Bagheri-Tirtashi Atefeh, Nasiri-Amiri Fatemeh, Adib-Rad Hajar, Nikbakht Hossein-Ali, Faramarzi Mahbobeh, Kiani Ezzat
Student Research Committee, Babol University of Medical Sciences, Babol, Iran.
Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
BMC Pregnancy Childbirth. 2025 Jan 22;25(1):53. doi: 10.1186/s12884-025-07138-6.
Stress plays an important role in the consequences of gestational diabetes mellitus [GDM]. It is possible to make a change in the lifestyle by providing counseling in the field of self-care based on stress management in order to avoid the adverse consequences of GDM. Therefore, the present study was designed and implemented with the aim of determining the effect of self-care counseling based on stress management on blood sugar control in women with GDM.
A randomized trial with two parallel arms was conducted involving 75 pregnant women diagnosed with GDM at 20-30 weeks of gestation, who were referred to Shohada Hospital in Behshahr city from July 2022 to March 2023. The women with GDM were divided into two groups for intervention and control through random block allocation. The intervention group received 8 virtual counseling sessions once a week for 45-50 min continuously based on stress management, while the control group only received antenatal usual care (AUC). The data were measured before and after the intervention using Fasting Blood Sugar [FBS] and HbA1c (glycated hemoglobin) tests, SDSCA [summary of diabetes self-care activities, NuPDQ‑17 [Prenatal Distress Questionnaire]and DASS [stress, depression and anxiety] questionnaires.
The mean FBS in the intervention group were significantly lower than the control group after the intervention (P < 0.001, η2 = 0.49). The HbA1c level was lower in the intervention group than in the control group, but not statistically significant (P = 0.078). The mean score of SDSCA after counseling in the intervention group was significantly higher than the control group (P < 0.001, η2 = 0.79). Also, the NuPDQ-17 after counseling in the intervention group was significantly lower than the control group (P < 0.001, η2 = 0.67). Moreover, the mean scores of the depression (P < 0.001, η2 = 0.82), anxiety (P < 0.001, η2 = 0.67) and stress (P < 0.001, η2 = 0.77) were significantly lower in the intervention group than in the control group.
Stress management-based self-care counseling to prenatal usual care could be considered as an adjunctive care option for reducing on blood sugar and increasing the self-care activities of pregnant women with gestational diabetes and reducing their stress during pregnancy.
压力在妊娠期糖尿病（GDM）的后果中起着重要作用。通过提供基于压力管理的自我护理领域的咨询来改变生活方式，以避免GDM的不良后果是可行的。因此，本研究旨在确定基于压力管理的自我护理咨询对GDM女性血糖控制的影响。
进行了一项双臂平行随机试验，纳入了75名在妊娠20 - 30周时被诊断为GDM的孕妇，她们于2022年7月至2023年3月被转诊至Behshahr市的Shohada医院。通过随机区组分配将GDM女性分为干预组和对照组。干预组每周接受1次、每次持续45 - 50分钟的8次虚拟咨询，内容基于压力管理，而对照组仅接受产前常规护理（AUC）。在干预前后使用空腹血糖（FBS）、糖化血红蛋白（HbA1c）检测、糖尿病自我护理活动总结（SDSCA）、产前困扰问卷（NuPDQ - 17）和抑郁、焦虑、压力量表（DASS）问卷进行数据测量。
干预后，干预组的平均FBS显著低于对照组（P < 0.001，η2 = 0.49）。干预组的HbA1c水平低于对照组，但差异无统计学意义（P = 0.078）。干预组咨询后的SDSCA平均得分显著高于对照组（P < 0.001，η2 = 0.79）。此外，干预组咨询后的NuPDQ - 17显著低于对照组（P < 0.001，η2 = 0.67）。而且，干预组的抑郁（P < 0.001，η2 = 0.82）、焦虑（P < 0.001，η2 = 0.67）和压力（P < 0.001，η2 = 0.77）平均得分显著低于对照组。
基于压力管理的自我护理咨询相较于产前常规护理，可被视为一种辅助护理选择，用于降低血糖、增加妊娠期糖尿病孕妇的自我护理活动并减轻其孕期压力。
