Health Hospital Research Articles (Page 1)

Measurement-based care (MBC) is an evidence-based practice that can improve the identification of co-occurring mental health conditions and substance use disorders, as well as population differences in care in lower resource settings, through ongoing monitoring of patient-reported symptoms. The current study examined, as reported by different stakeholders prior to implementation, barriers and facilitators of implementing screening tools to monitor mental health and substance use symptoms in the outpatient behavioral health setting at a safety-net hospital.A purposeful sampling approach was used to recruit stakeholders from two outpatient clinics (child, adult) to participate in individual interviews (clinic leadership) and stakeholder-specific focus groups (clinicians and administrative staff). De-identified transcripts were coded using a directed content analytic approach guided by constructs from the Consolidated Framework for Implementation Research (CFIR). A total of 14 clinicians, 6 clinic leaders, and 4 administrative staff participated in interviews and focus groups. Results indicate stakeholder agreement on specific implementation constructs (e.g., patient needs, networks and communication) and unique perspectives influenced by the stakeholders' day-to-day responsibilities. However, there were inconsistent responses regarding networks and communication across stakeholder groups. Clinicians only identified barriers, clinic leadership only identified facilitators, and administrative staff did not identify communication as a barrier or facilitator.Thus, when implementing MBC within a safety-net behavioral health clinic setting, cohesive communication may be perceived differently by clinicians, clinic leadership, and administrative staff and should be validated across staff roles.

Objective To compare the therapeutic efficacy of retromammary-space vacuum-assisted excision (VAE) and non-retromammary VAE for deep breast nodules ≤3 cm in maximum diameter, providing a clinical basis for selecting the optimal surgical approach. Methods A retrospective analysis was conducted on the clinical data of 162 patients who underwent minimally invasive surgery for deep breast nodules at Weifang Maternal and Child Health Hospital between May 2022 and November 2024. Among them, 81 patients received retromammary-space VAE, while another 81 underwent non-retromammary VAE. Based on nodule size, the retromammary-space VAE group was further divided into two subgroups: the 0–2 cm group ( n = 41, 0 < nodule ≤ 2 cm) and the 2–3 cm group ( n = 40, 2 cm < nodule ≤ 3 cm). The two groups were compared in terms of operative time, intraoperative blood loss, number of punctures, and incidence of postoperative complications. Subgroup analysis within the retromammary-space VAE group further compared these parameters between the two size-based subgroups. Results Compared with non-retromammary VAE, retromammary-space VAE demonstrated statistically significant advantages ( P < 0.05) in key parameters, including shorter operative time, less intraoperative blood loss, fewer punctures, and a lower incidence of postoperative complications. Subgroup analysis revealed that the 0–2 cm group had shorter operative time and less blood loss than the 2–3 cm group ( P < 0.05), while the number of punctures did not differ significantly between groups ( P > 0.05). Conclusion Retromammary-space VAE for deep benign breast nodules can effectively reduce intraoperative bleeding, shorten operative time, and lower the incidence of complications such as pectoralis muscle injury and hematoma. This technique allows precise puncture positioning beneath the nodule, minimizes the number of punctures, and maintains this advantage regardless of nodule size, demonstrating promising clinical applicability and potential for wider adoption.

ABSTRACT Objective: Intensive efforts are made to discharge patients successfully after mental health hospitalisation. However, there is limited knowledge about the usefulness of patients’ subjective assessments of their ability to adjust after discharge, and especially, the potential benefits of combining scales. Method: One week before discharge, 107 inpatients (aged 19–65 years), mostly hospitalized for schizophrenia (63%), were individually interviewed and completed the following scales: Sense of Coherence, Adaptability, Adjustment, Patients’ perceptions of hospitalisation, and background data. Three months later, discharged patients reported on (a) attendance at the regional outpatient clinic for follow-up and (b) re-hospitalisation in a mental health (MH) hospital. Results: The study findings indicate that the number of prior hospitalisations and the patient's subjective satisfaction with the hospitalisation significantly contributed to predicting later maladjustment. Additionally, patients’ responses to the Adjustment Scale retrospectively predicted their satisfaction with hospitalisation. Discussion: Patients’ subjective evaluation of their hospitalisation experience appears to be partly influenced by their prospective assessment of their ability to re-adjust after discharge. Therefore, it is valuable to explore the utility of a combined measure that includes ongoing data collection of patients’ hospitalisation experiences and their feelings of readiness for discharge, which could help reduce re-hospitalisation rates.

