School of Science and Engineering, University of Dundee, Dundee, United Kingdom.
School of Health Sciences, University of Dundee, Dundee, United Kingdom.
J Med Internet Res. 2022 Oct 27;24(10):e39689. doi: 10.2196/39689.
Gestational diabetes mellitus (GDM) is one of the most common medical complications during pregnancy. eHealth technologies are proving to be successful in supporting the self-management of medical conditions. Digital technologies have the potential to improve GDM self-management.
The primary objective of this systematic literature review was to identify the views of health professionals (HPs) and women with GDM regarding the use of eHealth for GDM self-management. The secondary objective was to investigate the usability and user satisfaction levels when using these technologies.
Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) approach, the search included primary papers in English on the evaluation of technology to support self-management of GDM from January 2008 to September 2021 using MEDLINE, CINAHL, Embase, ACM, and IEEE databases. The lists of references from previous systematic literature reviews, which were related to technology and GDM, were also examined for primary studies. Papers with qualitative, quantitative, and mixed methodologies were included and evaluated. The selected papers were assessed for quality using the Cochrane Collaboration tool, National Institute for Health and Care Excellence clinical guidelines, Critical Appraisal Skills Programme Qualitative Checklist, and McGill University Mixed Methods Appraisal Tool. NVivo (QSR International) was used to extract qualitative data, which were subjected to thematic analysis. Narrative synthesis was used to analyze the quantitative data.
A total of 26 papers were included in the review. Of these, 19% (5/26) of studies used quantitative research methodologies, 19% (5/26) used qualitative methods, and 62% (16/26) used mixed methods. In all, 4 themes were identified from the qualitative data: the benefits of using technology, engagement with people via technology, the usability of technology, and discouragement factors for the use of technology. The thematic analysis revealed a vast scope of challenges and facilitators in the use of GDM self-management systems. The challenges included usability aspects of the system, technical problems, data privacy, lack of emotional support, the accuracy of reported data, and adoption of the system by HPs. Convenience, improved GDM self-management, peer support, increased motivation, increased independence, and consistent monitoring were facilitators to use these technologies. Quantitative data showed that there is potential for improving the usability of the GDM self-management systems. It also showed that convenience, usefulness, increasing motivation for GDM self-management, helping with GDM self-management, and being monitored by HPs were facilitators to use the GDM self-management systems.
This novel systematic literature review shows that HPs and women with GDM encountered some challenges in using GDM self-management systems. The usability of GDM systems was the primary challenge derived from qualitative and quantitative results, with convenience, consistent monitoring, and optimization of GDM self-management emerging as important facilitators.
妊娠糖尿病（GDM）是孕妇最常见的医学并发症之一。电子健康技术在支持医疗条件的自我管理方面已被证明是成功的。数字技术有可能改善 GDM 的自我管理。
本系统文献综述的主要目的是确定卫生专业人员（HPs）和 GDM 女性对使用电子健康技术进行 GDM 自我管理的看法。次要目的是调查使用这些技术时的可用性和用户满意度水平。
根据 PRISMA（系统评价和荟萃分析的首选报告项目）方法，从 2008 年 1 月至 2021 年 9 月，使用 MEDLINE、CINAHL、Embase、ACM 和 IEEE 数据库，对评估支持 GDM 自我管理的技术的英语原始论文进行了搜索。还检查了与技术和 GDM 相关的先前系统文献综述的参考文献列表，以寻找原始研究。纳入了具有定性、定量和混合方法的论文，并对其进行了评估。使用 Cochrane 协作工具、英国国家卫生与保健优化研究所临床指南、批判性评估技能计划定性清单和麦吉尔大学混合方法评估工具对选定的论文进行了质量评估。使用 NVivo（QSR International）提取定性数据，并对其进行主题分析。使用叙述性综合分析定量数据。
综述共纳入 26 篇论文。其中，19%（5/26）的研究使用定量研究方法，19%（5/26）使用定性方法，62%（16/26）使用混合方法。总的来说，从定性数据中确定了 4 个主题：使用技术的好处、通过技术与他人互动、技术的可用性以及使用技术的阻碍因素。主题分析揭示了 GDM 自我管理系统使用中广泛存在的挑战和促进因素。挑战包括系统的可用性方面、技术问题、数据隐私、缺乏情感支持、报告数据的准确性以及 HPs 对系统的采用。便利性、改善 GDM 自我管理、同伴支持、提高动机、增加独立性和持续监测是使用这些技术的促进因素。定量数据表明，有可能提高 GDM 自我管理系统的可用性。它还表明，便利性、有用性、提高 GDM 自我管理的动机、帮助 GDM 自我管理以及接受 HPs 的监测是使用 GDM 自我管理系统的促进因素。
本新型系统文献综述表明，HPs 和 GDM 女性在使用 GDM 自我管理系统时遇到了一些挑战。GDM 系统的可用性是定性和定量结果得出的主要挑战，便利性、持续监测和 GDM 自我管理的优化是重要的促进因素。
