsNo main effect of goal‐setting condition on intention‐to‐change‐lifestyle was found. Linking life goals to health goals increased preference for stress management and, in exploratory analyses, was associated with higher intention‐to‐change‐lifestyle among lower‐ and medium‐educated patients. Findings emphasize the relevance of personalized, value‐based goal setting within cardiac rehabilitation.

To describe and explore older women's experiences of having had repeated urinary tract infections (UTIs). UTIs are one of the most common bacterial infections among older women. Approximately one-third of very old women suffer from at least one UTI each year. Despite the high incidence of UTI, little is known about the impact of UTI on health and daily life in older women. A qualitative descriptive design. A qualitative study using semi-structured interviews was conducted with 20 Swedish women aged 67-96 years who suffered from repeated UTIs the preceding year. The data were analysed using qualitative content analysis. Two main themes were identified: being in a state of manageable suffering and depending on alleviation. Being in a state of manageable suffering was described in terms of experiencing physical and psychological health problems, struggling to deal with the illness and being restricted in daily life. Depending on alleviation was illustrated in terms of having access to relief but also receiving inadequate care. This study demonstrated that UTIs are a serious health problem among older women that not only affects both physical and mental health but also has serious social consequences. The women in this study described the physical and psychological health problems, struggling to deal with the illness, being restricted in daily life, depending on access to relief and receiving inadequate care. It is important to improve the knowledge about how UTI affects the health of older women. This knowledge may help nurses develop strategies to support these women. One important part in the supportive strategies is that nurses can educate these women in self-care.

The aim is to describe experiences of daily life of women and men during the first four to six months after a myocardial infarction. The focus is on problems, managing problems and support from their network. A cardiac event is traumatic and may influence well-being during a significant period of time. Few qualitative studies have investigated experiences of both women and men after a myocardial infarction and remarkably little research has been conducted on men's experiences. The study design was descriptive, retrospective and qualitative. Semi-structured interviews were conducted with 20 women and 19 men from January 2000 to November 2001. Data were analysed using qualitative content analysis. Three themes were generated from the analysis: 'Threatening ordinary life', 'Struggling for control' and 'The ambiguous network'. Physical symptoms and emotional distress were the most commonly described problems during the first months after a myocardial infarction. The informants manage the problems by negotiating with themselves, relying on their own capabilities, changing attitudes and behaviours and taking their own decisions and actions. The network was generally supportive but rather often the informants also experienced communication problems when they interacted with their network. Women and men strive for balance between problems and resources in daily life after a myocardial infarction. How well they succeeded depends on how secure they feel how well they communicate their needs to their network and how sensitive their network is to their spoken and unspoken needs. The findings provide an insight into what kind of problems women and men may experience after myocardial infarction and how caregivers can aid them to increase security in their daily life. Some risk characteristics that may have increased their problems in daily life are suggested, for women and men respectively.

Midlife women's experiences living with heart disease

Myocardial infarction (MI) poses a serious threat to individuals and often disrupts the normal functioning of almost every aspect of their daily lives. Information about the experiences of men and women after MI is important to inform the development of needs-led, individualized cardiac care and rehabilitation, yet there is a paucity of qualitative studies investigating this issue. Kristofferzon et al. (2007) attempted to address this deficiency with a phenomenological study of the daily life experiences of Swedish men and women during the time from the onset of the MI to the interview, conducted four to six months later. The analysis generated three themes –‘threatening ordinary life’, ‘struggling for control’ and ‘the ambiguous network’– and a general pattern ‘striving for balance’. It is, however, not clear whether any analysis was undertaken to examine the process of adjustment of the patients after MI. The information presented in the different themes was discrete and even contradictory. For example, in the theme ‘threatening ordinary life’, the hindering factors for lifestyle change for women and men were respectively described as the ingrained habits of family members and low motivation of patients. However, the information in the theme ‘struggling for control’ indicated that women identified family as an important support for lifestyle changes and men tried to take their own initiative to change unhealthy habits. Also, in the theme ‘the ambiguous network’, the authors stated that women had problems in knowing what to ask the formal caregiver, but in another paragraph, women were found to appreciate the dialogues with the cardiac nurse while they were seeking health advice. Such inconsistencies might be because of the fact that the patients were describing their situations at different times during the four to six months after the MI. Perhaps what is needed now is research that explores the way patients’ situations change over the recovery period. Such information would be valuable in offering nurses and other health care professionals insights into the factors that are likely to facilitate or hinder successful adjustment to MI. As previous studies have only examined the adjustment process in female patients (Kerr & Fothergill-Bourbonnais 2002, Sutherland & Jensen 2000, Tobin 2000), information about gender differences in this regard is needed. Kristofferzon et al. (2006) focused on problems, managing problems and social support. Although the study identified gender differences in these areas, most of the findings do not appear unique or particularly different from previous studies of men and women with MI (Tobin 2000, Kristofferzon et al. 2003). However, there were some exceptions. For example, the finding about men's positive illness behaviour in response to chest pain was very different from that of the study by White and Johnson (2000), in which men reacted with denial to maintain their self-concept as ‘healthy’. The high social support of women also contrasted with an earlier review paper by the same authors (Kristofferzon et al. 2003). Comparing and contrasting the different aspects of these studies, in fact, might provide important cues to explain the differences in internal and external coping resources of patients after MI, and it is, perhaps, surprising that the authors did not allude to this in their paper. The process of adjustment to MI is complex and, although previous studies consistently report that patients initially attempt to make sense of a very disruptive situation and try strategies to return to a state of equilibrium, success is likely to be affected by a variety of factors, including gender and social network. Research should start to focus on issues such as: how does this process operate, what are the other possible influencing/mediating factors, how is a patient's coping resources affected, and to what extent should an MI be regarded as an issue in the patient's family and social contexts. The provision of such information would help shape the organization and delivery of cardiac care and rehabilitation services that play such an important role in assisting individuals to return to a normal life (Thompson 2002).