Emergency medicine can involve irregular working hours and shiftwork with unpredictable down time, making adequate nutrition and hydration difficult to obtain. The objectives of this study were to examine: (a) the extent to which Canadian Emergency Medicine physicians eat and/or drink during shifts; (b) factors influencing these habits; and (c) the impact on them when they do not eat/drink. A secondary objective was to examine the impact of the number of practice years on the frequency of eating on-shift. A mixed-methods study of 16 closed- and 2 open-ended survey questions was created using REDCap. Canadian staff physicians and residents who identified as "Emergency Medicine Physicians" were targeted via email and social media. Analyses involved descriptive statistics, multivariable logistic regression, and inductive and summative content analyses. Among 527 respondents, nearly 35% reported "never" or "hardly ever" eating during shifts and 36.6% reported "never" or "hardly ever" drinking water during shifts. Major barriers included lack of time (91.4%) and easily available food for purchase (35.9%). Open-ended responses reflected health reasons, mental clarity, and hospital culture as influencing factors. Years of practice were a significant predictor of eating "frequently" or "almost always" on shift [1.03 (95% CI 1.01-1.06)]. Over one-third of Canadian Emergency Medicine physicians in this study rarely or never eat or drink on shift. These nutrition and hydration habits of Emergency Medicine physicians require further study given their importance for physicians' physical and mental health, as well as patient care. The results of this study can influence conversations surrounding Emergency Medicine physicians' eating habits and ED culture, which could lead to improvements in overall wellness.

Respiratory syncytial virus (RSV) is a major health concern, especially for young children and older adults. In this study, we explored whether different age groups changed the timing of RSV season. This is important because public health guidelines, hospital preparedness, and preventive strategies like antibody prophylaxis and vaccination rely on accurate RSV season timing. By showing how RSV trends differ by age, our findings can help improve seasonality responses and ensure that preventive measures reach high-risk groups, especially infants, at the right time.

Background: Osteoporosis and sarcopenia are common but underrecognized contributors to frailty in older adults undergoing transcatheter aortic valve replacement (TAVR). Standard risk scores omit musculoskeletal parameters despite their known association with adverse outcomes. Objective: To evaluate whether osteoporosis predicted by an AI-based model using routine pre-TAVR CT scans is associated with long-term mortality in a large, multicenter TAVR cohort. Methods: We developed a radiomics-based machine learning model trained on 252 patients with paired CT and dual-energy X-ray absorptiometry (DXA) scans from Jewish General Hospital and McGill University Health Centre (Canada). The model estimated lumbar bone mineral density (BMD) and T-scores and was applied to preprocedural contrast-enhanced CT scans routinely acquired for TAVR planning in 906 patients across five institutions in the US, Canada, and Ireland. Osteoporosis was defined as AI-predicted T-score ≤ –2.5. Skeletal muscle density was extracted from the same CTs. Associations with all-cause mortality were assessed using Cox regression. Results: The radiomics-based regression model demonstrated strong agreement with DXA-derived BMD, achieving a mean absolute error of 0.06, R 2 of 0.87, and correlation coefficient of 0.93. The corresponding classification model predicting WHO T-score categories (normal, osteopenia, osteoporosis) achieved an overall accuracy of 0.82. Applied to the external TAVR cohort (n=906), the model identified 3.0% (27/906) of patients as osteoporotic (T-score ≤ –2.5). AI-defined osteoporosis was significantly associated with increased long-term mortality (HR 2.27; 95% CI: 1.23–4.19; p=0.009). Higher skeletal muscle density was also associated with reduced mortality (HR per 1 HU increase: 0.987; p=0.041). Patients classified as osteoporotic had lower muscle volume and higher frailty scores. Kaplan–Meier survival analysis further demonstrated that osteoporotic patients had significantly lower long-term survival. Although only 3% of the cohort had osteoporosis, survival curves diverged early and remained separated, suggesting this subgroup represents a clinically vulnerable population. Conclusion: An automated AI-based model accurately estimates BMD from routine pre-TAVR imaging and identifies patients at increased mortality risk. Opportunistic CT-based assessment of bone and muscle health may enhance frailty screening and risk stratification in older adults undergoing TAVR.

