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初产妇妊娠期糖尿病的管理:一项定性研究。

Gestational Diabetes Mellitus Management Among Primigravida Women: A Qualitative Study.

作者信息

Rath Kalyani, Smitha Moonjelly Vijayan

机构信息

Obstetrics and Gynaecology, Kalinga Institute of Nursing Sciences, Bhubaneswar, IND.

Obstetrics and Gynecology, College of Nursing, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND.

出版信息

Cureus. 2025 Jul 24;17(7):e88710. doi: 10.7759/cureus.88710. eCollection 2025 Jul.

Abstract

BACKGROUND

Gestational diabetes mellitus (GDM) is a growing public health concern, particularly in India, which has a high prevalence of diabetes. While much research focuses on clinical outcomes, there is limited understanding of the lived experiences of primigravida women diagnosed with GDM.

OBJECTIVE

This qualitative study aimed to explore the emotional responses, self-management practices, support systems, and healthcare interactions of first-time pregnant women diagnosed with GDM.

METHODS

Using a phenomenological approach, 18 primigravida women with GDM attending a tertiary care hospital in Bhubaneswar, India, were recruited as a sample through purposive sampling. Semi-structured interviews were conducted in Odia, audio-recorded, transcribed verbatim, and thematically analyzed with NVivo software.

RESULTS

Six major themes emerged during the course of the study. The emotional responses included shock, anxiety, fear for the baby's health, and self-blame. Lifestyle modifications were reported as challenging, especially dietary restrictions conflicting with cultural food habits, glucose monitoring discomfort, and difficulty maintaining physical activity. Family and peer support were vital for coping, while a lack of community awareness led to stigma and isolation. Healthcare interactions varied, with clear communication and empathy fostering trust, but inconsistent advice causing confusion. Knowledge empowerment and maternal motivation enhanced self-efficacy and adaptive routines. Concerns about future diabetes risk and GDM recurrence were common, with inadequate postpartum counseling noted.

CONCLUSION

Primigravida women with GDM face complex emotional, cultural, and practical challenges. Culturally tailored dietary guidance, empathetic healthcare communication, strengthened social support, and extended postpartum care are essential to improve self-management and health outcomes. Addressing these aspects holistically can enhance care quality and reduce diabetes burden in diverse settings.

摘要

背景

妊娠期糖尿病(GDM)日益引起公众健康关注,在糖尿病患病率较高的印度尤其如此。虽然许多研究聚焦于临床结局,但对于被诊断为GDM的初产妇的生活经历了解有限。

目的

这项定性研究旨在探索被诊断为GDM的初产妇的情绪反应、自我管理行为、支持系统及医疗保健互动情况。

方法

采用现象学方法,通过目的抽样,选取了18名在印度布巴内斯瓦尔一家三级护理医院就诊的患有GDM的初产妇作为样本。以奥里亚语进行半结构化访谈,进行录音、逐字转录,并使用NVivo软件进行主题分析。

结果

在研究过程中出现了六个主要主题。情绪反应包括震惊、焦虑、对胎儿健康的担忧以及自责。据报告,生活方式的改变具有挑战性,尤其是饮食限制与文化饮食习惯相冲突、血糖监测不适以及难以维持体育活动。家庭和同伴支持对于应对至关重要,而社区意识的缺乏导致了耻辱感和孤立感。医疗保健互动各不相同,清晰的沟通和同理心促进了信任,但不一致的建议导致了困惑。知识赋权和产妇动机增强了自我效能感和适应性日常行为。对未来糖尿病风险和GDM复发的担忧很常见,且产后咨询不足。

结论

患有GDM的初产妇面临复杂的情绪、文化和实际挑战。文化上量身定制的饮食指导、富有同理心的医疗保健沟通、加强社会支持以及延长产后护理对于改善自我管理和健康结局至关重要。全面解决这些方面的问题可以提高护理质量并减轻不同环境下的糖尿病负担。

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