Guo Jia, Long Qing, Yang Jundi, Lin Qian, Wiley James, Chen Jyu-Lin
Xiangya School of Nursing, Central South University, Changsha 410013, China.
Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, Changsha 410078, China.
Int J Environ Res Public Health. 2021 Feb 5;18(4):1519. doi: 10.3390/ijerph18041519.
Women with prior gestational diabetes mellitus (GDM) are at a higher risk of type 2 diabetes and other health issues after delivery. They may have a lower quality of life (QoL), experience more medical-related stress, and need more support than those without it. This study aimed to examine the six-month efficacy of an intensive lifestyle modification program on perceived stress, social support, and QoL among women with prior GDM in rural China. A total of 320 women with prior GDM were randomly assigned to an intervention group ( = 160) and a control group ( = 160). Participants in the intervention group received an intensive lifestyle modification (ILSM) program, including a series of six biweekly face-to-face sessions and five biweekly phone sessions delivered by trained local health workers. The control group received the usual care. Data about perceived stress, social support, QoL, and HbA1c were collected at baseline, at three months, and at six-month follow-ups. Generalized estimating equation analysis was used to assess the efficacy of the intervention. There were significant improvements in the psychological domain (β = 0.479 ± 0.153, = 0.002) and environmental domain (β = 0.462 ± 0.145, = 0.001) of QoL over six months; there were significant group effects (β = -0.718 ± 0.280, = 0.010) and time effects (β = 0.453 ± 0.211, = 0.032) in physiological domain, and there were significant group effects in the social relations domain (β = -0.669 ± 0.321, = 0.037). The ILSM group had a more pronounced downward trend in HbA1c than the control group (β = -0.050 ± 0.026, = 0.059). The ILSM program can help women with GDM improve their psychological and environmental domain of QoL. It can be recommended as a form of health promotion for improving QoL among women with prior GDM in rural primary care settings in developing countries.
既往患有妊娠期糖尿病（GDM）的女性产后患2型糖尿病和其他健康问题的风险更高。与未患GDM的女性相比，她们的生活质量（QoL）可能较低，经历更多与医疗相关的压力，并且需要更多支持。本研究旨在探讨强化生活方式改变计划对中国农村既往患有GDM的女性的感知压力、社会支持和生活质量的六个月疗效。共有320名既往患有GDM的女性被随机分为干预组（n = 160）和对照组（n = 160）。干预组的参与者接受了强化生活方式改变（ILSM）计划，包括由训练有素的当地卫生工作者进行的一系列为期六周的每两周一次的面对面课程和五次每两周一次的电话课程。对照组接受常规护理。在基线、三个月和六个月随访时收集有关感知压力、社会支持、生活质量和糖化血红蛋白（HbA1c）的数据。使用广义估计方程分析来评估干预的疗效。六个月内生活质量的心理领域（β = 0.479 ± 0.153，P = 0.002）和环境领域（β = 0.462 ± 0.145，P = 0.001）有显著改善；生理领域有显著的组效应（β = -0.718 ± 0.280，P = 0.010）和时间效应（β = 0.453 ± 0.211，P = 0.032），社会关系领域有显著的组效应（β = -0.669 ± 0.321，P = 0.037）。ILSM组的HbA1c下降趋势比对照组更明显（β = -0.050 ± 0.026，P = 0.059）。ILSM计划可以帮助患有GDM的女性改善其生活质量的心理和环境领域。在发展中国家农村初级保健环境中，它可作为一种促进健康的形式被推荐用于改善既往患有GDM的女性的生活质量。
