The Australian e-Health Research Centre, CSIRO, Herston, Queensland, Australia.
Diabetes Australia, Canberra, Australian Capital Territory, Australia.
Diabet Med. 2024 Nov;41(11):e15374. doi: 10.1111/dme.15374. Epub 2024 Jun 9.
To qualitatively explore the experiences of individuals with Gestational Diabetes Mellitus (GDM) in Australia, and to recognise opportunities for leveraging digital health to enhance the support of GDM management.
A cross sectional online survey assessed the experiences of individuals with GDM, the healthcare system and their digital health usage. Respondents (recruited via a national diabetes registry or social media) were adults receiving GDM care within Australia in the last 5 years, who responded to any of three open-ended questions (n = 815) exploring positive, negative and other GDM experiences. Thematic analysis was utilised, and themes were mapped to the socio-ecological systems framework.
At a system level, themes related to (1) accessibility of care including the value of digital health and the inflexible or inconsistent perception of the (2) implementation of guidelines. At an interpersonal level, themes covered the need for adequate (3) health information provision, and (4) supportive care, as well as highlighting (5) experiences of stigma including a desire for greater awareness of GDM. Individual-level themes included: (6) differential barriers to accessing care; (7) negative emotional burden; (8) internalisation of stigma; (9) dietary freedom and social impact and (10) opportunity for change derived from having GDM.
Findings suggest a demand for more supportive, person-centred GDM care, improved information provision and individualised implementation of clinical guidelines. Such mechanisms may support reduced barriers to accessing care or negative psychosocial impacts of GDM. Though not central to the identified experiences, digital health tools may help address the need for optimised GDM care.
定性探讨澳大利亚妊娠糖尿病患者的体验，并认识利用数字健康技术增强妊娠糖尿病管理支持的机会。
采用横断面在线调查评估妊娠糖尿病患者、医疗保健系统及其数字健康使用情况的体验。受访者（通过国家糖尿病登记处或社交媒体招募）为过去 5 年内在澳大利亚接受妊娠糖尿病护理的成年人，他们对三个开放式问题中的任何一个做出了回答，这些问题探讨了积极、消极和其他妊娠糖尿病体验（n=815）。采用主题分析方法，并将主题映射到社会生态系统框架中。
在系统层面，主题涉及（1）护理的可及性，包括数字健康的价值以及对（2）指南实施的僵化或不一致的看法。在人际层面，主题涵盖了对足够（3）健康信息提供和（4）支持性护理的需求，同时强调了（5）耻辱感体验，包括对提高对妊娠糖尿病认识的渴望。个体层面的主题包括：（6）获得护理的不同障碍；（7）负面情绪负担；（8）耻辱感内化；（9）饮食自由和社会影响；以及（10）从妊娠糖尿病中获得的改变机会。
研究结果表明，需要提供更具支持性、以患者为中心的妊娠糖尿病护理，改善信息提供和个性化实施临床指南。这些机制可能有助于减少获得护理的障碍或减轻妊娠糖尿病的负面心理社会影响。虽然数字健康工具不是确定的体验的核心，但它们可能有助于满足优化妊娠糖尿病护理的需求。
