Background: Insulin resistance (IR) and type 2 diabetes (T2DM) promote myocardial dysfunction in ... more Background: Insulin resistance (IR) and type 2 diabetes (T2DM) promote myocardial dysfunction in the absence of traditional cardiovascular risk factors such as hypertension or coronary heart disease. Termed diabetic cardiomyopathy (DMCM), this type of cardiomyopathy often evolves to heart failure (HF), therefore worsening outcomes for people living with T2DM. Low-fat diets (LF) have been recommended for patients with cardiovascular disease but have provided limited symptom relief.Aim: The aim of this research is to examine the effect of a low-carbohydrate (LC) diet compared with usual care (UC) in patients with DMCM. This study hypothesises that the LC diet will improve symptoms of HF and quality of life (QoL) in patients with DMCM.Setting: For this 16-week randomised controlled trial 80 adult patients ( 18 years of age) with T2DM (HbA1c ≥ 6.5) or IR (triglyceride glucose index value [TyG] 4.49) and HF from an outpatient HF clinic in Victoria, Australia were recruited.Methods: Parti...
BackgroundThe Coronavirus disease 2019 (COVID‐19) pandemic has had a major impact on healthcare s... more BackgroundThe Coronavirus disease 2019 (COVID‐19) pandemic has had a major impact on healthcare services with many changes to telehealth care delivery. More information is needed about the patient perspective of telehealth in hospital services and the potential costs and benefits for patients.AimTo measure patients' evaluation of telehealth, preferences for telehealth versus in‐person appointments, and potential cost savings by patient characteristics.MethodsA cross‐sectional online survey (including patient and appointment characteristics, telehealth evaluation, preferences for care and costs) of adult patients using video telehealth in four metropolitan tertiary hospital services in Melbourne, Victoria.ResultsA total of 1045 patients (median age 44 years; interquartile range 29–59) participated with an overall response rate of 9.2%. For 98.7% patients, telehealth was convenient, 96.4% stated that it saved time, 95.9% found telehealth acceptable to receive care and 97.0% found ...
IntroductionIn the management of type 2 diabetes, autonomy-supporting interventions may be a prer... more IntroductionIn the management of type 2 diabetes, autonomy-supporting interventions may be a prerequisite to achieving more long-term improvement. Preliminary evidence has shown that the guided self-determination (GSD) method might have an effect on haemoglobin A1c and diabetes distress in people with type 1 diabetes. Previous trials were at risk of uncertainty. Thus, the objective is to investigate the benefits and harms of a GSD intervention versus an attention control group intervention in adults with type 2 diabetes.Methods and analysisThis trial protocol is guided by the The Standard Protocol Items: Recommendations for International Trials Statement. We describe the protocol for a pragmatic randomised, dual-centre, parallel-group, superiority clinical trial testing a GSD intervention versus an attention control for people with type 2 diabetes in outpatient clinics. The participants (n=224) will be recruited from two diverse regions of Denmark. The experimental stepped-care inte...
Objective Evaluate the feasibility and acceptability of an online guided self-determination (GSD)... more Objective Evaluate the feasibility and acceptability of an online guided self-determination (GSD) program to improve diabetes self-management skills among young adults with type 1 diabetes (YAD). Methods An online program comprising seven structured interactive conversations was designed. A pre- and post- interventional study used a sequential, two-phase multiple method design. Phase one comprised a training program for diabetes educators (DEs). In Phase two YAD participated in program and completed pre- and post-surveys assessing motivation to self-manage, perceived competence in diabetes and communication with DEs. Both YAD and DEs provided a program evaluation. Results The online GSD program was acceptable, feasible and effective in improving autonomous motivation in self-management and communication with DEs. Easy access and program flexibility were highly appreciated by both participant groups and perceived to assist YAD to stay motivated. Conclusion The program had a significant impact on the diabetes self-management of YAD and was a feasible and acceptable way to engage and communicate with DEs. The GSD platform contributes to age appropriate and person-centred diabetes self-management. It can potentially reach geographically distanced populations, or with social circumstances or other barriers impeding in-person service provision.
