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Yuanyuan Jiang,1 Shan Jiang,1,2 Qing Long,1 Jundi Yang,1,3 Jyu-Lin Chen,4 Jia Guo1 1Xiangya School of Nursing, Central South University, Changsha, Hunan Province, People’s Republic of China; 2Zhongda Hospital Affiliated to Southeast University, Nanjing, Jiangsu, People’s Republic of China; 3School of Nursing, The University of Hong Kong, Hong Kong, People’s Republic of China; 4School of Nursing, University of California San Francisco, San Francisco, CA, USACorrespondence: Jia Guo, Tel +86 13875947418, Email guojia621@163.comBackground: Women in rural areas of China face the unique risk of developing diabetes, but data on the glycemic status among women without prior diabetes diagnosis in rural areas are lacking which may limit the decision-making for diabetes screening or prevention. This study was aimed to describe the glycemic status of women determined by hemoglobin A1c (HbA1c) and explore its associating factors.Methods: A cross-sectional survey was conducted among women without prior diabetes diagnosis from two counties of rural areas in Central South China from July to October 2018. On the basis of the life course framework, data on socio-demographic, environmental health, genetic, biological (blood pressure, weight and height, lipids), psychosocial, and healthy behavioral factors were collected on site either through questionnaires or field measurements. The questionnaires included social-demographic sheet, Perceived Stress Scale, Self-efficacy scales for health-related diet and exercise behaviors, and Chinese Diabetes Risk Questionnaire. Generalized linear model analysis was performed to determine the associating factors of glycemic status, which was measured by HbA1c level.Results: A total of 647 women were included in the study. The median age of women was 51.00 years (range 35– 65 years). The median HbA1c level was 5.1% (interquartile range 4.6%-5.5%, range 4– 13.6%), and 8.7% (n=56) of women were identified as elevated glycemic status (HbA1c> 6%). Environmental health factors (eg, living in less-developed county [β=0.206, p=0.027]), biological factors (eg, higher body mass index [β=0.201, p=0.036], higher total cholesterol [β=0.097, p=0.040], history of gestational diabetes mellitus [β=0.722, p< 0.001]), and psychosocial factors (eg, higher perceived stress [β=0.247, p=0.002]) were associated with higher HbA1c level.Conclusion: This study reported 8.7% of elevated glycemic status among women without prior diabetes diagnosis in rural Hunan Province, China. After a comprehensive investigation based on a theoretical framework, living in a less-developed county of rural areas, having larger body mass index, higher total cholesterol, higher perceived stress, and a gestational diabetes mellitus history were identified as associating factors of higher HbA1c level. Professional support regarding weight control, blood lipid control, stress management, and the prevention of gestational diabetes mellitus should be recommended among this population, especially for women from less-developed counties.Keywords: women, rural areas, glycemic status, hemoglobin A1c, associating factors, survey

Obesity is a known risk factor for type 2 diabetes mellitus (T2DM); however, the associations between underweight and T2DM and between weight status and prediabetes have not been systematically reviewed. We aimed to estimate the relative risks (RRs) of prediabetes/T2DM in underweight/overweight/obesity relative to normal weight. PubMed, Embase, Web of Science, and Cochrane Library were searched from inception to December 8, 2021. Prospective cohort studies with a minimum 12-month follow-up period reporting the association between baseline body mass index (BMI) categories and risk of prediabetes/T2DM in adults were included. Study quality was assessed using the Newcastle-Ottawa Scale. The main analyses of T2DM risk were performed using the ethnic-specific (Asian/non-Asian) BMI classification and additional analyses of prediabetes/T2DM risk by including all eligible studies. Random-effects models with inverse variance weighting were used. Subgroup analyses and meta-regression were conducted to explore the potential effects of pre-specified modifiers. The study protocol was registered with PROSPERO (CRD42020215957). Eighty-four articles involving over 2.69 million participants from 20 countries were included. The pooled RR of prediabetes risk was 1.24 (95% CI: 1.19-1.28, I

