OBJECTIVE:This umbrella review will assess the effectiveness of support interventions for improving well-being outcomes in parents of preterm infants. INTRODUCTION:Preterm birth presents significant emotional, psychological, and social challenges for parents, often adversely affecting their well-being. Numerous systematic reviews have examined support interventions aimed at improving parental outcomes. An umbrella review is warranted to synthesize and critically appraise this diverse evidence. Such a review could guide health care professionals in implementing effective, evidence-based strategies to support parents throughout the parenthood journey of preterm infants. ELIGIBILITY CRITERIA:This umbrella review will include systematic reviews that examine the effectiveness of support interventions designed to enhance the well-being of parents of preterm infants. All types of support interventions will be considered, regardless of the parents' gender or age, the infants' gestational age, or the contextual setting. METHODS:This review will follow the JBI methodology for umbrella reviews. A comprehensive search will be conducted across PubMed, the Cochrane Database of Systematic Reviews, CINAHL (EBSCOhost), Embase (Embase.com), Scopus, Open Access Theses and Dissertations (OATD), and the Mahidol Library Catalog (OPAC) to identify relevant reviews. There will be no date or language limitations. Two reviewers will independently screen titles, abstracts, and full texts using predefined eligibility criteria. The methodological quality of the included reviews will be assessed using the JBI Checklist for Systematic Reviews and Research Syntheses. Data will be extracted using a piloted, adapted JBI tool. Findings will be presented in tables with narrative summaries, visual aids, and a citation matrix to assess study overlap. REVIEW REGISTRATION:PROSPERO CRD420251071668.

OBJECTIVE:The objective of this review will be to synthesize existing qualitative evidence on the experiences and perceptions of caregivers for children and adolescents with type 2 diabetes mellitus (T2D). INTRODUCTION:The rising number of new cases of T2D in children and adolescents highlights the urgent need for effective management strategies. Caregivers of these children face significant challenges in providing care and managing the condition. ELIGIBILITY CRITERIA:This review will include caregivers of children and adolescents with T2D, regardless of age, gender, social status, or marital status. It will consider studies that explore caregivers' experiences and perceptions of caring for children and adolescents with T2D in home, school, and community settings, as well as those addressing treatment adjustments and peer responses within the school environment. Caregivers of children and adolescents with other types of diabetes, such as type 1 diabetes mellitus, will be excluded. METHODS:This qualitative systematic review will follow the JBI methodology for qualitative systematic reviews. We will search both published and unpublished studies in Embase (Ovid), MEDLINE (PubMed), CINAHL (EBSCOhost), Cochrane Library (CENTRAL), LILACS (BVS), PsycINFO (Ovid), Web of Science Core Collection, and Scopus without date limitations. Sources of unpublished studies and gray literature will include Google Scholar and the Open Access Theses and Dissertations. Two reviewers will independently assess methodological validity. The standardized JBI data extraction tool will be used for data extraction. Data will be synthesized using meta-aggregation, and the certainty of findings will be determined using the ConQual approach. REVIEW REGISTRATION:PROSPERO CRD420251116139.

Background/Objectives: HIV testing is essential for early HIV diagnosis, timely treatment initiation, and HIV prevention. Despite Thailand's long-standing HIV prevention programs and universal access to HIV testing services, nationally representative evidence on lifetime HIV testing among Thai adults remains limited. This study aimed to estimate the prevalence of lifetime HIV testing and identify factors associated with lifetime HIV testing among Thai adults. Methods: This study was a secondary analysis of data from the 6th Thai National Health Examination Survey. A total of 11,843 Thai adults aged 20-59 years were included. Descriptive statistics were used to estimate the prevalence of lifetime HIV testing. Survey-weighted logistic regression analyses were performed to examine factors associated with lifetime HIV testing. Results: The overall prevalence of lifetime HIV testing was 41.9%, with a prevalence of 42.4% among males, and 41.4% among females. Individuals aged 30-39 years (AOR = 1.64, 95% CI: 1.43-1.87) and 40-49 years (AOR = 1.67, 95% CI: 1.41-1.99), those with secondary education (AOR = 1.64, 95% CI: 1.43-1.87) or certificate/higher education (AOR = 1.74, 95% CI: 1.48-2.05), those currently living with a partner (AOR = 1.60, 95% CI: 1.43-1.79), participants with higher monthly income (10,000-24,999 THB: AOR = 1.13, 95% CI: 1.01-1.27; ≥25,000 THB: AOR = 1.39, 95% CI: 1.13-1.70), residents in the Northern region (AOR = 1.74, 95% CI: 1.45-2.09), and those who had a relative or acquaintance living with HIV/AIDS (AOR = 1.46, 95% CI: 1.34-1.59) were more likely to have lifetime HIV testing. In contrast, Muslim participants (AOR = 0.72, 95% CI: 0.57-0.90), residents of rural areas (AOR = 0.88, 95% CI: 0.79-0.97), residents in the Central (AOR = 0.82, 95% CI: 0.69-0.98) and Southern regions (AOR = 0.83, 95% CI: 0.72-0.94), and those with higher HIV-related stigma (AOR = 0.91, 95% CI: 0.84-0.99) were less likely to have lifetime HIV testing. Conclusions: Lifetime HIV testing among Thai adults remained suboptimal, with geographic and sociodemographic disparities.

