Department of Endocrinology, Diabetes, and Metabolic Diseases, University Medical Centre Ljubljana, Zaloska Cesta 7, 1000, Ljubljana, Slovenia.
Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
Acta Diabetol. 2024 Jun;61(6):773-780. doi: 10.1007/s00592-024-02251-y. Epub 2024 Mar 13.
Gestational diabetes (GDM) is a prevalent complication in pregnancy that requires effective self-management, which can be influenced by illness perceptions. Moreover, behavioral regulation can be affected by attachment styles. Thus, our study aimed to identify common GDM perception profiles and test their association with attachment styles.
In this cross-sectional study, 446 women completed the Relationship Questionnaire (RQ), the Brief Illness Perception Questionnaire (BIPQ), and additional items about GDM diagnosis, information, competence, adherence, behavioral change. Latent profile analysis (LPA) was conducted to determine GDM perception profiles. Multinomial logistic regression followed to calculate the association between GDM perception profiles and attachment styles.
Three distinct profiles emerged: coping (n = 172, 38.6%)-characterized by the most positive GDM perception, burdened (n = 222, 49.8%)-indicating the emotional burden of the disease, and resourceless (n = 52, 11.7%)-reporting lack of resources (i.e. information, competence). Women with insecure attachment styles were more likely to develop a burdened GDM perception profile. Specifically, the expression of a fearful (OR = 1.184 [95%CI: 1.03; 1.36], p = 0.016) and a preoccupied (OR = 1.154 [95%CI: 1.01; 1.32], p = 0.037) attachment style increased the likelihood for a burdened perception profile, while a secure attachment style (OR = 10.791 [95%CI: 0.65; 0.96], p = 0.017) decreased likelihood for developing resourceless GDM perception profile.
Three GDM perception profiles were identified and the role of attachment styles in shaping these perceptions was confirmed. Further studies are needed to investigate whether a tailored treatment approach based on the predominant attachment style could lead to more positive GDM perceptions, improved glycemic control, and better perinatal outcomes.
妊娠糖尿病（GDM）是一种常见的妊娠并发症，需要有效的自我管理，而这可能受到疾病认知的影响。此外，行为调节可能受到依恋类型的影响。因此，我们的研究旨在确定常见的 GDM 认知特征，并检验其与依恋类型的关系。
在这项横断面研究中，446 名女性完成了关系问卷（RQ）、简短疾病认知问卷（BIPQ）以及关于 GDM 诊断、信息、能力、依从性、行为改变的其他项目。采用潜在剖面分析（LPA）确定 GDM 认知特征。采用多项逻辑回归计算 GDM 认知特征与依恋类型之间的关联。
出现了三个不同的特征：应对（n=172，38.6%）-表现出最积极的 GDM 认知，负担（n=222，49.8%）-表示疾病的情绪负担，以及无资源（n=52，11.7%）-报告缺乏资源（即信息、能力）。依恋风格不安全感的女性更有可能出现负担型 GDM 认知特征。具体来说，表现出恐惧（OR=1.184[95%CI：1.03；1.36]，p=0.016）和专注（OR=1.154[95%CI：1.01；1.32]，p=0.037）依恋风格增加了负担型认知特征的可能性，而安全的依恋风格（OR=10.791[95%CI：0.65；0.96]，p=0.017）降低了出现资源不足型 GDM 认知特征的可能性。
确定了三种 GDM 认知特征，并证实了依恋风格在塑造这些认知中的作用。需要进一步研究以探讨基于主要依恋风格的个体化治疗方法是否可以导致更积极的 GDM 认知、改善血糖控制和更好的围产期结局。
