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针对患有糖尿病的青春期女孩开展孕前咨询的母女二元法。

Mother-daughter dyadic approach for starting preconception counseling at puberty in girls with diabetes.

作者信息

Charron-Prochownik Denise, Fischl Andrea Rodgers, Choi Jessica, Schmitt Patricia L, White Neil H, Becker Dorothy, Downs Julie, Hannan Margaret, Thurheimer Jennifer, Sereika Susan M

机构信息

Department of Health Promotion & Development, University of Pittsburgh, School of Nursing, USA.

Department of Pediatrics, Washington University in St. Louis, and St. Louis Children's Hospital, St. Louis, Missouri, USA.

出版信息

Res J Womens Health. 2014 Dec 29;1. doi: 10.7243/2054-9865-1-2.

Abstract

BACKGROUND

Preconception counseling (PC) significantly and inexpensively reduces risks of reproductive-health complications for women with diabetes. Our validated technology-based preconception counseling intervention, , is tailored for female teens with type 1 (T1D) and type 2 (T2D) diabetes and targets decision-making regarding effective family planning and seeking PC. Our teen-focused research was instrumental in changing the American Diabetes Association's Practice Recommendations to specify that preconception counseling should "Start at puberty…". This directive requires support from well-informed mothers of teens. Our goal is to provide both teen girls and their mothers with preconception counseling knowledge, and provide mothers with sex-communication training. Evaluation should focus on mother-daughter dyads.

PURPOSE

This feasibility study explored mother's and daughter's awareness and knowledge of diabetes and pregnancy, and preconception counseling; and compared mother-daughter responses using dyadic analyses.

METHODS

A mixed-method design was conducted with 10 mothers of daughters with T1D. Mothers were given intervention and completed knowledge and support questionnaires. Their responses were compared to those of their daughter's who were participating in a large randomized, control intervention trial with .

RESULTS

The major theme from one-on-one interviews was, "I know nothing about diabetes/pregnancy risks and PC". Mother's and daughter's perceptions of having limited knowledge were confirmed by low knowledge scores. Mothers perceived giving higher levels of support compared to their daughter's perceptions of receiving support.

CONCLUSION

Mothers can play a vital role in initiating discussions regarding reproductive-health with their daughters and reinforcing preconception counseling. Mother-daughter team approach for starting preconception counseling at puberty in girls with diabetes is feasible. Mother-daughter dyadic analyses can be important to explore possible mediating and moderating roles of mother-daughter communication and support about reproductive health on the relationship between intervention and sustainable outcomes.

摘要

背景

孕前咨询(PC)能显著且低成本地降低糖尿病女性生殖健康并发症的风险。我们基于技术的经过验证的孕前咨询干预措施是为患有1型糖尿病(T1D)和2型糖尿病(T2D)的少女量身定制的,目标是围绕有效的计划生育和寻求孕前咨询进行决策。我们以青少年为重点的研究有助于改变美国糖尿病协会的实践建议,明确指出孕前咨询应“从青春期开始……”。这一指令需要了解情况的少女母亲的支持。我们的目标是为少女及其母亲提供孕前咨询知识,并为母亲提供性沟通培训。评估应聚焦于母女二元组。

目的

这项可行性研究探讨了母亲和女儿对糖尿病与妊娠以及孕前咨询的认识和知识;并使用二元分析比较了母女的反应。

方法

对10位患有T1D女儿的母亲进行了混合方法设计的研究。母亲们接受了干预措施,并完成了知识和支持问卷。将她们的回答与参与一项大型随机对照干预试验的女儿们的回答进行比较。

结果

一对一访谈的主要主题是,“我对糖尿病/妊娠风险和孕前咨询一无所知”。母女知识得分较低,证实了她们认为自己知识有限的看法。母亲们认为自己给予的支持水平较高,而女儿们认为自己得到的支持水平较低。

结论

母亲在与女儿展开关于生殖健康的讨论以及强化孕前咨询方面可发挥至关重要的作用。对患有糖尿病的女孩在青春期开始进行孕前咨询采用母女团队方法是可行的。母女二元分析对于探讨母女关于生殖健康的沟通和支持在干预措施与可持续结果之间的关系中可能起到的中介和调节作用可能很重要。

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Standards of medical care in diabetes--2009.《糖尿病医疗护理标准——2009》
Diabetes Care. 2009 Jan;32 Suppl 1(Suppl 1):S13-61. doi: 10.2337/dc09-S013.

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