Browsing by Author "Sullivan C.S."

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    Attitude and Confidence in Managing Pre-existing Type 2 Diabetes Mellitus During Pregnancy Among Thai Women
    (2025-01-01) Phonyiam R.; Teng C.H.; Sullivan C.S.; Palmquist A.E.L.; Hodges E.A.; Cortes Y.I.; Baernholdt M.; Phonyiam R.; Mahidol University
    Background: The trend of rising T2DM prevalence is more pronounced in females and is of particular concern for pregnancy. The rate has jumped from 0.7 % to 1.5 % of all pregnancies over the past 14 years. Additionally, pregnancies affected by T2DM have higher rates of abortion and perinatal mortality compared to those with type 1 diabetes mellitus and gestational diabetes mellitus. The objective of the study was to explore the attitudes and confidence in managing T2DM among Thai women during pregnancy. Methods: This qualitative study was a part of a parent study using a convergent parallel mixed-methods design. A purposive sampling was used. Inclusion criteria included pregnant women aged 20—44 years, diagnosed with T2DM, and able to communicate in Thai. A total of 12 Thai pregnant women with T2DM, with an average age of about 34 years old, and whose pregnancies spanned from 7 to 38 weeks of gestation. Directed content analysis was used for qualitative data analysis. Results: Twelve interviews were completed. Four main themes were identified: 1) attitudes toward diabetes self-management, 2) confidence toward diabetes self-management in pregnancy, 3) varied paths to pregnancy: planned vs. unplanned conception, and 4) navigating adjustments of diabetes self-management in pregnancy. Conclusion: The study highlights the importance of enhancing preconception care and tailoring diabetes management guidance to align with cultural contexts. Supporting pregnant women with diabetes requires a comprehensive approach that incorporates behavioral, sociocultural, and systemic healthcare considerations.
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    “Feeding the baby breast milk shouldn't be a problem” breastfeeding confidence and intention in pregnant persons with type 2 diabetes mellitus from Thailand
    (2025-02-14) Phonyiam R.; Teng C.H.; Cortés Y.I.; Sullivan C.S.; Palmquist A.E.L.; Hodges E.A.; Baernholdt M.; Phonyiam R.; Mahidol University
    Breastfeeding initiation has been found to be lower in pregnant persons with type 2 diabetes mellitus (T2DM). However, no studies have explored the potential impact of T2DM during pregnancy on breastfeeding plans among Thai pregnant persons. This study aimed to describe breastfeeding confidence and intention during pregnancy among Thai pregnant persons with T2DM. This qualitative analysis utilized data from a parent study with a convergent parallel mixed-methods design. This study was guided by the National Institute on Minority Health and Health Disparities (NIMHD) Framework. Eligible participants were pregnant persons diagnosed with T2DM, aged 20–44 years, and proficient in speaking Thai. The pregnant persons participated in semi-structured interviews and completed three questionnaires: demographic, infant feeding intentions, and breastfeeding self-efficacy. Data analysis involved descriptive statistics for quantitative data and directed content analysis for qualitative data. Twelve interviews revealed four main themes: breastfeeding intentions during pregnancy, breastfeeding confidence throughout pregnancy, breastfeeding barriers (such as previous challenging experiences and physical distance between mother and baby), and breastfeeding facilitators (including benefits and cost-effectiveness, consumption of Thai foods and herbs, and the availability of breast milk shipping services). This study offers insights into the intentions and confidence of Thai pregnant persons with T2DM regarding breastfeeding their baby after childbirth. To improve breastfeeding outcomes, the pregnancy period could serve as an opportunity to assess breastfeeding confidence, barriers, and facilitators that influence breastfeeding intentions among pregnant persons with diabetes.