Transition to adulthood is a period in life when women encounter conflicts, ambiguities and rapidly expanding roles that may be stressful and difficult to manage. The aim of this study was to compare stress in daily life, health complaints and self-confidence in 26-year old women in two different cultures. A health survey study was performed among Swedish women (n = 386) and American women (n = 201) living in urban areas at the West coast of Sweden and in Minnesota. Both Swedish and American women reported stress in their everyday life, with higher figures for the Americans. Overall health was rated lower by the Swedish women and they reported more health complaints such as headache, general tiredness, irritability, depression and sleeping disorders. There was a difference between groups in self-confidence with higher figures for excellent self-confidence among American women. However, low self-confidence was reported by more American than Swedish women. A good work situation predicted self-confidence in Swedish women and financial confidence in American women. Physical fitness was associated with self-confidence in both groups. Young women in both cultures experienced high level of stress but health related complaints were more common among Swedish women. High stress and health complaints must be taken seriously and interventions to support young women in the midst of transition to adulthood should contain stress reduction as well as empowerment performed in a more effective way than today in different health care settings and at place of work.

Dyslipidemia, hypertension, and diabetes mellitus have been appropriately highlighted as established predictors of cardiovascular disease. These risk factors have become preeminent targets for influencing cardiovascular risk; their assessment, treatment, and monitoring are major emphases of clinical care, research investigation, treatment guidelines, organization position papers, and measures of physician and hospital performance. Notably, lifestyle risk factors, including dietary habits, physical inactivity, smoking, and adiposity, strongly influence the established cardiovascular risk factors and also affect novel pathways of risk such as inflammation/oxidative stress, endothelial function, thrombosis/coagulation, and arrhythmia. Furthermore, modest alterations of these lifestyle risk factors are achievable and have substantial effects on cardiovascular risk. Thus, basic lifestyle habits should be considered fundamental risk factors for cardiovascular disease. Although efforts to combat established and novel risk factors with pharmacological treatments are important and should continue, we call for a systematic rebalancing of current research, clinical care, and policy efforts to focus more on lifestyle. The rising costs of healthcare and the epidemics of overweight and obesity highlight the inadequacies of our current strategy. Substantially more resources should be directed toward research on lifestyle risk factors, their determinants, and effective interventions to change them. The clinical evaluation and treatment of dietary, physical activity, and smoking habits must become as routine and familiar as assessment of blood pressure, cholesterol, and glucose levels. Major policy initiatives and reimbursement guidelines must also be rebalanced to emphasize lifestyle risk factors. Cardiovascular diseases are leading causes of death and disability among men and women in nearly all nations.1 Identification of persons at higher or lower risk for cardiovascular events is important to facilitate effective use of resources and interventions to reduce disease burden among individuals and in society. Each of the established risk factors for cardiovascular disease—age, gender, dyslipidemia, hypertension, diabetes mellitus, and smoking—have been appropriately highlighted …

Prediabetes, a condition characterised by impaired glucose regulation, is on the rise worldwide. This condition puts people at risk for cardiovascular disease, and 50% of people with prediabetes will develop type 2 diabetes (T2D). People with prediabetes can reduce their risk of developing T2D through lifestyle changes such as regular physical activity and healthy eating. However, the experience of health risks can be associated with negative reactions that can undermine people's ability to self-regulate the health behaviours that would reduce such risk. Self-compassion, or treating oneself kindly in the face of challenge, is known to help people manage negative emotions and facilitate self-regulation. Therefore, self-compassion may be helpful for people with prediabetes who have to manage their health behaviours in the context of a health threat. The purpose of this study was to explore how people, from a small Canadian city who learn that they have prediabetes, react emotionally to their prediabetes diagnosis. We also explored participants' receptivity to applying self-compassion in the context of their prediabetes. Twenty-one adults, recently notified by their doctors as having HbA1c scores indicative of prediabetes (Mage =57.76, SD=5.43), engaged in a semi-structured interview between June 2017 and January 2018. Inductive thematic analysis was used to analyse the data and four themes emerged. Participants' reactions to learning that they had prediabetes were characterised by (a) distress and concern, (b) downplay of T2D risks, (c) guilt and shame, and participants were receptive to (d) self-compassion as a beneficial approach to take in relation to their prediabetes. Findings suggest that people experience negative reactions to their prediabetes diagnosis yet are receptive to self-compassion, which could mitigate these reactions. These findings can inform lifestyle behaviour change programmes for individuals living with prediabetes by providing a better understanding of their perspectives of disease diagnosis.

