Canary Islands Health Research Institute Foundation, (FIISC), Tenerife, Spain.
The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Madrid, Spain.
Health Expect. 2024 Feb;27(1):e13876. doi: 10.1111/hex.13876. Epub 2023 Nov 1.
Pregnant women with type 1 diabetes may have an increased risk of complications for both the baby and themselves. Educational programmes, preconception planning, strict glycemic control and comprehensive medical care are some of the antenatal interventions that have been proposed to improve the outcomes of pregnant women with type 1 diabetes. While some evidence-based recommendations about antenatal care are included in clinical practice guidelines (CPGs), the views, and experiences of women with type 1 diabetes about these interventions are not well known.
To understand and synthesize the perceptions of women with type 1 diabetes about the interventions before pregnancy.
A qualitative evidence synthesis (QES) was carried out with a framework analysis guided by the Cochrane Qualitative and Implementation Methods Group approach. Three online databases (Medline, Embase and Web of Science) were searched. We included qualitative articles that were published from 2011 to 2021 and which were available in English or Spanish.
Ten references met the inclusion criteria of the study and were included. Three main themes were identified: (a) acceptability of antenatal care, (b) feasibility and implementation consideration and (c) equity and accessibility difficulties.
Continuity of care, coordination between health professionals and services, and a more holistic approach are the key aspects women say need to be considered for more acceptable, feasible and equitable preconception and antenatal care.
This QES was carried out as part of the CPGs on diabetes mellitus type 1, carried out as part of the Spanish Network of Health Technology Assessment Agencies. In this CPG, the representatives of the patient associations are Francisco Javier Darias Yanes, from the Association for Diabetes of Tenerife, who has participated in all the phases of the CPG; Aureliano Ruiz Salmón and Julián Antonio González Hernández (representatives of the Spanish Diabetes Federation (FEDE) who have participated as collaborator and external reviewer, respectively.
患有 1 型糖尿病的孕妇可能会增加母婴双方并发症的风险。教育计划、孕前规划、严格的血糖控制和综合医疗保健是一些被提议用于改善 1 型糖尿病孕妇结局的产前干预措施。虽然临床实践指南（CPG）中包含了一些关于产前护理的循证建议，但患有 1 型糖尿病的女性对这些干预措施的看法和经验却知之甚少。
了解并综合分析孕妇对妊娠前干预措施的看法。
采用 Cochrane 定性和实施方法组方法指导的框架分析进行定性证据综合（QES）。在 Medline、Embase 和 Web of Science 三个在线数据库中进行搜索。纳入了 2011 年至 2021 年发表的、可用英语或西班牙语获取的定性文章。
符合研究纳入标准的有 10 篇参考文献被纳入。确定了三个主要主题：（a）产前护理的可接受性，（b）可行性和实施考虑因素，（c）公平性和可及性困难。
连续性护理、卫生专业人员和服务之间的协调以及更全面的方法是女性表示需要考虑的接受度更高、更可行和更公平的孕前和产前护理的关键方面。
作为 1 型糖尿病 CPG 的一部分进行了这项 QES，该 CPG 是作为西班牙卫生技术评估机构网络的一部分进行的。在该 CPG 中，患者协会的代表是来自特内里费糖尿病协会的 Francisco Javier Darias Yanes，他参与了 CPG 的所有阶段；Aureliano Ruiz Salmón 和 Julián Antonio González Hernández（西班牙糖尿病联合会（FEDE）的代表，他们分别作为合作者和外部审查员参与了该 CPG。