Abstract \ Chronic conditions also referred to as non communicable diseases are the largest cause... more Abstract \ Chronic conditions also referred to as non communicable diseases are the largest causes of death in the developed world *(AIHW, 2017; WHO, 2014). Moreover, due to their very nature, individuals who develop one or more chronic conditions must continue to live with the burden of the condition and the treatments. \ \ To date healthcare systems have not addressed chronic disease management well (Hacker et al., 2017). Given the increasing numbers of individuals presenting with one or multiple chronic diseases today, it makes it an imperative to develop superior approaches for managing patients with chronic conditions so that they enjoy a high level of well-being as well as try to stem the rising economic burden to healthcare systems and society (WHO, 2014). In Australia alone 50% of individuals have one chronic disease such as cancer, obesity diabetes or depression and 20% have at least two chronic diseases (AIHW, 2017). The problem is further underscored when one considers the projected costs of chronic disease management (ibid). \ \ This paper highlights a research stream that is embarking on identifying a new approach to increase patients’ life skills, empower them to better manage their condition and establish insights which increase their health literacy using Guided Self Determination (GSD). Supported by positive results from a Danish study, the GSD solution represents a paradigm shift in how chronic disease management is addressed (Zoffmann, 2004). The following presents the GSD method, describes the role for IS/IT and then highlights key aspects of the pilots to be conducted in Australia.
Aim and objectiveTo evaluate evidence that examined nurses' work experiences in hospital ward... more Aim and objectiveTo evaluate evidence that examined nurses' work experiences in hospital wards with single rooms. The research question was ‘What does the research tell us about nurses’ work experiences in hospital wards with single rooms?’BackgroundIn the last decades, new hospital builds have moved towards including a high proportion of single rooms. Yet, single rooms create ‘complex environments’ that impact the nurses.DesignA structured integrative review was undertaken of empirical evidence.MethodsOriginal, peer‐reviewed articles, written in English, were sourced from four databases: CINAHL, PubMed, Embase and Web of Science. The initial searches were performed in April 2021 and repeated in December 2022. Quality appraisal was undertaken using the Mixed Methods Appraisal Tool. A narrative synthesis approach was used to analyse the data. Reporting was guided by the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) statement.ResultsTwelve studies, pu...
International Journal of Environmental Research and Public Health
Inpatient falls are devastating for patients and their families and an ongoing problem for health... more Inpatient falls are devastating for patients and their families and an ongoing problem for healthcare providers worldwide. Inpatient falls overnight are particularly difficult to predict and prevent. The aim of this cohort study was to evaluate effectiveness of overnight portable video monitoring as an adjunct falls prevention strategy for high falls risk patients in inpatient clinical units. Over three months, three clinical inpatient wards were provided with baby monitor equipment to facilitate portable video monitoring. Portable video monitoring registers were completed nightly and nursing staff were invited to complete surveys (n = 31) to assess their experiences of using portable video monitoring. A total of 494 episodes of portable video monitoring were recorded over the three-month period, with clinical areas reporting a total of four inpatient falls from monitoring participants (0.8% of total portable video monitoring episodes). Overall, there was a statistically significant...
Background People of low socioeconomic position (SEP) are disproportionately affected by type 2 d... more Background People of low socioeconomic position (SEP) are disproportionately affected by type 2 diabetes (T2D), partly due to unhealthy eating patterns that contribute to inadequate disease self-management and prognosis. Digital technologies have the potential to provide a suitable medium to facilitate diabetes education, support self-management, and address some of the barriers to healthy eating, such as lack of nutritional knowledge or shopping or cooking skills, in this target group. Objective This study aims to test the feasibility, appeal, and potential effectiveness of EatSmart, a 12-week, evidence-based, theoretically grounded, fully automated web-based and mobile-delivered healthy eating behavior change program to help disadvantaged people living with T2D to eat healthily on a budget and improve diabetes self-management. Methods EatSmart is a mixed methods (quantitative and qualitative) pre-post design pilot study. Sixty socioeconomically disadvantaged people with T2D aged 1...