BackgroundMale nurses remain underrepresented in the global nursing workforce. Despite a growing need for gender diversity in healthcare, the career trajectories of male nurses, particularly those in managerial roles, have been underexplored.AimThe aim of this study was to determine the career process experiences of male nurse managers.MethodDescriptive phenomenological design, one of the qualitative research methods, was used in the study. Data were collected via video conferencing between September 2021 and February 2022 from 11 male nurse managers employed in university hospitals, Ministry of Health hospitals, and private healthcare facilities in Istanbul, Türkiye. Semi-structured interviews were conducted and analyzed using Colaizzi’s phenomenological analysis method. The form consisted of open-ended questions designed to gather participants’ personal and professional information, explore their experiences with career.FindingsCareer processes of male nurse managers findings were organized into four primary themes: “Pre-Employment Experiences”, “Entering the Workforce”, “Professional Experiences”, “Career Development and Future Plans”. These themes were further explored through the identification of 7 subthemes (Choice of Profession, Studentship, Interactions with Patients/Patient relatives, Interactions with Managers, Interactions with doctors, Being selected as a manager, Future plan) and corresponding codes.ConclusionMale nurse managers experienced both positive and negative situations related to their gender throughout their educational and professional journey, impacting their managerialprogression.

Objective: To evaluate the value of combined fetal heart V-angle (VSA), cardiothoracic ratio (CTR), whole heart spherical index (GSI) and axis of the heart (CAx) in predicting congenital heart disease (CHD) in early pregnancy by using color Doppler ultrasonography. Methods: From January 2022 to March 2024, 2529 fetuses with normal fetal heart color Doppler ultrasonography and 50 fetuses with CHD were collected from 11+0 weeks to 16+0 weeks at the double center of Beijing Haidian District Maternal and Child Health Hospital and Fujian Provincial Maternal and Child Health Hospital. The correlation of parameters in early pregnancy and gestational week (GA) was analyzed. The normal reference range and model were established and verified. Based on the established model, the diagnostic efficacy of the four parameters for CHD was quantitatively evaluated and its clinical application value was discussed. Results: There was negative correlation between VSA and GA, positive correlation between CTR and GSI, and no correlation between CAx and GA. Complete the construction of Z-value model of four parameters and the normal reference range of four parameters in five groups of gestational weeks; The establishment of polynomial linear regression model can effectively improve the detection rate of CHD by monomial regression model with single parameter. According to different fetal CHD classification forms, the four parameters have statistical significance in abnormal CHD sites and critical CHD, and can be used as effective parameters for screening CHD in early pregnancy. Conclusion: In this study, the four parameters of CAx, CTR, VSA and CSI can be used as effective parameters for the diagnosis of fetal CHD in early pregnancy. The normal reference range of four parameters in early pregnancy and the combined prediction model of multiple parameters were established for the first time, and the correlation between each parameter and GA in early pregnancy was analyzed to provide quantitative indicators for CHD screening. Further improve the accuracy of CHD early pregnancy prediction.

Background: It is well established that hypertensive disorders of pregnancy (HDP) confer downstream risk of cardiovascular (CV) disease. The purpose of this study was to assess long term differences in CV risk among normotensive postpartum females compared to those with different severity of HDP including gestational hypertension, preeclampsia (preE) with and without severe features (preE-Sev), and eclampsia. Methods: A total of 218,141 live births, among 157,606 unique females from 2017-2024 were studied across 22 Intermountain Health hospitals. Patients were identified by ICD-10 codes and electronic medical records using the MDClone ADAMS platform for those with a history of preexisting chronic hypertension (cHTN) and HDP conditions. Patient groups and sample sizes are displayed in Figure 1. Index dates were defined as first live delivery for the normotensive (no history of HDP) group and first live delivery with HDP for the HDP group. Cox hazard regression assessed the association of patient groups to death and the CV outcomes of incident heart failure (HF), stroke, coronary artery disease (CAD), and myocardial infarction (MI). Results: A total of 19.7% (n=31,077) of patients had HDP, with the large majority diagnosed at the first live birth (range: 85%-92%). Average age of the population was 28.9±5.5 and the majority white race (86.9%). Patients with HDP had more risk factors compared to normotensive patients (greater BMI, smoking, diabetes, hyperlipidemia, depression, and lower socioeconomic status). Mean follow-up was 4.8±2.3 years. The presence of HDP was associated with increased follow-up CV risk, particularly for incident stroke, HF, CAD and death (Figure 2). This risk increased with worsening HDP severity, with cHTN with superimposed HDP and eclampsia being the most severe. Conclusions: There is an incremental risk for long-term CV outcomes and death associated with worsening HDP severity. Heightened awareness and systematic aggressive CV risk reduction strategies should be employed among those with HDP.