INTRODUCTION:Type 2 diabetes mellitus affects pregnancy and can lead to maternal complications. Women affected by diabetes during pregnancy have ongoing physical, psychological, and social needs until birth preparation and after childbirth. The Social Determinants of Health (SDoH) can have a greater impact on health outcomes than healthcare services or personal lifestyle choices alone. To date, no study has explored how women with type 2 diabetes experience life after childbirth. To help close this knowledge gap, the proposed study aims to: 1) Culturally adapt and translate the Postnatal Well-being in Transition scale into Thai. 2) Quantitatively describe the SDoH and postnatal well-being during the diabetes transition among Thai women with T2DM. 3) Explore Thai women's experiences regarding their SDoH, based on the mean scores of their postnatal well-being during the diabetes transition. And 4) Explore and analyze the impact of postnatal care on women with T2DM using a mixed-methods approach. METHODS:This is an explanatory sequential mixed-methods study protocol with two distinct phases. The first phase involves the translation of the study instrument, while the second phase focuses on data collection for the mixed-methods study. Data will be collected from 50 postnatal women with type 2 diabetes mellitus who have delivered a baby within the past six weeks. Participants will provide data on demographics, social determinants of health, and their postnatal well-being in transition. From this group, 12 women will be selected to participate in semi-structured, one-on-one interviews to gain a deeper understanding of their experiences. The study will use triangulation to integrate and validate the findings from both the quantitative and qualitative data sources. ETHICS AND DISSEMINATION:Human Research Ethics Committee approval has been received from the Faculty of Medicine Ramathibodi Hospital, Mahidol University. The study findings will be reported in international journals.

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.

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 to 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. Keywords: Attitude, Confidence, Pregnant Women, Type 2 Diabetes Mellitus

Objective: The objective of this review will be to synthesize the effectiveness of school-based programs for type 2 diabetes mellitus (T2DM) prevention for school children and adolescents. Introduction: Schools function as a fundamental platform for communicating health-related knowledge, such as information on preventing chronic diseases such as diabetes. However, the effectiveness of school-based programs for preventing T2DM in children and adolescents remains unclear. Inclusion criteria: This review will consider both experimental and quasi-experimental study designs, including randomized controlled trials, cluster randomized controlled trials, non-randomized controlled trials, before and after studies, and interrupted time-series studies. School children and adolescents aged 6 to 18 years (in Grades 1 to 12) of any ethnicity will be considered. This review will consider studies on T2DM prevention and education programs in school settings. Comparators will include no treatment, standard care, or waitlist controls, with outcomes covering diabetes risk factors, knowledge, health literacy, insulin sensitivity, fasting blood glucose, and glycated hemoglobin. These parameters will be assessed using validated instruments. Methods: This review will follow the JBI methodology for systematic reviews of effectiveness. The databases to be searched will include MEDLINE, CINAHL, Embase, PsycINFO, and Scopus. Two independent reviewers will select studies, critically appraise them using the standard JBI critical appraisal instruments, and extract data. Studies will be pooled in a meta-analysis or presented narratively. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach will be used to grade the certainty of the evidence. Review registration: PROSPERO CRD42024499998

