Babu Giridhara R, Tejaswi B, Kalavathi M, Vatsala G M, Murthy G V S, Kinra Sanjay, Neelon Sara E Benjamin
Public Health Foundation of India, IIPH-H , Bangalore Campus, India.
Bruhat Bangalore Maha Nagara Palike , India.
J Public Health Res. 2015 Mar 9;4(1):448. doi: 10.4081/jphr.2015.448. eCollection 2015 Feb 20.
Screening and timely treatment of gestational hyperglycaemia (GH) is proved to be beneficial and improves maternal and foetal health outcomes. To understand screening practices, we explored the knowledge and perceptions of doctors working in public health facilities in Bangalore, India. We also studied participation factors by examining whether undergoing glucose estimation tests affects morning sickness in pregnant women.
We aimed to understand the screening practices and knowledge of doctors. A semi-structured questionnaire was self-administered by the 50 participant doctors, selected from the sampling frame comprising of all the doctors working in public health facilities. We included 105 pregnant women for baseline assessment, in whom a well-structured questionnaire was used.
We reported that gestational diabetes mellitus (GDM) screening was done in nearly all the health centres (96%). However, only 12% of the doctors could provide all components of GDM diagnosis and management correctly and 46% would diagnose by using a random blood glucose test. A majority (92%) of the doctors had poor knowledge (68%) about the cut-off values of glucose tests. More than 80% of pregnant women experienced some discomfort mostly due to rapid ingestion glucose in short span of time.
Our study established that screening for GH is done in most public health facilities. Nonetheless, knowledge of doctors on the glucose tests and their interpretation needs improvement. Re-orientation trainings of the doctors can improve their knowledge and thereby can efficiently screen for GH. Further, adequate planning prior to the tests can aid successful completion of them. Significance for public healthRising burden of hyperglycaemia in pregnancy is a cause for concern and is associated with short and long term deleterious consequences for mother and offspring. Hence, there is an urgent need to explore the screening practices for gestational hyperglycaemia (GH). The current study considers patient and doctors' perspectives regarding GH screening. The results from our study indicate several issues during screening of gestational hyperglycaemia in public health facilities in Bangalore, India. These included low awareness levels among doctors, lack of standard operating procedures and lack of adequate care and attention provided to pregnant women. Re-orientation trainings of the doctors within public health facilities can improve their knowledge and thereby can efficiently screen for GH. Further, adequate planning and preparation of the patient prior to the tests can help ensure successful completion of the tests. The findings of the study are comparable with the practices of public health hospitals in India.
妊娠期高血糖（GH）的筛查和及时治疗已被证明是有益的，可改善母婴健康结局。为了解筛查实践情况，我们探究了印度班加罗尔公共卫生机构医生的知识和看法。我们还通过检查进行血糖估计测试是否会影响孕妇的晨吐来研究参与因素。
我们旨在了解医生的筛查实践和知识。50名参与研究的医生自行填写了一份半结构化问卷，这些医生是从所有在公共卫生机构工作的医生组成的抽样框架中选取的。我们纳入了105名孕妇进行基线评估，使用了一份结构完善的问卷。
我们报告称，几乎所有健康中心（96%）都进行妊娠期糖尿病（GDM）筛查。然而，只有12%的医生能够正确提供GDM诊断和管理的所有要素，46%的医生会使用随机血糖测试进行诊断。大多数（92%）医生对血糖测试的临界值了解不足（68%）。超过80%的孕妇经历了一些不适，主要是由于在短时间内快速摄入葡萄糖。
我们的研究表明，大多数公共卫生机构都进行GH筛查。尽管如此，医生对血糖测试及其解读的知识仍需改进。对医生进行重新定向培训可以提高他们的知识水平，从而能够有效地筛查GH。此外，在测试前进行充分规划有助于测试的顺利完成。对公共卫生的意义妊娠期高血糖负担的不断增加令人担忧，并且与母亲和后代的短期和长期有害后果相关。因此，迫切需要探索妊娠期高血糖（GH）的筛查实践。本研究考虑了患者和医生对GH筛查的观点。我们研究的结果表明，在印度班加罗尔的公共卫生机构进行妊娠期高血糖筛查期间存在几个问题。这些问题包括医生的认识水平低、缺乏标准操作程序以及对孕妇缺乏足够的护理和关注。对公共卫生机构内的医生进行重新定向培训可以提高他们的知识水平，从而能够有效地筛查GH。此外，在测试前对患者进行充分的规划和准备有助于确保测试的顺利完成。该研究的结果与印度公共卫生医院的实践情况具有可比性。