Complex care curricula (or "interprofessional student hotspotting") are experiential, longitudinal programs based on complex care practice models where health professions students engage patients with complex health and social needs through personalized, hands-on interventions. Prior studies report mixed impacts of complex care curricula and practice models on hospital readmissions and health care costs, but evaluation of patient-driven goals and outcomes has been sparse. The objective of this study was to characterize the goals of individuals with complex health and social needs that engage with complex care curricula and the associated interventions and barriers reported by interprofessional student teams. Capstone projects of 30 student teams spanning a 5-year period (2015-2020) were analyzed via directed content analysis to identify patient goals, team interventions, and barriers. Thematic analysis revealed that the most common patient goals and team interventions focused on enhancing self-efficacy in managing health (72% and 59%, respectively) and health care system navigation (50% and 69%). Identified barriers fell into 3 major categories: barriers encountered with the health system (28%), related to the individual (66%), and arising in teamwork (50%). Over the course of each curricular cycle, students graduated with an appreciation of the importance of collaborative care for complex patients. The longitudinal impact of this analysis emphasizes patients as key stakeholders in the development of complex care curricula. By deepening our understanding of patient goals, intervention trends, and barriers-we allow for enhanced programming that prepares health professionals for practice, optimizes collaboration on interprofessional health teams, and ensures better outcomes for patients.

Mental health disorders affect over 15% of the global working-age population, contributing to an annual economic loss of approximately USD 1 trillion due to diminished productivity and increased healthcare expenditures. In India, the post-pandemic surge in hospitalizations has placed additional strain on mental health infrastructure, exacerbating an already significant treatment gap. Overcrowding and inadequate forecasting mechanisms have resulted in occupancy rates that exceed hospital capacity, underscoring the urgent need for predictive tools to support admission planning and resource allocation. This study introduces a novel forecasting framework that applies Bayesian Model Averaging (BMA) with Zellner’s g-prior used here for the first time alongside deep learning models for predicting weekly bed occupancy at India’s second-largest mental health hospital. Time series data from 2008 to 2024 were used to train six models: Time Delay Neural Networks (TDNN), Recurrent Neural Networks (RNN), Gated Recurrent Units (GRU), Long Short-Term Memory (LSTM), Bidirectional LSTM (BiLSTM), and Bidirectional GRU (BiGRU). Model performance was optimized using random search (RS) and grid search (GS) hyperparameter tuning, allowing the framework to account for model uncertainty while improving predictive accuracy and consistency. Among all models, BiLSTM with GS tuning and BMA-GS model showed the best forecasting performance for bed-occupancy, achieving 98.06% accuracy (MAPE: 1.939%) and effectively capturing weekly fluctuations within ±13 beds. In contrast, RS-tuned models yielded higher errors (MAPE: 2.331%). Moreover, the average credible interval width decreased from 16.34 under BMA-RS to 13.28 with BMA-GS, indicating improved forecast precision and reliability. This study demonstrates that embedding Bayesian statistics specifically BMA with Zellner’s g-prior into deep learning architectures offers a robust and scalable solution for forecasting hospital bed occupancy. The proposed framework enhances predictive accuracy and reliability, supporting data-driven planning for hospital administrators and policymakers. It aligns with the objectives of India’s National Mental Health Programme (NMHP) and Sustainable Development Goal 3, advancing equitable and efficient access to mental healthcare.