Qingting Li,1,&ast; Yao Chen,1,&ast; Maritta Välimäki,1 Qing Long,1 Jundi Yang,2 Jia Guo1 1Xiangya School of Nursing, Central South University, Changsha, 410013, People’s Republic of China; 2School of Nursing, the University of Hong Kong, Pokfulam, 999077, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Jia Guo, Email guojia621@163.comBackground: Depressive symptoms are prevalent in persons with type 2 diabetes mellitus and related with poor disease outcomes. Both general self-efficacy and coping style are associated with depressive symptoms. A model about proactive coping indicates that coping style plays a mediation role between general self-efficacy and depressive symptoms. But, empirical evidence is missing about this potential mediation relationship which may be a barrier of taking precise strategies for relieving depressive symptoms.Objective: This study aims to investigate the prevalence of elevated depressive symptoms in persons with type 2 diabetes mellitus and explore whether coping style preference mediates the association between general self-efficacy and depressive symptoms.Methods: This was a secondary data analysis of a cross-sectional survey (June–July 2017) among 721 persons with type 2 diabetes mellitus (45.4% male and 54.6% female) aged from 22 to 96 years old. Data on general self-efficacy, coping style preference and depressive symptoms were collected using validated questionnaires in hospital setting. The mediation model was tested using the bootstrapping (K=5000) in the MPlus program version 7.4. The results were reported following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.Results: The prevalence of elevated depressive symptoms was 58% (n = 418) among persons with type 2 diabetes mellitus at hospital setting. A higher level of general self-efficacy was related to less depressive symptoms via positive coping preference (p < 0.01).Discussion: About two-thirds of persons with type 2 diabetes mellitus experienced elevated depressive symptoms during hospitalization. The intervention elements, including strengthening general self-efficacy and promoting positive coping, are promising to decrease their depressive symptoms.Keywords: type 2 diabetes mellitus, depressive symptoms, self-efficacy, coping style, mediation analysis

Purpose To adapt an evidence-based coping skills training program to the cultural context and healthcare system for youth with T1D in China, and to evaluate the feasibility, acceptability, and preliminary efficacy of the modified program. Design and methods A multiphase process was used based on a heuristic framework for program modification. This included information gathering, preliminary adaptation, and feasibility evaluation. Results In Stage 1, the coping skills training protocol was translated and evaluated for relevance by the stakeholders (youth diagnosed with T1D, parents, and healthcare providers). Recommendations for revisions and culturally relevant scenarios were identified. In Stage 2, the program was adapted for youth with a wider age range. Scenarios and logistics of the program were changed, and a session on blood glucose management was added to enhance cultural relevance. In Stage 3, the feasibility of the modified program was evaluated with 15 youth participants diagnosed with T1D (mean age: 13.88 years). Problem-solving coping and the self-efficacy of the youth improved over time (p Practice implications The CST-China program has the potential to provide Chinese youth with T1D an interactive and engaging program to improve health outcomes. The adaptation process of a CST program can provide a reference for pediatric nurses to develop programs which are culturally relevant, acceptable to stakeholders, and aligned with the healthcare system in China. Conclusions A coping skills training program was systematically adapted and aligned to the healthcare system in China, with evidence of feasibility and acceptability in Chinese youth with T1D.

Wencong Lv,1 Jiaxin Luo,1 Qing Long,1 Jundi Yang,2 Xin Wang,1 Jia Guo1 1Clinical Nursing Department, Xiangya School of Nursing, Central South University, Changsha, Hunan, People’s Republic of China; 2Nursing Department, School of Nursing, The University of Hong Kong, Hong Kong, People’s Republic of ChinaCorrespondence: Jia GuoClinical Nursing Department, Xiangya School of Nursing, Central South University, 172 Tongzipo Road, Changsha, Hunan, 410013, People’s Republic of ChinaTel +86 13875947418Email guojia621@163.comBackground: Self-monitoring of blood glucose (SMBG) plays a crucial role in the maintenance of glycemic control in young people with type 1 diabetes mellitus (T1DM), but most of them do not perform SMBG as recommended. Few studies comprehensively explored factors that correlate with adherence to SMBG among this population on the basis of a framework. Hence, the aims of this study were to describe adherence to SMBG among young people with T1DM in China and explore its associating factors according to the Self and Family Management (SFM) framework.Methods: A cross-sectional study was conducted on young people with T1DM in Hunan Province of China from July to August 2020. Based on the SFM framework, self-reported questionnaires were organized for the collection of data on adherence to SMBG, socio-demographic and clinical factors, resources, health care system, and personal factors. Factors associated with adherence to SMBG were determined through multivariate logistic regression analysis.Results: A total of 165 young people were invited, of which 122 (73.9%) completed the questionnaires. The mean age was 12.41 years (SD = 3.18), and the proportion of young people who adhered to SMBG was 53.3%. Multivariate logistic regression analysis revealed that children aged 8– 12 years (OR = 0.188, P = 0.002), from two-parent families (OR = 0.232, P = 0.019), and with better personal factors (eg, with more information of SMBG, OR = 1.072, P = 0.020; lower diabetes-related worry, OR = 0.917, P = 0.031; higher level of pain during SMBG, OR = 1.852, P = 0.001), had better adherence to SMBG.Conclusion: Nearly half of the young people with T1DM were not adherent to SMBG in China. Clinicians need to pay more attention to adolescents from single-parent families with regard to their adherence to SMBG. Providing management strategies of SMBG, including delivering SMBG-related information, decreasing diabetes-related worry, and relieving pain related to SMBG, may improve adherence.Keywords: self-monitoring of blood glucose, young people, type 1 diabetes mellitus, influencing factors

