Human Potential Centre, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand.
School of Interprofessional Health, Auckland University of Technology, Auckland, New Zealand.
Nutr Diet. 2022 Apr;79(2):255-264. doi: 10.1111/1747-0080.12719. Epub 2022 Feb 6.
This study aimed to investigate New Zealand health professionals' views and experiences around the dietary and lifestyle management of gestational diabetes.
Semi-structured interviews were conducted remotely with health professionals; sessions were recorded and transcribed. Core themes were extracted using inductive thematic analysis using a framework method.
Twenty-seven health professionals were interviewed (13 diabetes dietitians, 8 specialist diabetes midwives, 2 community midwives, 1 antenatal clinic midwife, 1 obstetrician and 2 endocrinologists). Themes were organised into three central domains: (a) Social and cultural barriers, (b) Service provision and (c) Nutrition advice. Enabling themes included professional collaboration, innovation and creating trusting and supportive environments. Key barriers identified included accessibility, cultural barriers, overwhelmed service, fragmentation and conflicting information and nutrition resource gaps.
Findings highlight foremost a deficit in primary antenatal nutrition advice that may play a significant role in the fragmentation identified. Investment in community-inclusive services providing antenatal nutrition and diabetes education appears critical to overcome barriers associated with misinformation and poor outcomes. Pathways to include nutrition education from various primary care health providers should be investigated to ease the burden from specialist gestational diabetes clinicians and allow effective delegation of dietetic resources. Revision of current nutrition guidelines for the management of gestational diabetes in New Zealand is needed to facilitate consistent messaging and standards of care.
本研究旨在调查新西兰卫生专业人员在妊娠期糖尿病的饮食和生活方式管理方面的观点和经验。
通过远程方式对半结构化访谈健康专业人员；会话进行记录和转录。使用框架方法的归纳主题分析提取核心主题。
共采访了 27 名卫生专业人员（13 名糖尿病营养师、8 名专科糖尿病助产士、2 名社区助产士、1 名产前诊所助产士、1 名产科医生和 2 名内分泌学家）。主题分为三个核心领域：（a）社会和文化障碍、（b）服务提供和（c）营养建议。促成因素包括专业合作、创新以及创造信任和支持性环境。确定的主要障碍包括可及性、文化障碍、服务过度、碎片化和相互矛盾的信息以及营养资源差距。
研究结果主要突出了初级产前营养建议的不足，这可能在确定的碎片化中起着重要作用。需要投资于提供产前营养和糖尿病教育的社区包容性服务，以克服与错误信息和不良结果相关的障碍。应该研究各种初级保健提供者提供营养教育的途径，以减轻专科妊娠糖尿病临床医生的负担，并允许有效地分配饮食资源。新西兰需要修订目前用于管理妊娠期糖尿病的营养指南，以促进一致的信息传递和护理标准。
