Liggins Institute, The University of Auckland, Auckland, New Zealand.
PLoS One. 2022 Aug 12;17(8):e0271699. doi: 10.1371/journal.pone.0271699. eCollection 2022.
Tighter glycaemic targets may be of benefit for women with GDM and their infants. Barrier and enabler identification prior to implementation of tighter glycaemic targets for women with GDM may support a successful transition.
A cross-sectional questionnaire survey was conducted among Key Informant Health Professionals in ten hospitals in New Zealand. The survey assessed what was currently working using less tight glycaemic targets; what barriers and enablers were considered likely when introducing tighter glycaemic targets and whether these perceptions differed by health professional groups.
Sixty Key Health Informant Health Professionals completed the survey. When using the lower glycaemic targets, participants considered that women with GDM found the targets easy to use and that collaborative collegial support was effective. No significant barriers were identified. Perceived enablers identified prior to implementation of tighter targets included receiving collegial support (40, 67%), attending education sessions (38, 63%), use of pocket prompt cards (31, 52%), availability of wall charts (25, 42%) and glycaemic target reminder stickers (24, 40%). For health professionals referring into the Diabetes in Pregnancy Service effective communication (50, 83%) was considered important. Perceived barriers were confusion over glycaemic targets use (27 (45%), not being informed of the glycaemic target change (31, 52%), non-involvement with multidisciplinary decisions (29, 48%) and increased difficulty of blood glucose control for women (48, 80%). Overall, barriers and enablers between Health Professional groups did not differ.
Key Informant Health Professionals reported effective communication as a key perceived enabler and that woman would find it more difficult to control their blood glucose concentrations. Education sessions, multidisciplinary engagement, wall charts and stickers were considered effective to overcome the perceived barriers. Further research is needed to assess if the barriers perceived were realised and if the perceived enablers supported the implementation of the tighter glycaemic targets effectively.
对于患有 GDM 的女性及其婴儿而言，血糖控制目标更为严格可能会带来益处。在为患有 GDM 的女性实施更为严格的血糖控制目标之前，对障碍和促进因素进行识别，可能有助于成功过渡。
在新西兰 10 家医院中，对关键信息卫生专业人员进行了横断面问卷调查。该调查评估了使用较不严格的血糖控制目标时的效果；引入更为严格的血糖控制目标时，可能存在哪些障碍和促进因素；以及这些看法是否因卫生专业人员群体而异。
共有 60 名关键信息卫生专业人员完成了调查。在使用较低的血糖控制目标时，参与者认为患有 GDM 的女性发现这些目标易于使用，并且协作的同事支持非常有效。未发现明显的障碍。在实施更为严格的目标之前确定的潜在促进因素包括获得同事支持（40，67%）、参加教育课程（38，63%）、使用袖珍提示卡（31，52%）、获得图表（25，42%）和血糖目标提醒贴纸（24，40%）。对于转诊至妊娠糖尿病服务的卫生专业人员，有效的沟通（50，83%）被认为是重要的。认为存在障碍包括血糖控制目标使用方面的困惑（27（45%））、未被告知血糖控制目标变化（31，52%）、未参与多学科决策（29，48%）以及女性血糖控制难度增加（48，80%）。总体而言，不同卫生专业人员群体之间的障碍和促进因素并无差异。
关键信息卫生专业人员报告说，有效的沟通是一个关键的潜在促进因素，并且女性会发现更难以控制血糖浓度。教育课程、多学科参与、图表和贴纸被认为是克服潜在障碍的有效手段。需要进一步研究以评估所感知的障碍是否确实存在，以及所感知的促进因素是否有效支持了更为严格的血糖控制目标的实施。