(a) To explore the effect of perceived stress on satisfaction with quality of life (QOL) among Chinese adolescents with type 1 diabetes (T1D); and (b) to determine if coping styles and self-efficacy are mediators of the association between perceived stress and satisfaction with QOL.Adolescents with T1D experience ongoing stress related to a complex treatment regimen and live with a condition that differentiates them from their peers. It is important to know how adolescents with T1D cope with the stress and what psychosocial attributes contribute to satisfaction with QOL.Cross-sectional study.Data were collected from a sample of adolescents with T1D (N = 90) who had enrolled in a randomized control trial (baseline data) and a supplemental sample of N = 59 adolescents with T1D was recruited from a diabetes clinic from January 2016 - December 2016.The mean age of the participants was 13.91 years (range 8-20 years), the mean diabetes duration was 4.02 years. Approximately one-quarter of the sample exceeded the criterion score for perceived stress of 26, indicating stress sufficient to have a negative impact on physical and mental health. Adolescents with increased stress reported lower satisfaction with QOL compared with adolescents with less stress. Both externalization coping and self-efficacy were the mediators of the relationship between perceived stress and satisfaction with QOL.Many Chinese adolescents with T1D reported elevated stress levels which was associated with decreased satisfaction with QOL. There is a need for culturally relevant interventions to improve coping by limiting the use of externalized coping styles and strengthening self-efficacy.目的: (a)探讨中国1型糖尿病(T1D)青少年生活质量知觉压力的影响;以及 (b)确定应对方式和自我效能感是否在感知压力和生活质量满意度之间起中介作用。 背景: 患有T1D的青少年经历着与复杂治疗方案相关的持续压力,并且生活在与同龄人不同的环境中。了解患有T1D的青少年是如何应对压力的,以及什么样的社会心理特征有助于提高他们对生活质量的满意度,这些都是很重要的。 设计: 横断面研究. 方法: 数据收集自登记参加随机对照试验的卫生组织(基线数据)的T1D青少年样本(N = 90) 以及从2016年1月至2016年12月,从一家糖尿病诊所招募了59名患有T1D的青少年作为补充样本。 结果: 平均年龄13.91岁(8 ~ 20岁),平均糖尿病病程4.02年。大约四分之一的样本超过了26分的压力感知评分标准,表明压力足以对身心健康产生负面影响。与压力较小的青少年相比,压力较大的青少年对生活质量的满意度较低。具体化应对和自我效能感是感知压力与生活质量满意度之间的中介因素。 结论: 许多患有T1D的中国青少年报告压力水平升高,这与生活质量满意度下降有关。有必要采取与文化相关的干预措施,通过限制外化应对方式的使用和增强自我效能来改善应对方式。.

