Holmes-Truscott E, Litterbach E, Arampatzi C, Calyx C, Cherry J E, Gilbert-Morresi V, Williams A, Fuller-Tyszkiewicz M, Teede H, Speight J
School of Psychology, Deakin University, Geelong, Victoria, Australia.
The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Carlton, Victoria, Australia.
Diabet Med. 2025 Aug;42(8):e70073. doi: 10.1111/dme.70073. Epub 2025 May 23.
To explore experiences of stigma related to gestational diabetes (GDM) among Australian women and collaboratively develop a comprehensive item pool to assess experienced and internalised GDM-specific stigma.
A GDM Lived Experience Advisory Group (G-LEAG; n = 4) informed all aspects of a two-phase qualitative research process. Phase 1 included semi-structured online interviews with 20 women with current or recent GDM. Reflexive thematic analysis identified drivers and facilitators, markers, manifestations, impacts and protective mechanisms of GDM stigma. Findings informed the development of an item pool, debriefed and refined with a subset of 10 participants in Phase 2 interviews.
All participants perceived, experienced, anticipated and/or internalised GDM-specific stigma. They perceived GDM-specific stigma to be driven by stereotypes and blame, and facilitated by societal norms regarding motherhood and pregnancy, media messaging, as well as inflexible and inconsistent healthcare policies. They reported social, emotional and self care impacts, as well as perceived loss of autonomy in clinical care. They proposed potential protective mechanisms, including social and healthcare support, self-belief and self-compassion, and community awareness. In cognitive debriefing interviews, women reported that the draft items comprehensively covered their experiences of GDM-specific stigma and offered suggestions for refinement, resulting in a 74-item pool.
Findings provide rich insights into the experiences and impacts of stigma among women with GDM in Australia and resulted in a co-designed GDM-specific stigma item pool. The item pool is ready for psychometric assessment and item reduction, which will enable future quantification of the occurrence, impacts and mechanisms of GDM-specific stigma.
探讨澳大利亚女性中与妊娠期糖尿病（GDM）相关的耻辱感经历，并共同开发一个综合项目库，以评估经历过的和内化的特定于GDM的耻辱感。
一个妊娠期糖尿病生活经历咨询小组（G-LEAG；n = 4）为两阶段定性研究过程的各个方面提供了信息。第一阶段包括对20名患有当前或近期GDM的女性进行半结构化在线访谈。反思性主题分析确定了GDM耻辱感的驱动因素和促进因素、标志、表现形式、影响和保护机制。研究结果为项目库的开发提供了依据，并在第二阶段访谈中与10名参与者的一个子集进行了汇报和完善。
所有参与者都感知到、经历过、预期到和/或内化了特定于GDM的耻辱感。他们认为特定于GDM的耻辱感是由刻板印象和指责驱动的，并受到关于母亲身份和怀孕的社会规范、媒体信息以及不灵活和不一致的医疗政策的促进。他们报告了社会、情感和自我护理方面的影响，以及在临床护理中感知到的自主权丧失。他们提出了潜在的保护机制，包括社会和医疗支持、自我信念和自我同情以及社区意识。在认知汇报访谈中，女性报告说，草案项目全面涵盖了她们特定于GDM的耻辱感经历，并提出了完善建议，从而形成了一个74项的项目库。
研究结果为澳大利亚患有GDM的女性中耻辱感的经历和影响提供了丰富的见解，并产生了一个共同设计的特定于GDM的耻辱感项目库。该项目库已准备好进行心理测量评估和项目精简，这将使未来能够对特定于GDM的耻辱感的发生、影响和机制进行量化。
