Zhu Ying, Cheng Qunfang, Liao Wenmei, Wang Hui, Wang Rong
School of Nursing, University of South China, Yancheng Maternal and Child Health Hospital Affiliated to Medical College of Yangzhou University (Yancheng Maternal and Child Health Hospital), Yancheng, Jiangsu Province, China.
Nursing Department, Yancheng Maternal and Child Health Hospital Affiliated to Medical College of Yangzhou University Nursing Department (Yancheng Maternal and Child Health Hospital), Yancheng, Jiangsu Province, China.
Medicine (Baltimore). 2025 Jul 25;104(30):e43311. doi: 10.1097/MD.0000000000043311.
Gestational diabetes mellitus (GDM) is a common and high-risk pregnancy complication, increasing the risk of maternal hypertension, preterm birth, infections, and other issues, as well as long-term effects on the newborn. This study aimed to assess the effectiveness of a risk perception-based nursing model for high-risk GDM pregnant women, focusing on blood glucose control, self-management, psychological adjustment, and pregnancy outcomes. A retrospective cohort design was used, with clinical data collected from 106 high-risk GDM pregnant women between June 2023 and December 2024. The observation group (n = 54) received the risk perception-based nursing model, while the control group (n = 52) received routine care. Evaluation indicators included blood glucose levels from the oral glucose tolerance test, General Self-Efficacy Scale scores, self-management ability, anxiety levels, and pregnancy outcomes, such as premature rupture of membranes, macrosomia, neonatal hypoglycemia, cesarean section rate, postpartum hemorrhage, and preterm birth rate. No significant differences in baseline characteristics were observed between the 2 groups. At 37 weeks of gestation, the observation group showed significantly lower fasting blood glucose, 1-hour, and 2-hour postprandial glucose levels than the control group (P < .05). The observation group also had significantly higher General Self-Efficacy Scale scores and better self-management in areas like diabetes knowledge, behaviors, attitude, and social support (P < .01). Psychological assessments showed a significant decrease in anxiety levels in the observation group (P < .001). Pregnancy outcomes were improved, with significantly lower rates of premature rupture of membranes, macrosomia, and neonatal hypoglycemia in the observation group (P < .01). There were no significant differences in cesarean section rate, postpartum hemorrhage, or preterm birth rate. These findings suggest that the risk perception-based nursing model significantly improves blood glucose control, self-management, and psychological adjustment, reducing certain adverse pregnancy outcomes. This study provides valuable insights for personalized clinical nursing, with potential for wider clinical application.
妊娠期糖尿病（GDM）是一种常见的高危妊娠并发症，会增加孕妇患高血压、早产、感染及其他问题的风险，还会对新生儿产生长期影响。本研究旨在评估基于风险认知的护理模式对高危GDM孕妇的有效性，重点关注血糖控制、自我管理、心理调适及妊娠结局。采用回顾性队列设计，收集了2023年6月至2024年12月期间106例高危GDM孕妇的临床资料。观察组（n = 54）接受基于风险认知的护理模式，对照组（n = 52）接受常规护理。评估指标包括口服葡萄糖耐量试验的血糖水平、一般自我效能感量表得分、自我管理能力、焦虑水平以及妊娠结局，如胎膜早破、巨大儿、新生儿低血糖、剖宫产率、产后出血和早产率。两组在基线特征上未观察到显著差异。妊娠37周时，观察组的空腹血糖、餐后1小时和2小时血糖水平均显著低于对照组（P <.05）。观察组的一般自我效能感量表得分也显著更高，在糖尿病知识、行为、态度和社会支持等方面的自我管理更好（P <.01）。心理评估显示观察组的焦虑水平显著降低（P <.001）。妊娠结局得到改善，观察组的胎膜早破、巨大儿和新生儿低血糖发生率显著降低（P <.01）。剖宫产率、产后出血或早产率无显著差异。这些结果表明，基于风险认知的护理模式显著改善了血糖控制、自我管理和心理调适，降低了某些不良妊娠结局。本研究为个性化临床护理提供了有价值的见解，具有更广泛临床应用的潜力。