Objective: The objective of this review was to explore the breastfeeding experiences and the management of mother’s own milk among mothers of preterm infants during their infant’s hospitalization. Introduction: Mothers of preterm infants often face distinct breastfeeding challenges that differ considerably from those experienced by mothers of term infants. The qualitative synthesis of evidence regarding the breastfeeding experiences of mothers with preterm infants in hospital settings is a valuable area of research that remains underexplored. Eligibility criteria: This systematic review included qualitative studies, as well as the qualitative components of mixed methods studies, that involved mothers of preterm infants, regardless of maternal age or social background. The review specifically focused on studies that explored maternal experiences with breastfeeding and mother’s own milk management during the hospitalization of their preterm infants. Methods: This review was conducted following JBI methodology for qualitative research, with the aim of examining relevant evidence from both published and unpublished studies up to July 2024. The initial search was conducted using PubMed, followed by an extensive search across PubMed, CINAHL (EBSCOhost), Embase (EBSCOhost), and Scopus. Unpublished studies and gray literature were searched through the Mahidol Library Catalogs and the Open Access Theses and Dissertations database. Retrieved records from academic databases, unpublished studies, gray literature, and reference lists of the retrieved records were screened. Studies published in English or Thai were eligible for inclusion. Two reviewers independently screened studies for eligibility and conducted critical appraisals. Data were then extracted and synthesized using meta-aggregation independently by 2 reviewers. All reviewers reached a consensus on the categories and finalized the synthesized findings. Results: This review included 53 studies conducted across 20 countries spanning 6 continents, involving approximately 1212 mothers. A total of 225 findings were identified and organized into 11 categories based on thematic similarities, resulting in 4 synthesized findings: i) Mothers are central to the breastfeeding process, playing a key role in making decisions regarding the provision of breast milk for their preterm infants; ii) Mothers of preterm infants often encounter unique personal challenges in providing breast milk to their infants; iii) External systems serve as both facilitators and barriers to breastfeeding and mother’s own milk management; and iv) Comprehensive support systems enhance breastfeeding practices and outcomes. Conclusions: This review provides a systematic synthesis of the experiences of breastfeeding and mother’s own milk management among mothers of preterm infants in hospital settings. It highlights that these mothers face significant breastfeeding difficulties due to their infant’s health-related concerns, emphasizing the need for comprehensive support to overcome these barriers. The limitations of this review include variability in the quality of the included studies and the potential for language bias. Recommendations for future research include further exploration of the breastfeeding experiences of mothers of preterm infants across diverse contexts, including home and community environments. Additionally, comprehensive breastfeeding support strategies, informed by the synthesized findings, should be investigated to enhance breastfeeding practices and outcomes for these mothers. Review registration: PROSPERO CRD42024501454

Background: Diabetes during pregnancy poses significant risks to maternal and fetal health. This study explores health care providers’ perspectives on factors influencing pregnant women with type 2 diabetes management in Thailand. Methods: A qualitative descriptive study based on the National Institute on Minority Health and Health Disparities (NIMHD) Research Framework. Semi-structured interviews were conducted with 13 physicians and nurses from two public hospitals (urban and rural areas). Directed content analysis was used to analyze the data, with themes and subthemes derived from initial codes based on the NIMHD framework. Results: Thirteen health care providers participated, including 10 nurses and 3 physicians. Three major themes emerged. Each theme was categorized into NIMHD domains of influence, including biological, behavioral, physical/built environment, and sociocultural environment. Theme 1: Individual-level factors include biological vulnerability and mechanisms in diabetes risk, maternal and neonatal complications, unplanned pregnancy and unawareness of preexisting diabetes, lifestyle behavior factors contributing to diabetes risk, diabetes management during pregnancy, environmental and workplace adjustments for pregnant women, sociodemographic challenges in diabetes management during pregnancy, and culture and beliefs in pregnancy care. Theme 2: Interpersonal-level factors include maternal responsibility for a safe pregnancy, family involvement in pregnancy care, promoting diabetes awareness and healthy lifestyle in schools and workplaces, and the role of social media and digital platforms in maternal health. Theme 3: Community-level factors include the role of community functioning in maternal health, access to healthy and safe food in the community, and cultural shifts toward convenience food options. Discussion: Emphasizing these factors requires a coordinated approach involving health care providers, families, communities, schools, workplaces, and policymakers. Tailored interventions promoting diabetes screening, healthy lifestyles, and supportive environments for pregnant women, particularly those from disadvantaged backgrounds, are crucial. Future research should focus on developing culturally sensitive, community-based strategies to overcome barriers to care and improve diabetes management during pregnancy.

