School of Nursing, Lanzhou University, Lanzhou, Gansu, China; Department of Clinical Nursing, School of Nursing, Air Force Medical University, Xi'an, China.
School of Nursing, Lanzhou University, Lanzhou, Gansu, China.
Midwifery. 2024 Nov;138:104141. doi: 10.1016/j.midw.2024.104141. Epub 2024 Aug 13.
Gestational diabetes mellitus is a common complication during pregnancy, and its prevalence rates have increased dramatically in recent years. Treatment of gestational diabetes requires the active self-management, however, this can be challenging. Understanding the barriers and facilitators of adherence to self-management recommendations is essential for designing effective interventions.
To identify and synthesize barriers and facilitators to self-management of gestational diabetes reported by pregnant women.
This was a mixed-methods systematic review, including qualitative, quantitative, and mixed-methods studies. A literature search was conducted in four databases (PubMed, Embase, CINAHL, and the Web of Science). Eligible studies explored the barriers and/or facilitators, experiences and/or perceptions to engage in self-management in women with gestational diabetes. The Capability, Opportunity, Motivation, Behaviour model was used to classify barriers and facilitators affecting self-management.
Thirty-six studies (23 qualitative, 11 quantitative, and 2 mixed-methods) met the inclusion criteria. We identified barriers and facilitators relating to capability (e.g., physical discomforts and constraints; lack of knowledge of GDM and self-management behaviours; forgetfulness), opportunity (e.g., limited education and resources; social support from family, friends, and peer groups; conflict with existing lifestyles or cultural norms), and motivation (e.g., perceived negative consequence of self-management behaviours or not perceived benefits; negative emotion; concern the health of the baby).
In this study, we identified the barriers and facilitators of self-management in women with gestational diabetes, which were explained by relevant theoretical models. Interventions should be developed with full consideration of these findings to ensure that pregnant women have the correct knowledge and confidence to self-manage their complications.
妊娠糖尿病是一种常见的妊娠并发症，近年来其患病率显著上升。治疗妊娠糖尿病需要孕妇积极的自我管理，但这可能具有挑战性。了解坚持自我管理建议的障碍和促进因素对于设计有效的干预措施至关重要。
确定并综合妊娠糖尿病孕妇自我管理报告的障碍和促进因素。
这是一项混合方法系统评价，包括定性、定量和混合方法研究。在四个数据库（PubMed、Embase、CINAHL 和 Web of Science）中进行了文献检索。符合条件的研究探讨了妊娠糖尿病女性参与自我管理的障碍和/或促进因素、经验和/或看法。使用能力、机会、动机、行为模型来分类影响自我管理的障碍和促进因素。
符合纳入标准的研究有 36 项（23 项定性研究、11 项定量研究和 2 项混合方法研究）。我们确定了与能力（例如，身体不适和限制；缺乏对 GDM 和自我管理行为的了解；健忘）、机会（例如，教育和资源有限；来自家人、朋友和同龄群体的社会支持；与现有生活方式或文化规范冲突）和动机（例如，自我管理行为的感知负面后果或没有感知到益处；负面情绪；担心婴儿的健康）相关的障碍和促进因素。
在这项研究中，我们确定了妊娠糖尿病女性自我管理的障碍和促进因素，这些因素可以用相关的理论模型来解释。干预措施的制定应充分考虑这些发现，以确保孕妇拥有正确的知识和信心来自我管理其并发症。
