Grady Caroline M, Geller Pamela A
Drexel University, Philadelphia, PA.
Diabetes Spectr. 2016 Feb;29(1):37-43. doi: 10.2337/diaspect.29.1.37.
Objective. The American Diabetes Association (ADA) recommends that women with diabetes attend preconception counseling and improve blood glucose levels before pregnancy to decrease risks of adverse outcomes. However, two-thirds of women with diabetes do not plan their pregnancies. Research has examined views regarding preconception counseling of pregnant women with diabetes, but perceptions of women with diabetes who have never been pregnant have not been explored. The purpose of this study was to examine the relationship between women's locus of control, self-efficacy, and outcome expectations of preconception counseling. Design and Methods. A sample of 147 nulligravid women with type 1 diabetes (mean age 25.9 years) was recruited online to complete a self-report survey. Measures included a sociodemographics form, a study-specific questionnaire regarding diabetes management and education, the Reproductive Health Attitudes and Behaviors instrument, and the Diabetes-Specific Locus of Control measure. Results. A standard multiple linear regression analysis indicated that self-efficacy was positively associated with expectations of preconception counseling (P <0.001), whereas self-blame was negatively associated (P = 0.001). Three-fourths of the women reported not receiving preconception counseling from health care providers. Conclusion. Self-efficacy was positively associated with women's expectation of preconception counseling usefulness, whereas self-blame for poor disease management was inversely related. The low reported rates of preconception counseling demonstrate that ADA recommendations for starting preconception counseling at puberty have not been followed uniformly. Women with diabetes should be provided education to increase their belief that they have control over their disease, which may lead to positive perceptions of preconception counseling and healthier pregnancies.
目的。美国糖尿病协会（ADA）建议患有糖尿病的女性在孕前接受孕前咨询，并在怀孕前改善血糖水平，以降低不良后果的风险。然而，三分之二的糖尿病女性并未计划怀孕。已有研究探讨了糖尿病孕妇对孕前咨询的看法，但从未怀孕的糖尿病女性的看法尚未得到研究。本研究的目的是探讨女性的控制点、自我效能感与孕前咨询结果期望之间的关系。
设计与方法。通过网络招募了147名未孕的1型糖尿病女性（平均年龄25.9岁）作为样本，以完成一份自我报告调查。测量工具包括一份社会人口统计学表格、一份关于糖尿病管理和教育的特定研究问卷、生殖健康态度与行为量表以及糖尿病特异性控制点测量工具。
结果。一项标准多元线性回归分析表明，自我效能感与孕前咨询期望呈正相关（P<0.001），而自责感与之呈负相关（P = 0.001）。四分之三的女性报告未从医疗保健提供者那里接受孕前咨询。
结论。自我效能感与女性对孕前咨询有用性的期望呈正相关，而对疾病管理不善的自责感与之呈负相关。报告的孕前咨询低比率表明，ADA关于在青春期开始孕前咨询的建议并未得到统一遵循。应为患有糖尿病的女性提供教育，以增强她们对自身疾病具有掌控力的信念，这可能会使她们对孕前咨询产生积极看法，并孕育更健康的胎儿。
