Gough Aisling, McCance David, Alderdice Fiona, Harper Roy, Holmes Valerie
Queen's University Belfast, Northern Ireland, United Kingdom.
BMJ Qual Improv Rep. 2015 Oct 12;4(1). doi: 10.1136/bmjquality.u209621.w3984. eCollection 2015.
Women with diabetes need to plan for pregnancy if they are to reduce their risk of poor pregnancy outcome. While care providers have focused on setting up specialist pre-pregnancy planning clinics to help women prepare for pregnancy, the majority of women do not attend, entering pregnancy unprepared. A major barrier to accessing this care, and a consequence of poor preconception counselling, is a lack of knowledge as to the need to plan and the reasons why. This project addressed an urgent need to raise awareness of the importance of planning for pregnancy among women with diabetes and among the healthcare professionals (HCPs) caring for them. Focus groups with the target groups informed the development of a preconception counselling resource for women with diabetes. Originally produced as a DVD (Diabetes UK funding), this resource has been embedded in routine care in Northern Ireland (NI) since 2010. A subsequent service evaluation of pregnancy planning indicators undertaken across all five antenatal-metabolic clinics in NI indicated that women who viewed the resource were better prepared for pregnancy. In order to increase the positive impact of the resource and to ensure longer term sustainability the DVD was converted to a website, http://www.womenwithdiabetes.net (Public Health Agency NI funding). The evaluation also highlighted that women with type 2 diabetes were a hard to reach group. As these women are often cared for outside of specialist clinics, it is pertinent that all HCPs caring for women with diabetes are aware of the importance of preconception counselling. Funding also supported the development of an e-learning continuing professional development (CPD) resource within the website. The e-learning resource has since been embedded into existing CPD programmes and is an important tool to ensure that all HCPs caring for women with diabetes are empowered to provide preconception counselling at every opportunity.
患有糖尿病的女性若想降低不良妊娠结局的风险,就需要做好妊娠规划。尽管医疗服务提供者致力于设立专门的孕前规划诊所,以帮助女性为怀孕做好准备,但大多数女性并未前往就诊,而是毫无准备地怀孕了。获得此类护理的一个主要障碍以及孕前咨询不足的一个后果是,女性缺乏对规划必要性及其原因的认识。该项目满足了一项迫切需求,即提高糖尿病女性及其护理医疗专业人员(HCPs)对妊娠规划重要性的认识。与目标群体进行的焦点小组讨论为开发糖尿病女性孕前咨询资源提供了依据。该资源最初是以DVD形式制作的(由英国糖尿病协会资助),自2010年以来已纳入北爱尔兰(NI)的常规护理中。随后对NI所有五家产前代谢诊所进行的妊娠规划指标服务评估表明,观看该资源的女性对怀孕准备得更充分。为了增强该资源的积极影响并确保长期可持续性,DVD被转换成了一个网站,即http://www.womenwithdiabetes.net(由NI公共卫生机构资助)。评估还强调,2型糖尿病女性是一个难以接触到的群体。由于这些女性通常在专科诊所之外接受护理,所有护理糖尿病女性的HCPs都意识到孕前咨询的重要性是很有必要的。资金还支持在网站内开发一个电子学习继续职业发展(CPD)资源。此后,该电子学习资源已被纳入现有的CPD项目中,并且是确保所有护理糖尿病女性的HCPs有能力抓住一切机会提供孕前咨询的重要工具。