Enablers and Barriers for Women With Gestational Diabetes Mellitus to Achieve Optimal Glycaemic Control - a Qualitative Study Using the Theoretical Domains Framework
Loading...
Files
Size: 829.09 KB, File format: Adobe PDF
Date
Authors
Martis, Ruth
Brown, Julie
McAra-Couper, Judith
Crowther, Caroline
Supervisor
Item type
Degree name
Journal Title
Journal ISSN
Volume Title
Publisher
BMC
Abstract
Background: Glycaemic target recommendations vary widely between international professional organisations for women with gestational diabetes mellitus (GDM). Some studies have reported women's experiences of having GDM, but little is known how this relates to their glycaemic targets. The aim of this study was to identify enablers and barriers for women with GDM to achieve optimal glycaemic control.
Methods: Women with GDM were recruited from two large, geographically different, hospitals in New Zealand to participate in a semi-structured interview to explore their views and experiences focusing on enablers and barriers to achieving optimal glycaemic control. Final thematic analysis was performed using the Theoretical Domains Framework.
Results: Sixty women participated in the study. Women reported a shift from their initial negative response to accepting their diagnosis but disliked the constant focus on numbers. Enablers and barriers were categorised into ten domains across the three study questions. Enablers included: the ability to attend group teaching sessions with family and hear from women who have had GDM; easy access to a diabetes dietitian with diet recommendations tailored to a woman's context including ethnic food and financial considerations; free capillary blood glucose (CBG) monitoring equipment, health shuttles to take women to appointments; child care when attending clinic appointments; and being taught CBG testing by a community pharmacist. Barriers included: lack of health information, teaching sessions, consultations, and food diaries in a woman's first language; long waiting times at clinic appointments; seeing a different health professional every clinic visit; inconsistent advice; no tailored physical activities assessments; not knowing where to access appropriate information on the internet; unsupportive partners, families, and workplaces; and unavailability of social media or support groups for women with GDM. Perceived judgement by others led some women only to share their GDM diagnosis with their partners. This created social isolation.
Conclusion: Women with GDM report multiple enablers and barriers to achieving optimal glycaemic control. The findings of this study may assist health professionals and diabetes in pregnancy services to improve their care for women with GDM and support them to achieve optimal glycaemic control.
Description
Keywords
Dietary advice, Exercise, Gestational diabetes mellitus, Health literacy, Pregnant women, Self-management, Theoretical domains framework, Science & Technology, Life Sciences & Biomedicine, Obstetrics & Gynecology, Physical activity, Perceived barriers, behaviour change, blood glucose, risk, association, experiences, management, adherence, 4203 Health Services and Systems, 32 Biomedical and Clinical Sciences, 42 Health Sciences, Behavioral and Social Science, Perinatal Period - Conditions Originating in Perinatal Period, Diabetes, Prevention, Pediatric Research Initiative, Clinical Research, Maternal Health, Pregnancy, Women's Health, Metabolic and endocrine, Reproductive health and childbirth, 3 Good Health and Well Being, 1110 Nursing, 1114 Paediatrics and Reproductive Medicine, 1117 Public Health and Health Services, Obstetrics & Reproductive Medicine, 3215 Reproductive medicine, 4204 Midwifery
Source
BMC Pregnancy and Childbirth, ISSN: 1471-2393 (Print); 1471-2393 (Online), BMC, 18(1), 91-. doi: 10.1186/s12884-018-1710-8
Publisher's version
Rights statement
© 2018 The Author(s). Open access.
Permanent link
Collections
Endorsement
Review
Supplemented By
Referenced By
Creative Commons license
Except where otherwise noted, this item's license is described as Creative Commons Attribution 4.0 International License