Huang Jing, Parsons Judith, Forbes Angus, Wang Ling, Forde Rita
Division of Care for Long-term Conditions, Florence Nightingale Faculty of Nursing, Midwifery, and Palliative Care, London SE18WA, UK.
Division of Care for Long-term Conditions, Florence Nightingale Faculty of Nursing, Midwifery, and Palliative Care, London SE18WA, UK.
Midwifery. 2025 Aug;147:104432. doi: 10.1016/j.midw.2025.104432. Epub 2025 Apr 23.
Women with a history of gestational diabetes mellitus (GDM) have a higher risk of developing type 2 diabetes (T2DM). Postpartum diabetes screening is usually recommended to identify glucose intolerance and introduce timely diabetes prevention strategies. However, the uptake of postpartum diabetes screening is suboptimal, especially in China, where GDM is prevalent. Healthcare professionals (HCPs) may offer unique insights into the challenges women face when attending screening, helping to develop interventions that improve uptake and fit in with routine clinical practice.
To explore HCPs' perceptions of barriers and facilitators to postpartum diabetes screening uptake.
Online semi-structured interviews were conducted with HCPs recruited via online networks. The data were analysed using framework analysis and the socio-ecological model.
Eighteen HCPs, including obstetricians, midwives, nurses, nurse managers, and a dietician participated. Thirteen themes were generated across four levels (individual, interpersonal, organisational and policy). Individual level themes included: women's limited understanding, adherence and motivation; low diabetes risk awareness; and competing priorities. Interpersonal challenges involved communication and relationships between HCPs and women. Organizational barriers included workforce shortages, a lack of systemic GDM follow-up and care integration, and limited screening accessibility. At the policy level, GDM follow-up was not promoted nor prioritised.
HCPs have a vital role in improving patient education, postpartum follow-up and support after GDM to reduce long-term health risks. Strengthening HCP training in communication with women and improving continuity and integration of care could enhance GDM follow-up and prevent diabetes in women following GDM.
有妊娠期糖尿病（GDM）病史的女性患2型糖尿病（T2DM）的风险更高。通常建议进行产后糖尿病筛查，以识别糖耐量异常并及时引入糖尿病预防策略。然而，产后糖尿病筛查的接受情况并不理想，尤其是在中国，GDM很普遍。医疗保健专业人员（HCPs）可能对女性在接受筛查时面临的挑战提供独特见解，有助于制定改善接受度并符合常规临床实践的干预措施。
探讨HCPs对产后糖尿病筛查接受度的障碍和促进因素的看法。
通过在线网络招募HCPs进行在线半结构化访谈。使用框架分析和社会生态模型对数据进行分析。
18名HCPs参与，包括产科医生、助产士、护士、护士长和一名营养师。在四个层面（个人、人际、组织和政策）产生了13个主题。个人层面的主题包括：女性的理解、依从性和动机有限；糖尿病风险意识低；以及相互竞争的优先事项。人际挑战涉及HCPs与女性之间的沟通和关系。组织障碍包括劳动力短缺、缺乏系统性的GDM随访和护理整合，以及筛查可及性有限。在政策层面，GDM随访未得到推广或优先考虑。
HCPs在改善患者教育、产后随访以及GDM后的支持以降低长期健康风险方面起着至关重要的作用。加强HCPs与女性沟通的培训，以及改善护理的连续性和整合性，可以加强GDM随访并预防GDM后女性患糖尿病。
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