Rapid modernization in China has impacted the daily lives and health of women, including a rise in obesity. However, little is known about the impact of menopausal status, behavior, and psychosocial factors on the risk of obesity for rural women in China. The aim of this study is to identify risk factors, including demographic information (education, family history of T2DM, menopausal status), obesity-related behavior, and psychosocial factors associated with overweight/general obesity and abdominal obesity. In a cross-sectional study design, participants had their weight, height, and waist circumference measured and completed questionnaires regarding family demographics, obesity-related health behaviors (physical activity, diet, sleep), and psychosocial information (stress, social support, and self-efficacy related to physical activity and healthy diet). A total of 646 women were included in this study; 46.6% were overweight/generally obese, and 48% had abdominal obesity. Postmenopausal women had a higher prevalence of general and central obesity. Regular physical activity decreased the risk for overweight/general obesity and abdominal obesity (OR = .41 and .31, respectively, p = .04) in premenopausal women. Postmenopausal women who had not breastfed their infants and reported moderate/high-stress had a higher risk for overweight/general obesity (OR = 3.93, and 2, respectively) and those who reported less than 6 hours of sleep per day increased their risk for abdominal obesity (OR = 2.08). Different factors associated with obesity were found in Chinese women, depending on menopausal status. Future studies should examine the impact of menopause on a woman’s risk for obesity, as well as develop tailored interventions to improve health, well-being and reduce the risk of obesity.

Women with prior gestational diabetes mellitus (GDM) are at a higher risk of type 2 diabetes and other health issues after delivery. They may have a lower quality of life (QoL), experience more medical-related stress, and need more support than those without it. This study aimed to examine the six-month efficacy of an intensive lifestyle modification program on perceived stress, social support, and QoL among women with prior GDM in rural China. A total of 320 women with prior GDM were randomly assigned to an intervention group (n = 160) and a control group (n = 160). Participants in the intervention group received an intensive lifestyle modification (ILSM) program, including a series of six biweekly face-to-face sessions and five biweekly phone sessions delivered by trained local health workers. The control group received the usual care. Data about perceived stress, social support, QoL, and HbA1c were collected at baseline, at three months, and at six-month follow-ups. Generalized estimating equation analysis was used to assess the efficacy of the intervention. There were significant improvements in the psychological domain (β = 0.479 ± 0.153, p = 0.002) and environmental domain (β = 0.462 ± 0.145, p = 0.001) of QoL over six months, there were significant group effects (β = −0.718 ± 0.280, p = 0.010) and time effects (β = 0.453 ± 0.211, p = 0.032) in physiological domain, and there were significant group effects in the social relations domain (β = −0.669 ± 0.321, p = 0.037). The ILSM group had a more pronounced downward trend in HbA1c than the control group (β = −0.050 ± 0.026, p = 0.059). The ILSM program can help women with GDM improve their psychological and environmental domain of QoL. It can be recommended as a form of health promotion for improving QoL among women with prior GDM in rural primary care settings in developing countries.

Diabetes self-management is suboptimal in adolescents with type 1 diabetes (T1D), including those in China. The aim of the study was to investigate the impact of parent–child relationship quality on diabetes self-management. Data were collected by a self-report survey among 122 Chinese adolescents from April to July 2017. The data were analyzed using a one-way analysis of variance, descriptive analyses, correlation analyses, and mediation analyses. The mean age was 13.8 (range, 10–18) years, and the mean diabetes duration was 4.1 (±3.1) years. About half of the adolescents with T1D experienced high levels of perceived stress. Parent–child relationship quality mediated the associations between perceived stress and collaboration with parents, diabetes care activities, and diabetes communication on aspects of diabetes self-management ( ps < 0.05). To reduce the negative impacts of perceived stress on diabetes self-management in this population, parent–child relationship quality should be considered an important element of family-based interventions and clinical practice.

Background: Gestational diabetes mellitus (GDM) increases the long-term risk of hypertension and cardiovascular events for mothers later in life but has not been well recognized by nurses. The aims of the study were to describe the proportion of increased blood pressure in rural women with previous GDM and to explore the sex (biological) and gender (sociocultural) factors that contribute to the increased blood pressure.Methods: A cross-sectional descriptive survey including 397 women with previous GDM was conducted in rural areas of Central South of China between November 2017 and June 2018. The variables of sex (e.g., age, ethnicity, family history of hypertension, time since delivery, 75-g oral glucose tolerance test, body mass index, and waist circumference) and gender (education, occupation, income, physical activity, fruit and vegetable intake, sedentary time, perceived stress, and general self-efficacy) were collected on research site. Increased blood pressure referred to systolic blood pressure of ≥130 mm Hg and/or diastolic blood pressure of ≥85 mm Hg. Logistic regression was performed to recognize the sex and gender factors associated with increased blood pressure. Results: There were nearly 20% (78/397) of participants first found increased blood pressure. Among those participants who had increased blood pressure, advanced age, a family history of hypertension, and abnormal 2-h plasma glucose levels were sex-related factors associating with the increased blood pressure (P < 0.05), while obesity indicators (body mass index and waist circumference) were not associated (P > 0.05). General self-efficacy, a gender factor, had a protective relationship with increased blood pressure (P < 0.05). Conclusions: Increased blood pressure is prevalent in rural Chinese women with previous GDM. Both sex and gender are determinants. Interventions promoting glycemic status and general self-efficacy are promising to improve their cardiovascular health later in life.

Author(s): Tang, Yujia; Guo, Jia; Long, Qing; Yang, Jundi; Luo, Jiaxin; Yang, Shuangyan; Li, Xiangxin; Mao, Ping; Chen, Jyu-Lin | Abstract: AIMS:The aims of the present study were: a) to investigate the current state of postpartum glucose screening in rural China; and b) to explore the factors influencing postpartum blood glucose screening among women with prior GDM based on Andersen's behavioural model of health service use. DESIGN:A multisite, cross-sectional study design, conducted from November 2017 to January 2018. METHODS:A total of 465 women with prior GDM were included from two county-level hospitals in rural China. The potential influencing factors for postpartum blood glucose screening based on Andersen's behavioural model, including predisposing, enabling, and need factors, were collected by self-reported questionnaires. Chi-square tests and logistic regression were used to explore the influence of these factors on whether screening of blood glucose level after delivery occurred. RESULTS:The mean age of the women was 31.92nyears old (SD 5.16) and the mean time after delivery was 16.73nmonths (SD 15.07). The postpartum glucose screening proportion was 32.7%. Women who did not have a full-time job (p= .011) (predisposing factor), had not received any treatment for GDM (p= .002), and were not informed about screening plans for diabetes by health professionals (p l .001) (enabling factor) were less likely to engage in postpartum glucose screening. The need factor, high actual risk of developing type 2 diabetes mellitus (T2DM), was not associated with postpartum blood glucose screening (pg .05). CONCLUSIONS:In rural China, most women with prior GDM were not screened for T2DM after delivery. The women with prior GDM who did not have a full-time job or had not received any prior treatment for GDM should be the target population for health education on postpartum glucose screening. IMPACT:There is a need for data on postpartum blood glucose testing rates among rural women. Future interventions aimed at increasing postpartum blood glucose screening are needed.

ObjectivesGestational diabetes mellitus (GDM) increases the risk of hypertension and cardiovascular events among mothers later in life. This risk has not been well recognised by healthcare professionals in rural China. Our objectives were to (1) describe the proportion of rural women with increased blood pressure and a history of GDM; and (2) explore the biological and sociocultural factors associated with increased blood pressure.DesignA retrospective cohort study using data from a cross-sectional survey.SettingData were collected in two county-level hospitals in the central south of China between November 2017 and June 2018.ParticipantsPostpartum women aged >18 years with a history of GDM (N=397).MethodsBiological and sociocultural variables were examined. We used bivariate analyses to examine the associations between time since delivery and 2-hour postload glucose, and logistic regression to determine the biological and sociocultural factors associated with increased postpartum blood pressure.ResultsApproximately 20% (n=78) of women had increased blood pressure, defined as a systolic blood pressure ≥130 mm Hg and/or a diastolic blood pressure ≥85 mm Hg. The biological factors of advanced age, family history of hypertension and abnormal 2-hour postload plasma glucose levels were positively associated with increased blood pressure (pConclusionsOne in five rural Chinese postpartum women with a history of GDM were found to have increased blood pressure. Biological and sociocultural factors were associated with increased postpartum blood pressure; women with lower general self-efficacy were more likely to have increased blood pressure. Disseminating knowledge about the high risk of developing increased blood pressure among women with prior GDM in rural China is indicated. Diabetes prevention programmes could consider adding general self-efficacy promotion strategies in this population.