Background: Sociocultural and behavioral factors have a multifaceted impact on maternal health. In Thailand, cultural influences significantly shape behaviors of diabetes self-management in women. However, the experience of self-managing diabetes in pregnant women with preexisting Type 2 Diabetes Mellitus (T2DM) remains unclear. Objectives: The study aimed to explore challenges and support factors of diabetes self-management among pregnant women with preexisting T2DM in Thailand, and to compare these factors between women in two groups (optimal and suboptimal maternal health outcomes). Methods: A convergent mixed-methods study was conducted at a tertiary hospital (March to October 2022). Eligible participants were Thai pregnant women, aged 20-44, diagnosed with T2DM. Participants first completed a questionnaire and then were interviewed about diabetes self-management. Maternal health outcomes (i.e., gestational weight gain and glycated hemoglobin [HbA1c]) were reviewed and extracted. Descriptive statistics were used for quantitative analysis, while directed content analysis was used for qualitative data. Side-by-side matrices were used to describe the qualitative subthemes with quantitative results. Results: Twelve Thai pregnant women participated in the study, aged 27 to 40 years, with gestational ages ranging from 7 to 38 weeks and T2DM diagnoses spanning from 3 weeks to 10 years. Half of the participants were obese before pregnancy. Weight gain patterns revealed that 41.67% had inadequate gain, 33.33% had optimal gain, and 25% had excessive gain. HbA1C levels indicated that 75% had good glycemic control. Three women achieved optimal weight gain and glycemic control, while nine exhibited suboptimal health outcomes. We identified six main themes: 1) challenges at the individual level in managing diabetes, 2) support factors at the individual level for diabetes management, 3) challenges at the interpersonal level in controlling diet, 4) interpersonal support factors for managing diabetes, 5) challenges at the societal level in accessing healthcare, and 6) societal support factors for healthcare access. Conclusion: The findings suggest that managing diabetes during pregnancy necessitates dynamic, patient-centered care throughout the pregnancy journey. Regarding the clinical implication, it is important to tailor approaches to the Thai context and to prioritize education and boost women’s confidence in managing diabetes throughout pregnancy.

BACKGROUND:Research has shown that late fatigue post-stroke is associated with poorer long-term outcomes, but the association between early fatigue with concurrent outcomes like physical function within six months is underexplored. AIM:To explore the interrelationship between stroke survivors' adaptation to fatigue and physical function changes during hospitalization and at one, three, and six months post-stroke. DESIGN:A prospective longitudinal cohort study with a convergent mixed-methods design. METHODS:Adults (≥18 years) with first-ever ischemic stroke were included. Fatigue, physical function, and data from semi-structured interviews were collected at four time points. A mixed-effect model was used to explore the quantitative relationship, with physical function as the dependent outcome and fatigue as the fixed-effect variable. Directed content analysis was used for qualitative data. A side-by-side display was used to present mixed-methods findings. RESULTS:Thirty-two survivors were in the quantitative arm; nine of those were in the qualitative arm. Quantitative analysis showed that each unit increase in fatigue decreased physical function by 0.27, adjusting for age, depression, and time. Qualitative findings confirmed that fatigue hindered recovery and pre-stroke activity resumption. Survivors described a vicious cycle between fatigue and function, with varying fatigue patterns and exacerbating factors within six months. CONCLUSIONS:Fatigue and physical function were interrelated within six months after stroke. Given the small, single-center sample, these results should be interpreted cautiously. Still, our findings highlight the value of early, systematic fatigue assessment and collaborative discussions between survivors and health professionals to guide individualized management strategies. CLINICAL REHABILITATION IMPACT:Managing post-stroke fatigue requires both survivor-led strategies (e.g., self-monitoring, rest, pacing) and professional support to address contributing conditions. Routine follow-up should include systematic fatigue assessment, collaborative discussion of management options, and periodic re-evaluation to optimize recovery.

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.

Poststroke fatigue severely affects stroke survivors (SSs) physically and mentally. Although the literature acknowledges the critical role of care partners (CPs) in survivors' fatigue adaptation, this topic remains under-explored. This study, guided by the Adaptive Leadership Framework for Chronic Illness, explored how SSs and CPs managed fatigue collaboratively within 6 months poststroke. This longitudinal qualitative analysis included nine first-time ischemic SSs and their CPs who consented to interviews. Semistructured interviews were conducted during the index hospitalization (or within 10 days postdischarge) and at 1, 3, and 6 months poststroke. Directed content analysis was used to analyze the data. Four themes were identified. First, SSs and CPs engaged in collaborative work by achieving a mutual understanding of fatigue levels but misalignment was found during 3-6 months poststroke. Second, CPs provided emotional and practical support, exercising adaptive leadership to help survivors adapt to fatigue. The support squad, including informal and formal helpers beyond the primary CPs, also undertook adaptive leadership behaviors to facilitate the post-stroke adaptation to fatigue for both SSs and CPs. Third, the day-to-day realities of post-stroke fatigue presented persistent challenges for SSs. Fourth, SSs managed fatigue (adaptive work) by using self-awareness, resting, and pacing activities. Results suggested the need for SSs and CPs to develop a shared understanding of fatigue. Healthcare professionals should treat SSs and CPs as an adaptive unit, ensuring access to support resources at discharge to facilitate post-stroke adaptation to fatigue.

