Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.
Faculty of Health and Social Sciences, Centre for Women's, Family and Child Health, University of South-Eastern Norway, Kongsberg, Norway.
Scand J Prim Health Care. 2021 Mar;39(1):44-50. doi: 10.1080/02813432.2021.1882077. Epub 2021 Feb 8.
We aimed to explore how women with gestational diabetes mellitus (GDM) experience advice about diet and self-monitoring of blood glucose received in primary health care (PHC) and secondary health care (SHC) with a focus on how women perceived the care coordination and collaboration between healthcare professionals.
DESIGN, SETTING AND SUBJECTS: Individual interviews were conducted with 12 pregnant women diagnosed with GDM. Six women had immigrant backgrounds, and six were ethnic Norwegian. Women received GDM care in the area of Oslo, Norway. Interviews were analysed using thematic analysis.
Women described feeling shocked when they were diagnosed with GDM and feeling an immediate need for information about the consequences and management of GDM. Most of the women felt that their general practitioner (GP) had too little knowledge about GDM. Women with an immigrant background felt that the PHC midwives provided them with sufficient dietary advice related to GDM. Ethnic Norwegian women appreciated receiving more individually tailored dietary advice in SHC. Self-monitoring of blood glucose influenced women's daily lives; however, they perceived the training in PHC and SHC as adequate. The women experienced poor collaboration between healthcare professionals in PHC and SHC, which implied that they sometimes had to initiate follow-up steps in their GDM care by themselves.
Ideally, women diagnosed with GDM should meet healthcare professionals with sufficient knowledge about GDM as soon as possible after being diagnosed. The collaboration between healthcare professionals involved in the care of women with GDM should be improved to avoid having women feel that they need to coordinate their own care.KEY POINTS•The management of gestational diabetes mellitus requires appropriate follow-up by healthcare professionals•Pregnant women's need for information about the consequences and management of gestational diabetes mellitus was highest immediately after diagnosis•Women perceived that they received more individually tailored information about diet and self-monitoring of blood glucose in secondary health care compared to primary health care•Women felt that general practitioners had insufficient knowledge about gestational diabetes mellitus•Based on our results, care coordination and collaboration between healthcare professionals involved in the care of women with gestational diabetes mellitus should be improved.
本研究旨在探讨患有妊娠期糖尿病(GDM)的女性在初级保健(PHC)和二级保健(SHC)中接受关于饮食和自我血糖监测的建议时的体验,重点关注女性如何看待医护人员之间的医疗协调和合作。
设计、地点和研究对象:对 12 名被诊断为 GDM 的孕妇进行了个体访谈。其中 6 名女性有移民背景,6 名女性为挪威裔。这些女性在挪威奥斯陆地区接受 GDM 护理。采用主题分析法对访谈内容进行分析。
女性在被诊断为 GDM 时感到震惊,并立即需要了解 GDM 的后果和管理信息。大多数女性认为她们的全科医生(GP)对 GDM 的了解太少。有移民背景的女性认为 PHC 助产士为她们提供了足够的与 GDM 相关的饮食建议。挪威裔女性则认为在 SHC 中接受更个性化的饮食建议更合适。自我血糖监测会影响女性的日常生活,但她们认为 PHC 和 SHC 中的培训是足够的。女性在 PHC 和 SHC 中经历了医护人员之间的协作不佳,这意味着她们有时需要自己主动采取后续步骤来管理 GDM。
理想情况下,女性在被诊断为 GDM 后应尽快与对 GDM 有足够了解的医护人员会面。应改善参与 GDM 护理的医护人员之间的协作,以避免让女性感到需要自行协调自己的护理。
妊娠期糖尿病的管理需要医护人员进行适当的随访。
女性在被诊断为 GDM 后立即对有关 GDM 后果和管理的信息有最大的需求。
与 PHC 相比,女性在 SHC 中接受的关于饮食和自我血糖监测的个性化信息更多。
女性认为全科医生对妊娠期糖尿病的了解不足。
根据我们的研究结果,需要改善参与 GDM 护理的医护人员之间的医疗协调和合作。