Jones Emily J, Appel Susan J, Eaves Yvonne D, Moneyham Linda, Oster Robert A, Ovalle Fernando
College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA..
Capstone College of Nursing, University of Alabama, Tuscaloosa, AL.
J Obstet Gynecol Neonatal Nurs. 2012 Mar;41(2):246-257. doi: 10.1111/j.1552-6909.2012.01339.x.
To describe cardiometabolic risk among a sample of American Indian women with previous gestational diabetes and describe the women's knowledge, risk perception for type 2 diabetes and cardiovascular disease, and self-efficacy beliefs related to preventing these diseases.
Mixed methods, cross-sectional, exploratory, descriptive.
Four campuses within one American Indian tribal health care system in a southwestern state.
A purposeful sample of 22 self-identified American Indian women with a history of gestational diabetes.
Qualitative interview data were subjected to content analysis, and descriptive statistics were used to analyze quantitative questionnaire data and biophysiologic data.
The majority of participants (13 of 21) were classified as having metabolic syndrome, and 13 of 18 women were found to be insulin resistant. In general, the women had high levels of knowledge related to type 2 diabetes and cardiovascular disease and high risk perception, but low self-efficacy related to preventing cardiometabolic disease. The overarching theme from the in-depth interviews, struggling to change lifestyle behaviors while doubting prevention is possible, encompassed four categories that provided further illumination into participants' risk perceptions and self-efficacy beliefs: concerns, control, beliefs/attitudes, and prevention.
High levels of knowledge and risk perception do not necessarily promote increased self-efficacy to prevent cardiometabolic disease among American Indian women with previous gestational diabetes. Findings indicate the need to further explore women's self-efficacy beliefs in the context of American Indian culture prior to developing interventions aimed at increasing self-efficacy to prevent or delay type 2 diabetes and cardiovascular disease. Women with previous gestational diabetes are at increased risk for developing cardiovascular disease, independent of a diagnosis of type 2 diabetes.
描述曾患妊娠糖尿病的美国印第安女性样本中的心脏代谢风险，并描述这些女性对2型糖尿病和心血管疾病的知晓情况、风险认知以及与预防这些疾病相关的自我效能信念。
混合方法、横断面、探索性、描述性研究。
西南部某州一个美国印第安部落医疗系统内的四个院区。
22名自我认定有妊娠糖尿病史的美国印第安女性的目的性样本。
对定性访谈数据进行内容分析，使用描述性统计分析定量问卷数据和生物生理数据。
大多数参与者（21人中的13人）被归类为患有代谢综合征，18名女性中有13人存在胰岛素抵抗。总体而言，这些女性对2型糖尿病和心血管疾病有较高的知晓水平和风险认知，但在预防心脏代谢疾病方面自我效能较低。深入访谈的总体主题是，在怀疑预防是否可行的同时努力改变生活方式行为，该主题包含四个类别，进一步阐明了参与者的风险认知和自我效能信念：担忧、控制、信念/态度和预防。
对于曾患妊娠糖尿病的美国印第安女性，高水平的知晓和风险认知不一定会促进预防心脏代谢疾病的自我效能提高。研究结果表明，在制定旨在提高预防或延缓2型糖尿病和心血管疾病自我效能的干预措施之前，需要在美国印第安文化背景下进一步探索女性的自我效能信念。曾患妊娠糖尿病的女性患心血管疾病的风险增加，与2型糖尿病的诊断无关。