Aim To explore the impact of COVID-19 on psychosocial well-being and learning for nursing and mid... more Aim To explore the impact of COVID-19 on psychosocial well-being and learning for nursing and midwifery undergraduate students in an Australian university. Background The World Health Organization has reported a substantial psychological impact of COVID-19 on healthcare professionals to date. Evidence is lacking, however, regarding university nursing and midwifery students of the pandemic and its impact on their educational preparation and/or clinical placement during the COVID-19 pandemic. Design Cross-sectional survey of nursing and midwifery undergraduate students enrolled in the Bachelor of Nursing suite of courses from the study institution in August- September 2020. Methods A cross-sectional self-administered anonymous online survey was distributed to current nursing and midwifery undergraduate students. The survey included three open-ended questions; responses were thematically analysed. Results Of 2,907 students invited, 637 (22%) responded with 288 of the respondents (45%) providing a response to at least one of the three open-ended questions. Three major themes associated with the impact of the pandemic on psychosocial well-being and learning were identified: psychosocial impact of the pandemic, adjustment to new modes of teaching and learning, and concerns about course progression and career. These themes were underpinned by lack of motivation to study, feeling isolated, and experiencing stress and anxiety that impacted on students’ well-being and their ability to learn and study. Conclusions Students were appreciative of different and flexible teaching modes that allowed them to balance their study, family, and employment responsibilities. Support from academic staff and clinical facilitators/mentors combined with clear and timely communication of risk management related to personal protective equipment (PPE) in a healthcare facility, were reported to reduce students’ stress and anxiety. Ways to support and maintain motivation among undergraduate nursing and midwifery students are needed.
International Journal of Nursing Education Scholarship, 2021
Objectives To assess depression, anxiety and stress among undergraduate nursing and midwifery stu... more Objectives To assess depression, anxiety and stress among undergraduate nursing and midwifery students during the COVID-19 pandemic, and identify socio-demographic and educational characteristics associated with higher depression, anxiety and stress scores. Methods Cross-sectional study during August–September 2020, using an anonymous, online, self-administered survey. E-mail invitations with a survey link were sent to 2,907 students enrolled in the Bachelor of Nursing suite of courses, offered across four campuses of a single university in Victoria, Australia. Depression, anxiety and stress were assessed using the DASS-21. Data on socio-demographic and educational characteristics, self-rated physical health and exposure to COVID-19 were also collected. DASS-21 subscale scores were compared with existing data for various pre-pandemic and COVID-19 samples. Multiple regression was used to investigate factors associated with higher scores on depression, anxiety and stress subscales. Re...
Aim This study aimed to engage young adults with type 1 diabetes (T1D) who have self-reported low... more Aim This study aimed to engage young adults with type 1 diabetes (T1D) who have self-reported low motivation and suboptimal blood glucose control in a specifically tailored Guided Self-Determination online program and to explore the perspectives of young adults and their diabetes educators regarding the utility of the Guided Self-Determination program on an online platform. Methods An exploratory descriptive design with four stages involving: 1. Developing the Guided Self-Determination program online 2. Training diabetes educators to use the Guided Self-Determination program in an online format 3. Implementing and pilot testing the Guided Self-Determination program 4. Evaluating the online version Results Eight diabetes educators and eleven young adults with T1D participated in the study. Both groups of participants found the Guided Self-Determination program online promoted re¼ections that created solutions and facilitated an expedient client journey based on the young adults’ needs/goals, which in turn, changed the way they collaborated with each other. Participants identified website design issues relating to an inability to save material and not being mobile-friendly, although this did not impact participation or outcomes. Conclusions The online Guided Self-Determination format is a suitable, convenient and advantageous way to communicate and engage with young adults with T1D. All participants found the online communication expedient, ¼exible and particularly suitable for young adults who had lost motivation. The Guided Self- Determination program online is worth further technological development to improve the life skills and self-management of young adults with T1D.
