Svensson Line, Nielsen Karoline Kragelund, Maindal Helle Terkildsen
Department of Public Health, Aarhus University, Aarhus, Denmark.
Steno Diabetes Center Copenhagen, Gentofte, Denmark.
Scand J Caring Sci. 2018 Jun;32(2):756-764. doi: 10.1111/scs.12506. Epub 2017 Aug 30.
Women with gestational diabetes mellitus (GDM) receive acute but short-term care during pregnancy. There is less direct support during the postpartum period; women are offered general advice on how to follow a healthy lifestyle to avoid developing future type 2 diabetes. Observational studies suggest that a substantial proportion of women with prior GDM do not sustain recommended lifestyle changes postpartum. In a qualitative study, we examined how Danish women diagnosed with GDM experience the transition from a GDM-affected pregnancy to the postpartum period.
Semistructured interviews with six women diagnosed with GDM. Data were analysed using qualitative content analysis.
A GDM diagnosis was accompanied by worries about the health of the woman's baby. This was also the driving force behind the women's motivation to engage in lifestyle changes during pregnancy. The outpatient treatment was perceived to be strict and associated with various challenges, including cravings and discomfort. After the delivery, taking care of the baby became the women's dominant focus. Social and emotional support from partners were needed to maintain motivation and prioritise a healthy lifestyle. The women's experience of the health system varied. However, in the postpartum period all the women experienced limited interaction and initiative from their healthcare providers in supporting them to engage in a healthy lifestyle.
This study identified barriers and facilitators to sustaining a healthy lifestyle postpartum. Efforts at multiple levels - including the individual, family and health system - are needed to facilitate and support a healthy lifestyle among women with prior GDM.
妊娠期糖尿病（GDM）女性在孕期接受的是急性但短期的护理。产后得到的直接支持较少；会向女性提供关于如何遵循健康生活方式以避免未来患2型糖尿病的一般建议。观察性研究表明，很大一部分既往患有GDM的女性产后并未维持推荐的生活方式改变。在一项定性研究中，我们调查了被诊断为GDM的丹麦女性如何体验从受GDM影响的孕期到产后阶段的转变。
对六名被诊断为GDM的女性进行半结构化访谈。采用定性内容分析法对数据进行分析。
GDM诊断伴随着对女性腹中胎儿健康的担忧。这也是女性在孕期积极改变生活方式的动力所在。门诊治疗被认为很严格，且伴随着各种挑战，包括渴望和不适。分娩后，照顾婴儿成为女性的主要关注点。需要伴侣给予社会和情感支持，以维持动力并优先选择健康的生活方式。女性对医疗系统的体验各不相同。然而，在产后阶段，所有女性都感到医疗服务提供者在支持她们采取健康生活方式方面的互动和主动性有限。
本研究确定了产后维持健康生活方式的障碍和促进因素。需要在多个层面——包括个人、家庭和医疗系统——做出努力，以促进和支持既往患有GDM的女性保持健康的生活方式。