Purpose Adverse pregnancy outcomes, including gestational diabetes mellitus (GDM), gestational hypertension (GHp), macrosomia, preterm birth, and low birth weight, pose significant risks to maternal and neonatal health. Pre-pregnancy overweight is a modifiable risk factor for these outcomes. However, comprehensive analyses of multiple adverse outcomes and their dose-response relationships with pre-pregnancy body mass index (BMI) remain limited. Methods This retrospective cohort study included 748 women with singleton pregnancies who delivered at Yuyao Maternal and Child Health Hospital from January 1, 2022, to December 31, 2022. Participants were categorized into normal-weight and overweight groups based on pre-pregnancy BMI. Logistic regression models were used to evaluate associations between overweight and adverse pregnancy outcomes, adjusting for confounding variables. Restricted cubic spline (RCS) regression was employed to investigate dose-response relationships between BMI and pregnancy outcomes. Results Pre-pregnancy overweight was significantly associated with higher risks of GDM (adjusted OR = 3.122, 95% CI [1.754–5.557], p < 0.001), GHp (adjusted OR = 2.864, 95% CI [1.566–5.239], p = 0.001), and macrosomia (adjusted OR = 2.119, 95% CI [1.076–4.173], p = 0.030). No significant associations were observed with preterm birth or low birth weight. RCS analysis showed no evidence of nonlinear relationships, indicating that the risk of adverse outcomes increased linearly with BMI. Conclusion Pre-pregnancy overweight is a significant modifiable risk factor for adverse maternal and neonatal outcomes, particularly GDM, GHp, and macrosomia. These findings underscore the importance of integrating BMI monitoring and personalized weight management strategies into pre-pregnancy care programs to mitigate risks and improve maternal and neonatal health outcomes.

Background Although some prediction models have been developed to evaluate postpartum haemorrhage in caesarean delivery with complications, limited attention has focused on unplanned return to the operating room (UPROR), especially in twin pregnancies. On this note, this study seeks to investigate the risk factors for UPROR and Postpartum Haemorrhage (PPH) in twin pregnancies after caesarean section (CS) and develop a nomogram for predicting PPH. Objective This study aimed to investigate the risk factors for UPROR and PPH in twin pregnancies after CS in China and develop a nomogram for PPH prediction. Methods A multicentre retrospective cohort study was conducted. There were a total of 1198 twin pregnant women who underwent a CS at the Women’s Hospital, School of Medicine, Zhejiang University in Hangzhou, Ninghai Maternal and Child Health Hospital, Fuyang Women and Children’s Hospital in China from January 2017 to December 2021. All 1198 pregnant women were randomly divided into two groups (D for development and V for validation), one for training and one for validation by ratio 7:3. A nomogram was developed to predict PPH (blood loss ≥1000 ml) and UPROR based on the model generated by logistic regression analysis. The training cohort and the validation cohort were evaluated in PPH, and a decision curve analysis was developed. Results 16.77% (201/1198) women experienced PPH, 142 of which (142/840, 16.90%) in the training cohort and 59 (59/358, 16.48%) in the validation cohort. Seven optimal variates were obtained as predictors of PPH in twin pregnancies, including assisted reproductive technology (ART), advanced gestational weeks, placenta previa, emergency operation, total birth weight, and the use of uterotonic and anticoagulants. The AUC for the nomogram was 0.75 (95% CI, 0.71-0.79) for the training cohort, while that was 0.83 (95% CI, 0.79–0.88) for the validation dataset. 3.67% (44/1198) of women experienced UPROR for tamponade after the CS; PPH was the cause in all cases, none of whom had a hysterectomy. Six optimal variates were obtained as predictors of UPROR in twin pregnancies, including advanced maternal age, ART, parity ≥ 1, placenta previa, total amount of amniotic fluid (ml) ≥ 1500, and twin growth discordance. The AUC for the nomogram was 0.74 (95% CI, 0.66–0.82). Conclusion The novel nomogram prediction model for UPROR in twin pregnancies via cesarean section has clinical potentials, including the prevention of PPH in twin pregnancies.

Head injuries are among the most common reasons for emergency department visits and can have long-term consequences for patients and the healthcare system. The aim was to study the incidence, causes, severity, and sex differences of head injuries at Landspítali during 2010-2023. A retrospective study including all presentations of head injury between 2010 and 2023 to the Landspítali emergency department. Data were retrieved from the hospital's health database according to ICD-10 and NOMESCO. Injury scores (ISS/AIS) were calculated for all diagnoses. Descriptive statistics, Poisson regression analysis, chi-square, and Kruskal-Wallis tests with post hoc analyses were performed. Head injuries accounted for 81,111 presentations, during the period from 2010 until 2023, averaging 5,794 per year. The daily average decreased from 19.4 to 13 cases. Incidence declined significantly (5.6% annually), but the proportion of admissions rose from three to five percent. The most common diagnoses were soft-tissue injuries and concussions. Mild and moderate injuries decreased, and severe injuries increased across the research period. Men more often had mild and severe injuries, whereas women more often had moderate injuries. Most injuries among children were mild. Ninety-day mortality remained stable. Most injury events were due to accidents and mishaps; violence was more frequent among those aged 15-29 years. Despite the reduction in head injury cases in recent years, head injuries remain a substantial public health problem. Strengthened epidemiological data collection is needed to support policymaking, especially for vulnerable age groups. There is a growing need for integrated services for both older adults and young people in risk groups.

Burden of carbapenem-resistant Gram-negative bacterial infections in Vietnam: a national hospital survey.

Clinical potential of whole-genome data linked to mortality statistics in patients with breast cancer in the UK: a retrospective analysis.

Impact of a measles outbreak on a UK children's emergency department and the public health response: a retrospective observational study.

Exposure to outdoor artificial light at night and excessive gestational weight gain: A retrospective cohort study.

Uterine artery embolization (UAE) is an effective treatment for adenomyosis, but ovarian collateral supply can increase the risk of recurrence. This study aimed to explore the safety and efficacy of combined UAE and unilateral ovarian artery embolization (OAE) in adenomyosis patients with ovarian artery collateral supply exceeding 10% of ipsilateral uterine perfusion, particularly focusing on ovarian function. This single-center retrospective study was conducted at Fujian Maternity and Child Health Hospital from June 2021 to April 2023, including 23 eligible patients, with 18 completing the 12-month follow-up. The exposure was combined UAE + OAE treatment, with outcome variables including reproductive hormone levels, ovarian reserve function, and clinical symptom improvement. At 12 months, the median symptom severity score decreased by 79% (57→12, Δ45 [95%CI 38–52], P <.001), quality of life score increased by 95% (40→78, Δ38 [32–44], P <.001), and pain score (numerical rating scale) decreased by 71% (7→2, Δ5 [4–6], P <.001). anti-Müllerian hormone transiently declined at 3 months (3.91→1.86 ng/mL, Δ−2.05 [−2.41 to −1.69], P = .006) but recovered by 6 months (4.01 ng/mL) and remained stable at 12 months (4.18 ng/mL). Follicle-stimulating hormone, luteinizing hormone, and antral follicle count (AFC) remained stable (P >.4), all patients resumed regular menses without menopausal symptoms, and no major complications were reported. In this small, single-center cohort of relatively young adenomyosis patients with significant ovarian artery collateral supply, combined UAE + OAE was associated with symptom improvement and no measurable impairment of ovarian reserve over 12 months. However, confirmation of the safety and efficacy of combined UAE + OAE in younger adenomyosis patients requires data from larger, multicenter cohorts and randomized trials.

PurposeWomen with gestational diabetes mellitus (GDM) may experience disordered eating (DE), leading to adverse pregnancy outcomes and compromised mental health. However, in-depth studies in this field are lacking. This study explored the DE experiences among women with GDM, focusing on behavioral characteristics and potential risk factors.Patients and MethodsThis study was a descriptive qualitative study. Using purposive sampling, 23 pregnant women with GDM who had exhibited DE behaviors within the past month were recruited from a maternal and child health hospital in Nanjing, China. Semi-structured interviews were conducted with the participants. Data were analyzed using conventional content analysis.ResultsThree categories of DE experiences among women with GDM were identified: (1) behavioral characteristics; (2) internal drivers; (3) external enablers. DE behaviors in women with GDM primarily included restrictive eating, binge eating, and inappropriate insulin use. These behaviors often formed a vicious cycle: initial excessive restrictive eating led to binge eating due to intense hunger and food cravings, which in turn caused elevated glycemia and prompted impromptu restrictive eating, restarting the cycle. Inappropriate insulin use aimed at maintaining glycemic stability further perpetuated DE. Additionally, the study identified three internal drivers and three external enablers. Excessive risk perception mainly drove restrictive eating, insufficient internal motivation triggered binge eating, and low self-efficacy exacerbated both. Perceived pressure from dietary norms was a key external risk factor for the development of restrictive eating. Permissive messages from family members and disruptions from unexpected social events induced binge eating.ConclusionInternal and external factors led to a restrictive-binge eating cycle in women with GDM, sustained by inappropriate insulin use. Excessive risk perception about hyperglycemia and fetal health existed as unique risk factors. Future studies should be conducted across diverse cultural and geographical contexts to enhance the generalizability of our findings.