Background: Insulin resistance (IR) and type 2 diabetes (T2DM) promote myocardial dysfunction in ... more Background: Insulin resistance (IR) and type 2 diabetes (T2DM) promote myocardial dysfunction in the absence of traditional cardiovascular risk factors such as hypertension or coronary heart disease. Termed diabetic cardiomyopathy (DMCM), this type of cardiomyopathy often evolves to heart failure (HF), therefore worsening outcomes for people living with T2DM. Low-fat diets (LF) have been recommended for patients with cardiovascular disease but have provided limited symptom relief.Aim: The aim of this research is to examine the effect of a low-carbohydrate (LC) diet compared with usual care (UC) in patients with DMCM. This study hypothesises that the LC diet will improve symptoms of HF and quality of life (QoL) in patients with DMCM.Setting: For this 16-week randomised controlled trial 80 adult patients ( 18 years of age) with T2DM (HbA1c ≥ 6.5) or IR (triglyceride glucose index value [TyG] 4.49) and HF from an outpatient HF clinic in Victoria, Australia were recruited.Methods: Parti...
BackgroundThe Coronavirus disease 2019 (COVID‐19) pandemic has had a major impact on healthcare s... more BackgroundThe Coronavirus disease 2019 (COVID‐19) pandemic has had a major impact on healthcare services with many changes to telehealth care delivery. More information is needed about the patient perspective of telehealth in hospital services and the potential costs and benefits for patients.AimTo measure patients' evaluation of telehealth, preferences for telehealth versus in‐person appointments, and potential cost savings by patient characteristics.MethodsA cross‐sectional online survey (including patient and appointment characteristics, telehealth evaluation, preferences for care and costs) of adult patients using video telehealth in four metropolitan tertiary hospital services in Melbourne, Victoria.ResultsA total of 1045 patients (median age 44 years; interquartile range 29–59) participated with an overall response rate of 9.2%. For 98.7% patients, telehealth was convenient, 96.4% stated that it saved time, 95.9% found telehealth acceptable to receive care and 97.0% found ...
IntroductionIn the management of type 2 diabetes, autonomy-supporting interventions may be a prer... more IntroductionIn the management of type 2 diabetes, autonomy-supporting interventions may be a prerequisite to achieving more long-term improvement. Preliminary evidence has shown that the guided self-determination (GSD) method might have an effect on haemoglobin A1c and diabetes distress in people with type 1 diabetes. Previous trials were at risk of uncertainty. Thus, the objective is to investigate the benefits and harms of a GSD intervention versus an attention control group intervention in adults with type 2 diabetes.Methods and analysisThis trial protocol is guided by the The Standard Protocol Items: Recommendations for International Trials Statement. We describe the protocol for a pragmatic randomised, dual-centre, parallel-group, superiority clinical trial testing a GSD intervention versus an attention control for people with type 2 diabetes in outpatient clinics. The participants (n=224) will be recruited from two diverse regions of Denmark. The experimental stepped-care inte...
Objective Evaluate the feasibility and acceptability of an online guided self-determination (GSD)... more Objective Evaluate the feasibility and acceptability of an online guided self-determination (GSD) program to improve diabetes self-management skills among young adults with type 1 diabetes (YAD). Methods An online program comprising seven structured interactive conversations was designed. A pre- and post- interventional study used a sequential, two-phase multiple method design. Phase one comprised a training program for diabetes educators (DEs). In Phase two YAD participated in program and completed pre- and post-surveys assessing motivation to self-manage, perceived competence in diabetes and communication with DEs. Both YAD and DEs provided a program evaluation. Results The online GSD program was acceptable, feasible and effective in improving autonomous motivation in self-management and communication with DEs. Easy access and program flexibility were highly appreciated by both participant groups and perceived to assist YAD to stay motivated. Conclusion The program had a significant impact on the diabetes self-management of YAD and was a feasible and acceptable way to engage and communicate with DEs. The GSD platform contributes to age appropriate and person-centred diabetes self-management. It can potentially reach geographically distanced populations, or with social circumstances or other barriers impeding in-person service provision.