BackgroundBreastfeeding positively influences glucose regulation in postpartum women with diabetes.AimThis study aimed to describe breastfeeding barriers and facilitators in postpartum women with type 2 diabetes mellitus (T2DM).MethodsThis qualitative analysis utilized data from a parent study with a convergent parallel mixed-methods design. We interviewed postpartum women with T2DM and extracted fasting plasma glucose levels from medical records taken at 4 to 6 weeks after childbirth.ResultsEight postpartum women with T2DM participated. Those who exclusively breastfed had normal fasting plasma glucose levels. Six themes emerged as breastfeeding barriers and facilitators across individual, interpersonal, and societal levels. Individual barriers included low milk production, dietary cravings, and emotional challenges of first-time motherhood. Interpersonal barriers involved lactation issues, baby conditions, and mother-baby separation post-birth. Societal barriers included short maternal leave, workplace difficulties with pumping, baby's location, and healthcare costs. Individual facilitators included breastfeeding intention and dietary practices to boost milk. Interpersonal facilitators were understanding baby cues and family support. Societal facilitators were involved in Thai postpartum traditions, health literacy, and lactation rooms in hospitals.ConclusionsOur findings highlighted the importance of identifying women's barriers and facilitators in breastfeeding, addressing physical and emotional challenges, and conducting lactation assessments. The study emphasized the need for increased workplace support for ongoing breastfeeding and individualized support that considers cultural beliefs and hospital practices.

BACKGROUND:Home-based chemotherapy (HBC) has emerged as a standard option for treating various types of cancer, primarily to decrease the waiting time for treatment. As HBC gains more recognition, ongoing research is delving into the experiences of patients with cancer who receive chemotherapy in a home setting or chemotherapy closer to home. Understanding these experiences is vital for the use of chemotherapy delivery outside the traditional hospital environments. This review aims to synthesize and critically appraise qualitative studies that investigate the experience and perspectives of patients with cancer who received parenteral chemotherapy administration in home settings. Findings will be used to develop evidence-based policies to support home-based care models. METHODS:This review will follow JBI methods for systematic reviews of qualitative evidence. The databases for searching will include MEDLINE (PubMed), CINAHL (EBSCOhost), PsycINFO (EBSCOhost), ProQuest Health and Medical Collection, two Chinese databases, CNKI and Wanfang, and one Thai database, ThaiJO. Studies published in English, Chinese, and Thai will be considered for inclusion. Two reviewers will independently undertake study selection, data extraction, and critical appraisal of the methodological quality of studies. The synthesized findings will be assessed using the ConQual approach. DISCUSSION:The synthesis of qualitative studies on this topic will provide insights into the nuanced and varied experiences of patients receiving chemotherapy within the comfort of their homes. The review will also provide evidence-based recommendations to policymakers and healthcare administrators, to support the implementation of HBC for patients. SYSTEMATIC REVIEW REGISTRATION:Systematic review registration: PROSPERO CRD42024500476.

OBJECTIVE:The objective of this review is to synthesize the existing qualitative evidence on the breastfeeding experiences of mothers of hospitalized preterm infants. INTRODUCTION:Breastfeeding is crucial for the well-being and development of preterm infants born before 37 weeks' gestation. Mothers of preterm infants often face challenges that make breastfeeding particularly complex. Understanding mothers' breastfeeding experience is important for health care professionals, as it enables them to provide appropriate support and assistance. The qualitative evidence synthesis regarding the breastfeeding experiences of mothers of preterm infants in hospital settings is a valuable area of research that has not been documented. INCLUSION CRITERIA:This review will consider all qualitative studies that explore mothers' experiences of breastfeeding and mother's own milk management for their hospitalized infants. Mothers of preterm infants who provide their own milk to their infants will be considered, regardless of their age, gravidity, parity, singleton/multiple pregnancies, gender identity, marital status, social status, or preterm infant's gestational age. METHODS:This review will follow the JBI approach for qualitative systematic review. The search strategy aims to find both published and unpublished studies, with no date limit. A search of PubMed, CINAHL (EBSCOhost), and Embase (EBSCOhost) will be undertaken to identify articles on the topic. Studies published in English will be considered for inclusion in this review. Two independent reviewers will evaluate the methodological validity of the selected papers before incorporating them into the review. Data synthesis will be conducted using the meta-aggregation approach, and synthesized findings will be assessed using the ConQual approach. REVIEW REGISTRATION:PROSPERO CRD42024501454.

This study aimed to validate a translated and culturally adapted version of the Infant Feeding Intentions (IFI) Scale for use in Thailand. Prenatal breastfeeding intention is a strong indicator of breastfeeding initiation. The stronger the intention to breastfeed among pregnant women, the more likely breastfeeding will be initiated after childbirth and continue for an extended period. There are currently no IFI scales that have been validated for use in Thailand. The translation of the IFI scale from English to Thai was conducted through a six-stage approach that included initial translation, synthesis of translations, back-translation, expert committee review for content validity, reliability testing, and submission of the translated IFI to notify the scale developers. Both Item and Scale Content Validity Indices equaled 1, scored by five experts, who also validated the content for cross-cultural adaptation. The final Thai IFI (T-IFI) scale demonstrated high content validity. A total of 30 Thai pregnant women participated in the reliability testing. The Cronbach's alpha of the 5-item T-IFI scale was 0.857, which indicated satisfactory internal consistency. The T-IFI scale demonstrated high content validity and was culturally appropriate for use in a Thai-speaking population. It has potential to strengthen assessments of prenatal infant feeding intention among pregnant women in Thailand.

BACKGROUND:Pregnant women with pre-existing type 2 diabetes mellitus (T2DM) are at risk of poor maternal and neonatal health outcomes. Previous systematic reviews on pregnant women with T2DM have focused on physical activity, blood glucose monitoring, and insulin injections. OBJECTIVE:The purpose of this scoping review was to examine the barriers and facilitators to diabetes self-management in pregnant women with pre-existing type 2 diabetes mellitus. METHODS:PubMed, CINAHL, and EMBASE databases were searched using the PRISMA-ScR guidelines. Inclusion criteria included manuscripts written in English and qualitative studies. Consensus statements were excluded. A metasummary was used to identify patterns in barriers and facilitators across studies. A vote-counting method was used to summarize qualitative findings. RESULTS:A total of ten qualitative publications were selected. This review suggests four themes describing barriers, including barriers to diabetes self-management in pregnancy, stress related to pregnancy with diabetes, a barrier to access to health care, and sensing a loss of control. The fifth theme described facilitators of diabetes self-management in pregnancy. CONCLUSION:This supports an integrative model of maternity care and culturally relevant practices to overcome critical barriers and optimize key facilitators to enhance diabetes self-management behaviors and improve maternal and neonatal health outcomes.

Women with type 2 diabetes mellitus are at a higher risk of pregnancy complications. Although traditional beliefs and practices influence diabetes management and breastfeeding, recommendations integrating Thai cultural beliefs in maternal care are lacking. The purpose of this study is to describe diabetes self-management in pregnancy and breastfeeding experiences in women with preexisting type 2 diabetes mellitus from Thailand. A convergent parallel mixed-methods study will be conducted. Data will be collected from 20 pregnant women with preexisting type 2 diabetes mellitus in Thailand who are either primigravida or multigravida, aged 20-44 years old, speak the Thai language, and provide consent. The National Institute on Minority Health and Health Disparities Framework's sociocultural and behavioral domains guides the research aims. Data will be collected two times. The first time is during pregnancy (T1); study participants will complete questionnaires and engage in an interview about diabetes self-management, breastfeeding confidence, and breastfeeding intention. The second time is at 4-6 weeks postpartum (T2); study participants will be interviewed about their breastfeeding experiences. We will review and extract maternal health outcomes including body mass index, gestational weight gain, and glycated hemoglobin for T1 as well as fasting plasma glucose for T2. Qualitative data will be analyzed using directed content analysis. Quantitative data will be analyzed using descriptive statistics. Data sources will be triangulated with relative convergence in the results. This proposed study is significant because the findings will be used as a preliminary guide to developing a culturally tailored approach to enhance health outcomes of Thai women with diabetes in pregnancy and postpartum periods.