Al Hashmi Iman
-
Minerva Obstet Gynecol. 2022 Apr;74(2):146-154. doi: 10.23736/S2724-606X.21.04754-7. Epub 2021 Apr 20.
Previous studies on (GDM) focused on finding new strategies to decrease the incidence of its complications; however, there is insufficient evidence that investigate the influencing factors of adherence to healthy behaviors. This study examined the influencing factors of adherence to healthy behaviors among pregnant women with gestational diabetes (GDM).
Descriptive cross-sectional design was used among pregnant women with gestational diabetes. The study participants completed study instruments twice (pre-test & post-test), with a four-weeks gap. The measurement scales included summary of diabetes self-care activities measure (SDSCA), diabetes management self-efficacy scales (DMSES) and open-ended questions to assess barriers and motivators of adherence. The analytical tool was multiple linear regression.
The results from multiple regression indicated that 20.0% of the total variation in the adherence to healthy behaviors was explained by women's perceived self-efficacy and the overall relationship was significant [F (1, 88) =23.60, P<0.000]. From the demographic variables, only, the gestational age at delivery was found to be a significant predictor of adherence to healthy behaviors (t=-3.1, P<0.05), adjusted R-square =15.6. Physical limitation and time constraints (40%) were the most reported barriers for adherence. Participants' concern of GDM-related complications (94.4%) and family moral support (52.2%) were the main identified motivators for adherence.
The importance of assessing determinants, barriers and motivators of adherence to healthy behaviors should be considered before planning any antenatal health promotion interventions designed for women with GDM. The study findings have implications for research, practice, policy advisors and public health. For practice, maternal nurses should consider the identified barriers in this study in any health education intervention and provide solutions and resources to the pregnant women to overcome these barriers. Policy advisors need to take into considerations providing pregnant women with flexible working hours that could encourage them maintaining healthy lifestyle behaviors during the pregnancy period. Researchers interested in GDM should examine in the upcoming studies different self-efficacy enhancing strategies among pregnant women with GDM.
以往关于妊娠期糖尿病（GDM）的研究主要集中在寻找降低其并发症发生率的新策略；然而，尚无充分证据探究影响健康行为依从性的因素。本研究调查了妊娠期糖尿病孕妇健康行为依从性的影响因素。
对妊娠期糖尿病孕妇采用描述性横断面设计。研究参与者分两次（预测试和后测试）完成研究工具，间隔四周。测量量表包括糖尿病自我护理活动总结量表（SDSCA）、糖尿病管理自我效能量表（DMSES）以及评估依从性障碍和动机的开放式问题。分析工具为多元线性回归。
多元回归结果表明，女性的自我效能感解释了健康行为依从性总变异的20.0%，总体关系显著[F(1, 88)=23.60，P<0.000]。在人口统计学变量中，仅分娩时的孕周被发现是健康行为依从性的显著预测因素（t=-3.1，P<0.05），调整后的R方=15.6。身体限制和时间限制（40%）是最常报告的依从性障碍。参与者对GDM相关并发症的担忧（94.4%）和家庭道德支持（52.2%）是确定的主要依从性动机。
在为GDM女性规划任何产前健康促进干预措施之前，应考虑评估健康行为依从性的决定因素、障碍和动机的重要性。研究结果对研究、实践、政策顾问和公共卫生具有启示意义。在实践中，产科护士在任何健康教育干预中都应考虑本研究中确定的障碍，并为孕妇提供解决方案和资源以克服这些障碍。政策顾问需要考虑为孕妇提供灵活的工作时间，这可能会鼓励她们在孕期保持健康的生活方式行为。对GDM感兴趣的研究人员应在未来的研究中研究GDM孕妇中不同的自我效能增强策略。
