King Rosemary, Wellard Sally
School of Nursing, University of Ballarat, PO Box 663, Ballarat, 3353, Victoria, Australia.
Midwifery. 2009 Apr;25(2):126-33. doi: 10.1016/j.midw.2007.01.016. Epub 2007 May 16.
to explore the experiences of women with type 1 diabetes, living in rural Australia, while preparing for pregnancy and childbirth. Additionally, we aimed to describe the women's engagement with, and expectations of, health-care providers during this period, and subsequently highlight potential service and informational gaps.
qualitative research using a collective case-study design; seven women with type 1 diabetes who had given birth within the previous 12 months participated in in-depth interviews about their experiences of pregnancy and birth. Data were analysed thematically.
The experience of type 1 diabetes, preconception preparation and pregnancy among rural Australian women was explored, including interactions with health professionals.
seven women aged between 26 and 35 years agreed to be interviewed. The woman had one or two children and had given birth within the past 12 months.
rigid narrow control of blood glucose levels before conception and during pregnancy created unfamiliar body responses for women, with hypoglycaemic symptoms disappearing or changing. For example, some women mentioned developing tunnel vision or numbness and tingling around their lips and tongue as different symptoms of hypoglycaemia. Women needed information and support to differentiate between what might be normal or abnormal bodily processes associated with pregnancy, diabetes, or both. The women's preparation for conception and pregnancy was reliant on the level of available expertise and advice. Participants' experiences were coloured by their limited access and interactions with expert health professionals.
women with type 1 diabetes experienced significant hardship during their pregnancy, including a higher incidence of hypoglycaemic episodes, a loss of hypoglycaemic symptom recognition and weight gain. These difficulties were compounded by a scarcity of available information to support the management of their pregnancy and a lack of availability of experienced health professionals.
national and international consensus guidelines emphasise the importance of preconception and pregnancy care for women with type 1 diabetes. Close clinical supervision and the development of closer co-operation and partnership between the women and health-care providers before conception and during pregnancy may improve outcomes for these women and their babies. Building confidence in professional care requires increased access to specialist services, increased levels of demonstrated knowledge and expertise and better general community access to information about preparation for pregnancy and birth among women who have type 1 diabetes.
探讨澳大利亚农村地区1型糖尿病女性在备孕和分娩期间的经历。此外，我们旨在描述这些女性在此期间与医疗服务提供者的接触情况及期望，进而突出潜在的服务和信息差距。
采用集体案例研究设计的定性研究；7名在过去12个月内分娩的1型糖尿病女性参与了关于她们怀孕和分娩经历的深入访谈。对数据进行了主题分析。
探讨了澳大利亚农村地区女性1型糖尿病、孕前准备和怀孕的经历，包括与医疗专业人员的互动。
7名年龄在26至35岁之间的女性同意接受访谈。这些女性育有一两个孩子，且在过去12个月内分娩。
孕前和孕期对血糖水平的严格控制给女性带来了陌生的身体反应，低血糖症状消失或改变。例如，一些女性提到出现视野变窄或嘴唇和舌头周围麻木刺痛等不同的低血糖症状。女性需要信息和支持来区分与怀孕、糖尿病或两者相关的正常或异常身体过程。女性的备孕和怀孕准备依赖于可得的专业知识和建议水平。参与者的经历因与专业医疗人员接触有限和互动不足而受到影响。
1型糖尿病女性在孕期经历了重大困难，包括低血糖发作频率增加、低血糖症状识别能力丧失和体重增加。可用信息匮乏以支持其孕期管理以及缺乏经验丰富的医疗专业人员，使这些困难更加复杂。
国内和国际共识指南强调了1型糖尿病女性孕前和孕期护理的重要性。在孕前和孕期进行密切的临床监督以及女性与医疗服务提供者之间建立更紧密的合作关系，可能会改善这些女性及其婴儿的结局。增强对专业护理的信心需要增加专科服务的可及性、提高已展示的知识和专业水平，并使普通社区更好地获取1型糖尿病女性孕前和分娩准备的信息。