Managing type 1 diabetes can be challenging, especially for youth, so there is a need for effective interventions to help youth live with diabetes.To determine the efficacy of a coping skills training (CST) program for Chinese youth with type 1 diabetes and to explore whether the efficacy of the program was different for school-aged children than for adolescents with type 1 diabetes.A total of 100 youth with type 1 diabetes aged 8 to 20 years were randomly placed in either an intervention group (CST + standard care [SC]) or a control group (SC). Data were collected at baseline, 6-month, and 12-month follow-ups on primary outcomes of perceived stress, coping, and self-efficacy and secondary outcomes of diabetes self-management, quality of life, and glycated hemoglobin A1c (HbA1c). A generalized estimating equation analysis for repeated measures was used to determine the program effects and differential effects by age group.The CST program had no significant effect on primary or secondary outcomes over 12 months. However, there was a significant increase in positive coping (P .001), self-efficacy (P = .017), diabetes problem-solving and goals of diabetes self-management (P = .007, P = .001), and quality of life (P = .016) of school-aged children in the intervention group compared with the control group. There were no significant differences in primary or secondary outcomes between the intervention group and the control group (P .05).The CST program was effective for school-aged children, improving psychosocial and diabetes self-management outcomes. Further research is needed to develop programs that improve outcomes in adolescents with type 1 diabetes.

The aims of this study were to: (a) determine if self-efficacy mediates the relationship between perceived stress and diabetes self-management in adolescents with type 1 diabetes (T1D); and (b) explore whether perceived stress moderated the self-efficacy and diabetes self-management relationship.Non-experimental, descriptive correlational design, conducted from January-December 2016.Guided by the Adaptation to Diabetes framework, data on demographic and clinical characteristics, perceived stress, self-efficacy and diabetes self-management were collected. Descriptive analyses and regression analyses were generated by SPSS Version 22. Structural equation modelling was implemented with the MPlus program.There was no direct effect of perceived stress on diabetes self-management; however, self-efficacy mediated the relationship between perceived stress and diabetes self-management. Adolescents who had high self-efficacy and low perceived stress demonstrated better diabetes care activities and diabetes communication than would be predicted from the main effects of self-efficacy and perceived stress alone.Decreasing perceived stress and improving self-efficacy are important strategies to improve diabetes self-management in adolescents with T1D.Adolescents with T1D experience considerable stress with daily self-management demands. This study highlights the mediating role of self-efficacy on perceived stress and diabetes self-management. Assessment of perceived stress and self-efficacy in self-management tasks in adolescents with T1D may help nurses individualize self-management education and support. Incorporating strategies to promote stress management and self-efficacy in diabetes education may also improve diabetes self-management.目的: 本研究的目的是:(a)确定自我效能感是否调节在1型糖尿病(T1D)青少年的感知压力和糖尿病自我管理之间的关系;(b)探讨感知压力是否调节自我效能感和糖尿病自我管理关系。 设计: 2016年1月-12月间实施的非实验性的描述性相关设计。 方法: 在糖尿病适应性框架的指导下,收集了人口学和临床特征、感知压力、自我效能和糖尿病自我管理方面的数据。采用SPSS 22版本进行描述性分析和回归分析。利用MPlus程序进行结构方程建模。 结果: 感知压力对糖尿病自我管理没有直接影响;然而,自我效能感调节了感知压力和糖尿病自我管理之间的关系。具有高自我效能感和低感知压力的青少年表现出更好的糖尿病护理活动和糖尿病沟通能力,这是自我效能感和感知压力的主要影响所不能预测的。 结论: 减少感知压力和提高自我效能感是改善青少年T1D患者糖尿病自我管理的重要策略。 影响: 患有T1D的青少年在日常自我管理需求方面承受着相当大的压力。本研究强调了自我效能感在感知压力和糖尿病自我管理中的中介作用。评估青少年T1D患者的自我管理任务中的感知压力和自我效能感可以帮助护士赋予自我管理教育和支持个性化。在糖尿病教育中采用促进压力管理和自我效能感的策略也可以改善糖尿病自我管理。.

This paper presents field measurements of diaphragm walls. During the study, a typical measurement section was embedded with concrete strain meters to measure the forces on and in the diaphragm walls. This permitted an extensive investigation of the internal force changes in diaphragm walls. Furthermore, the stability of diaphragm walls was evaluated and optimized. The data and design optimization led to the following conclusions: variations in the stresses of diaphragm walls were observed with increases in the excavation depth of foundation pits. The strain data obtained from field measurements allowed the calculation of safety factors for the diaphragm walls, which met national code standards. Therefore, the investigated diaphragm walls were judged to be safe. The variations in the diaphragm walls' internal forces were obtained for use as references in the design and construction of similar projects in the future.