Department of Medicine, Division of General Internal Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA.
J Womens Health (Larchmt). 2011 Feb;20(2):239-45. doi: 10.1089/jwh.2010.2233. Epub 2011 Jan 25.
Women with a history of gestational diabetes mellitus (GDM) have an increased risk of developing type 2 diabetes (T2DM) but often do not return for follow-up care. We explored barriers to and facilitators of postpartum follow-up care in women with recent GDM.
We conducted 22 semistructured interviews, 13 in person and 9 by telephone, that were audiotaped and transcribed. Two investigators independently coded transcripts. We identified categories of themes and subthemes. Atlas.ti qualitative software (Berlin, Germany) was used to assist data analysis and management.
Mean age was 31.5 years (standard deviation) [SD] 4.5), 63% were nonwhite, mean body mass index (BMI) was 25.9 kg/m(2) (SD 6.2), and 82% attended a postpartum visit. We identified four general themes that illustrated barriers and six that illustrated facilitators to postpartum follow-up care. Feelings of emotional stress due to adjusting to a new baby and the fear of receiving a diabetes diagnosis at the visit were identified as key barriers; child care availability and desire for a checkup were among the key facilitators to care.
Women with recent GDM report multiple barriers and facilitators of postpartum follow-up care. Our results will inform the development of interventions to improve care for these women to reduce subsequent diabetes risk.
有妊娠糖尿病（GDM）病史的女性发生 2 型糖尿病（T2DM）的风险增加，但她们常常不进行产后随访。本研究旨在探讨近期患有 GDM 的女性进行产后随访的障碍因素和促进因素。
我们进行了 22 次半结构式访谈，其中 13 次为面对面访谈，9 次为电话访谈，并对访谈内容进行录音和转录。两名研究人员独立对转录内容进行编码。我们确定了主题和子主题的类别。使用 Atlas.ti 定性软件（德国柏林）协助数据分析和管理。
参与者的平均年龄为 31.5 岁（标准差为 4.5），63%为非裔美国人，平均体质指数（BMI）为 25.9kg/m²（标准差为 6.2），82%的人参加了产后检查。我们确定了四个总体主题，说明了产后随访的障碍因素，以及六个主题，说明了产后随访的促进因素。适应新生儿和对就诊时诊断出糖尿病的恐惧所导致的情绪压力被认为是主要障碍因素；而儿童保育的可用性和进行检查的愿望是促进护理的主要因素。
近期患有 GDM 的女性报告了产后随访的多种障碍因素和促进因素。我们的研究结果将为制定干预措施提供信息，以改善这些女性的护理，从而降低后续糖尿病的风险。
