Navigating the food environment: lived experiences of managing type 2 diabetes mellitus through dietary change

This thesis portfolio aimed to understand the lived experiences of individuals with T2DM who make changes to their diet and lifestyle, to lose weight as a way to manage their T2DM condition. The first chapter is a systematic review, using a thematic synthesis methodology to explore individual’s experiences of proposed dietary modifications with a weight loss focus. Four themes were identified that helped us to understand the commonalities and differences in people’s experiences of this approach. We learned that providing tailored nutritional information that is comprehensible and culturally appropriate needed to be prioritised. We also identified a number of additional avenues for research exploration, and consideration from a policy perspective, given the variability in guidance offered for individuals. The second chapter built upon what was learned from this review, and specifically focused on one weight loss focused intervention delivered in NHS Lothian, Scotland. An interpretive phenomenological approach was employed, which allowed the researchers to explore patients' experiences on a case-by-case basis, and in depth. The research provides two vantage perspectives by participants of the programme showcasing the experience of those beginning and ending the weight management intervention. The findings allow a greater depth of understanding of the emotional voyage of being diagnosed with T2DM and undertaking this programme to make health behaviour change. There are a number of insights that provide scope for future research avenues and clinical considerations

Scoping Review: Suicide Specific Intervention Programmes for People Experiencing Homelessness

Background: The homeless population are among the most vulnerable groups to experience suicide ideation and behavior. Several studies have shown that people who are homeless experience more significant suicidal ideation and behavior than the general population. However, there is limited information about what suicide interventions exist, to what extent they are grounded in robust research, and which intervention components effectively reduce suicidal ideation and behavior in the homeless community. This research aimed to characterise the current evidence base in the area of suicide prevention for homeless individuals. Methods: A scoping review guided by Arksey and O’Malley’s five-stage framework was conducted and a narrative synthesis was performed. Pubmed, EMBASE, PsychInfo, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Open Grey, and Bielefeld Academic Search Engine were searched up to 8 May 2020. Results: A total of 3209 records were identified through database and grey literature searching. Three studies are included in this review. Key outcomes identify suicide intervention prevention programmes; similarities and differences across interventions, and examples of staff training. A quality review of the studies was completed. Conclusion: A stark gap in the evidence of suicide specific prevention interventions targeted at homeless populations