Background Women with gestational diabetes mellitus (GDM) are more likely to develop metabolic syndrome (MS). However, the effectiveness of web-based health management in preventing women at high risk of GDM from developing MS has rarely been studied. Purpose The aim of this study was to evaluate the longitudinal effects of nurse-led web-based health management on maternal anthropometric, metabolic measures, and neonatal outcomes. Methods A randomized controlled trial was conducted from February 2017 to February 2018, in accordance with the Consolidated Standards of Reporting Trials guidelines. Data were collected from 112 pregnant women at high risk of GDM who had been screened from 984 potential participants in northern Taiwan. