Transition to motherhood in type 1 diabetes: design of the pregnancy and postnatal well-being in transition questionnaires
1 Deakin University, School of Nursing and Midwifery, 221 Burwood Highway, Burwood, Victoria 3125, Australia
2 Deakin University- Barwon Health, Waterfront, PO Box 281, Geelong, Victoria 3220, Australia
3 Australian Centre for Behavioural Research in Diabetes, Diabetes Australia-Vic, 570 Elizabeth Street, Melbourne 3000, Australia
4 Centre for Mental Health and Well-being Research, School of Psychology, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia
5 AHP Research, 16 Walden Way, Hornchurch, UK
6 Deakin University-Epworth HealthCare, Centre for Clinical Research Nursing, 89 Bridge Road, Richmond, Victoria 3121, Australia
BMC Pregnancy and Childbirth 2013, 13:54 doi:10.1186/1471-2393-13-54Published: 27 February 2013
Life 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.
The 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.
The 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.
The 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.