Abstract \ Chronic conditions also referred to as non communicable diseases are the largest cause... more Abstract \ Chronic conditions also referred to as non communicable diseases are the largest causes of death in the developed world *(AIHW, 2017; WHO, 2014). Moreover, due to their very nature, individuals who develop one or more chronic conditions must continue to live with the burden of the condition and the treatments. \ \ To date healthcare systems have not addressed chronic disease management well (Hacker et al., 2017). Given the increasing numbers of individuals presenting with one or multiple chronic diseases today, it makes it an imperative to develop superior approaches for managing patients with chronic conditions so that they enjoy a high level of well-being as well as try to stem the rising economic burden to healthcare systems and society (WHO, 2014). In Australia alone 50% of individuals have one chronic disease such as cancer, obesity diabetes or depression and 20% have at least two chronic diseases (AIHW, 2017). The problem is further underscored when one considers the projected costs of chronic disease management (ibid). \ \ This paper highlights a research stream that is embarking on identifying a new approach to increase patients’ life skills, empower them to better manage their condition and establish insights which increase their health literacy using Guided Self Determination (GSD). Supported by positive results from a Danish study, the GSD solution represents a paradigm shift in how chronic disease management is addressed (Zoffmann, 2004). The following presents the GSD method, describes the role for IS/IT and then highlights key aspects of the pilots to be conducted in Australia.
Aim and objectiveTo evaluate evidence that examined nurses' work experiences in hospital ward... more Aim and objectiveTo evaluate evidence that examined nurses' work experiences in hospital wards with single rooms. The research question was ‘What does the research tell us about nurses’ work experiences in hospital wards with single rooms?’BackgroundIn the last decades, new hospital builds have moved towards including a high proportion of single rooms. Yet, single rooms create ‘complex environments’ that impact the nurses.DesignA structured integrative review was undertaken of empirical evidence.MethodsOriginal, peer‐reviewed articles, written in English, were sourced from four databases: CINAHL, PubMed, Embase and Web of Science. The initial searches were performed in April 2021 and repeated in December 2022. Quality appraisal was undertaken using the Mixed Methods Appraisal Tool. A narrative synthesis approach was used to analyse the data. Reporting was guided by the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) statement.ResultsTwelve studies, pu...
International Journal of Environmental Research and Public Health
Inpatient falls are devastating for patients and their families and an ongoing problem for health... more Inpatient falls are devastating for patients and their families and an ongoing problem for healthcare providers worldwide. Inpatient falls overnight are particularly difficult to predict and prevent. The aim of this cohort study was to evaluate effectiveness of overnight portable video monitoring as an adjunct falls prevention strategy for high falls risk patients in inpatient clinical units. Over three months, three clinical inpatient wards were provided with baby monitor equipment to facilitate portable video monitoring. Portable video monitoring registers were completed nightly and nursing staff were invited to complete surveys (n = 31) to assess their experiences of using portable video monitoring. A total of 494 episodes of portable video monitoring were recorded over the three-month period, with clinical areas reporting a total of four inpatient falls from monitoring participants (0.8% of total portable video monitoring episodes). Overall, there was a statistically significant...
Background People of low socioeconomic position (SEP) are disproportionately affected by type 2 d... more Background People of low socioeconomic position (SEP) are disproportionately affected by type 2 diabetes (T2D), partly due to unhealthy eating patterns that contribute to inadequate disease self-management and prognosis. Digital technologies have the potential to provide a suitable medium to facilitate diabetes education, support self-management, and address some of the barriers to healthy eating, such as lack of nutritional knowledge or shopping or cooking skills, in this target group. Objective This study aims to test the feasibility, appeal, and potential effectiveness of EatSmart, a 12-week, evidence-based, theoretically grounded, fully automated web-based and mobile-delivered healthy eating behavior change program to help disadvantaged people living with T2D to eat healthily on a budget and improve diabetes self-management. Methods EatSmart is a mixed methods (quantitative and qualitative) pre-post design pilot study. Sixty socioeconomically disadvantaged people with T2D aged 1...