BackgroundThe reproductive years provide a window into future risk for Type 2 Diabetes (T2DM); women’s risk is seven to 10 times higher after gestational diabetes (GDM) and two to four times higher after a hypertensive disorder of pregnancy (HDP). Targeting reproductive-aged women at high risk for T2DM could reduce future incidence. However, little is known about such women’s diabetes risk perceptions, barriers to/motivators of lifestyle change or their knowledge about lifestyle change—information essential to understanding how to engage these at-risk women in tailored prevention programs promoting long-term health. This study’s aims were to describe: among reproductive-aged women at high risk for T2DM, what is/are (1) personal health-risk awareness, (2) lifestyle-change interest, and (3) barriers to/motivators of participation in lifestyle-change programs?MethodsWomen aged 18 and older were eligible if they had one of the following health risks: (1) GDM or HDP during pregnancy, (2) prediabetes diagnosis, or (3) BMI classified as obese. Three Zoom focus groups, organized by risk group, were conducted with a total of 20 participants. Qualitative content and thematic analysis were used for the focus-group transcriptions.ResultsWomen’s personal health-risk awareness was limited and generalized (e.g., being overweight might lead to other risks) and rarely reflected awareness connected to their personal health history (e.g., GDM increases their lifetime risk of T2DM). Participants had at least one of the outlined eligibility health risks (e.g., GDM, prediabetes); they did not believe their healthcare providers sufficiently followed or addressed those risks. All women expressed interest in making healthy-lifestyle changes, including engagement in formal programs, but they identified multiple barriers to healthy-behavior change related to being “busy moms.” Women emphasized the need for social support and realistic solutions that accounted for the dynamics of motherhood and family life. Common motivators included the desire to maintain health for their families and to set a good example for their children.ConclusionsParticipants lacked knowledge and were eager for information. Healthcare improvement opportunities include better coordination of care between primary and specialty-care providers, and more frequent communication and education on diabetes-related health risks and long-term health. Formal lifestyle programs should tailor content by providing multiple formats and flexibility of scheduling while leveraging peer support for sustained engagement.

Tracking Diabetes Therapy Into The 21st Century

Health problems are affected by several factors, including lifestyle, diet, work environment factors, exercise, and stress. Changes in lifestyle can lead to an increase in the prevalence of degenerative diseases such as coronary heart disease, diabetes mellitus (DM), obesity, and high blood pressure. Risk factors that will occur due to increasing age include blood circulation disorders such as hypertension, blood vessel disorders, DM, and disorders of the joints. The purpose of this study was to determine the correlation between blood glucose levels and blood pressure in prolanis (Chronic Disease Management Program) members. The type and design of this study used an Analytical Observational design and a Cross Sectional design. The population in this study was 71 people with a sample of 35 respondents. The data in this study were secondary data obtained from data on blood glucose levels and blood pressure of prolanis members of the Somagede Public Health Care Center. The results of statistical tests showed that 11 people (31%) had high blood glucose levels, 18 people (52%) had normal blood glucose levels, and 6 people (17%) had low blood glucose levels. In addition, of these respondents, it was found that 11 people (31%) had high blood pressure, 24 people (63%) had normal blood pressure, and 2 people (6%) had low blood pressure. The analysis with the Pearson test showed that the value of p = 0.728, which means that H0 was accepted. Thus, there is no relationship between glucose levels and blood pressure in Prolanis members of the Somagede Public Health Care Center, Banyumas Regency. The null correlation between blood pressure and glucose levels might be because of the respondents' ability to control glucose levels, hence there are no complications that can increase blood pressure values.

To explore how women previously treated for breast cancer experience living with arm impairment after axillary surgery. Descriptive qualitative study. The inductive starting point for the analysis was followed by a deductive approach as the categories were related to the components of the sense of coherence framework. Twenty-eight relapse-free Swedish-speaking females participated in six focus group discussions conducted between September and December 2022. All participants had undergone sentinel lymph node biopsy with or without completion axillary dissection4 years earlier. Data were analysed using qualitative content analysis. Three categories and an overall theme were identified. The categories 'Sense-making', 'Daily life' and 'Driving force' reflect actions to understand and prevent arm symptoms, adaptations made in daily life and the empowering resources adopted to meet challenges. The overall theme, 'Balancing challenges and personal resources', comprised a process that began at diagnosis and remained ongoing for some participants. Most participants considered their new life situations manageable. However, those with more pronounced arm impairment reported that they did not always receive adequate aid, and that their daily lives were negatively affected. Returning to everyday life after axillary surgery for breast cancer is associated with varying degrees of challenges. Individuals with persistent arm impairment find returning to normal life more challenging. Therefore, further improvements in person-centred care are of utmost importance. Members of the Swedish Breast Cancer Association were involved in the creation of the interview guide. This study emphasises the requirement for providing further individualised support to those living with more severe arm impairment after axillary surgery. This study was reported in accordance with the Standards for Reporting Qualitative Research.