Tzotzis Louise, Hooper Mary-Ellen, Douglas Angela, Kurz Ella, Atchan Marjorie, Spiller Sarah, Davis Deborah
School of Nursing, Midwifery and Public Health, University of Canberra, Australia.
School of Rehabilitation and Health Sciences, University of Canberra, Australia.
Women Birth. 2023 Mar;36(2):205-216. doi: 10.1016/j.wombi.2022.08.006. Epub 2022 Aug 26.
Gestational diabetes mellitus (GDM) represents a growing challenge worldwide, with significant risks to both the mother and baby that extend beyond the duration of the pregnancy and immediate post-partum period. Women from ethnic minority groups who access GDM care in high-income settings face particular challenges. The aim of this systematic integrative review is to explore the experiences and needs of women with GDM from select ethnic groups in high-income healthcare settings.
For the purposes of this systematic integrative review, a comprehensive search strategy explored the electronic databases CINAHL, Medline, Web of Science, and Scopus were searched for primary studies that explored the needs and experiences of women with gestational diabetes from select ethnic minority groups living in high-income nations. The ethnicity of the women in the study included: East, South and Southeast Asian, Indian subcontinent, Aboriginal/First Nations, Torres Strait Islander, Pacific Islander, Māori, Middle Eastern, African, or South/Latina American. Studies were assessed with the Crowe Critical Appraisal Tool and findings were synthesised with thematic analysis.
This review included 15 qualitative studies, one mixed method, and one cross-sectional study. Six high-income nations were represented. The voices and experiences of 843 women who originated from at least one ethnic minority group are represented. Four major themes were constructed: psychological impact of GDM, GDM care and education, GDM and sociocultural impact, and GDM and lifestyle changes.
Limitations exist in the provision of culturally appropriate care to support the management of GDM in women from select ethnic groups in high-income healthcare settings. Women require care that is culturally appropriate, considering the individual needs and cultural practices of the woman. Engaging a woman's partner and family ensures good support is provided. Culturally appropriate care needs to be co-designed with communities so that women are at the centre of their care, avoiding a one-size-fits-all approach.
妊娠期糖尿病（GDM）在全球范围内构成了日益严峻的挑战，对母婴均存在重大风险，且这些风险不仅限于孕期及产后即刻。在高收入环境中接受GDM护理的少数族裔女性面临着特殊挑战。本系统综合评价的目的是探讨高收入医疗环境中特定族裔的GDM女性的经历和需求。
为了进行本系统综合评价，采用了全面的检索策略，对电子数据库CINAHL、Medline、科学网和Scopus进行检索，以查找探索生活在高收入国家的特定少数族裔妊娠期糖尿病女性的需求和经历的原始研究。研究中女性的种族包括：东亚、南亚和东南亚、印度次大陆、原住民/第一民族、托雷斯海峡岛民、太平洋岛民、毛利人、中东、非洲或南美/拉丁美洲。采用克罗伊批判性评价工具对研究进行评估，并通过主题分析对研究结果进行综合。
本评价纳入了15项定性研究、1项混合方法研究和1项横断面研究。涉及6个高收入国家。代表了至少来自一个少数族裔群体的843名女性的声音和经历。构建了四个主要主题：GDM的心理影响、GDM护理与教育、GDM与社会文化影响以及GDM与生活方式改变。
在高收入医疗环境中，为特定族裔的女性提供符合文化背景的护理以支持GDM管理方面存在局限性。考虑到女性的个体需求和文化习俗，女性需要符合文化背景的护理。让女性的伴侣和家人参与进来可确保提供良好的支持。需要与社区共同设计符合文化背景的护理，使女性成为其护理的核心，避免一刀切的方法。