Aim To explore the impact of COVID-19 on psychosocial well-being and learning for nursing and mid... more Aim To explore the impact of COVID-19 on psychosocial well-being and learning for nursing and midwifery undergraduate students in an Australian university. Background The World Health Organization has reported a substantial psychological impact of COVID-19 on healthcare professionals to date. Evidence is lacking, however, regarding university nursing and midwifery students of the pandemic and its impact on their educational preparation and/or clinical placement during the COVID-19 pandemic. Design Cross-sectional survey of nursing and midwifery undergraduate students enrolled in the Bachelor of Nursing suite of courses from the study institution in August- September 2020. Methods A cross-sectional self-administered anonymous online survey was distributed to current nursing and midwifery undergraduate students. The survey included three open-ended questions; responses were thematically analysed. Results Of 2,907 students invited, 637 (22%) responded with 288 of the respondents (45%) providing a response to at least one of the three open-ended questions. Three major themes associated with the impact of the pandemic on psychosocial well-being and learning were identified: psychosocial impact of the pandemic, adjustment to new modes of teaching and learning, and concerns about course progression and career. These themes were underpinned by lack of motivation to study, feeling isolated, and experiencing stress and anxiety that impacted on students’ well-being and their ability to learn and study. Conclusions Students were appreciative of different and flexible teaching modes that allowed them to balance their study, family, and employment responsibilities. Support from academic staff and clinical facilitators/mentors combined with clear and timely communication of risk management related to personal protective equipment (PPE) in a healthcare facility, were reported to reduce students’ stress and anxiety. Ways to support and maintain motivation among undergraduate nursing and midwifery students are needed.
International Journal of Nursing Education Scholarship, 2021
Objectives To assess depression, anxiety and stress among undergraduate nursing and midwifery stu... more Objectives To assess depression, anxiety and stress among undergraduate nursing and midwifery students during the COVID-19 pandemic, and identify socio-demographic and educational characteristics associated with higher depression, anxiety and stress scores. Methods Cross-sectional study during August–September 2020, using an anonymous, online, self-administered survey. E-mail invitations with a survey link were sent to 2,907 students enrolled in the Bachelor of Nursing suite of courses, offered across four campuses of a single university in Victoria, Australia. Depression, anxiety and stress were assessed using the DASS-21. Data on socio-demographic and educational characteristics, self-rated physical health and exposure to COVID-19 were also collected. DASS-21 subscale scores were compared with existing data for various pre-pandemic and COVID-19 samples. Multiple regression was used to investigate factors associated with higher scores on depression, anxiety and stress subscales. Re...
Aim This study aimed to engage young adults with type 1 diabetes (T1D) who have self-reported low... more Aim This study aimed to engage young adults with type 1 diabetes (T1D) who have self-reported low motivation and suboptimal blood glucose control in a specifically tailored Guided Self-Determination online program and to explore the perspectives of young adults and their diabetes educators regarding the utility of the Guided Self-Determination program on an online platform. Methods An exploratory descriptive design with four stages involving: 1. Developing the Guided Self-Determination program online 2. Training diabetes educators to use the Guided Self-Determination program in an online format 3. Implementing and pilot testing the Guided Self-Determination program 4. Evaluating the online version Results Eight diabetes educators and eleven young adults with T1D participated in the study. Both groups of participants found the Guided Self-Determination program online promoted re¼ections that created solutions and facilitated an expedient client journey based on the young adults’ needs/goals, which in turn, changed the way they collaborated with each other. Participants identified website design issues relating to an inability to save material and not being mobile-friendly, although this did not impact participation or outcomes. Conclusions The online Guided Self-Determination format is a suitable, convenient and advantageous way to communicate and engage with young adults with T1D. All participants found the online communication expedient, ¼exible and particularly suitable for young adults who had lost motivation. The Guided Self- Determination program online is worth further technological development to improve the life skills and self-management of young adults with T1D.
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Papers by Bodil Rasmussen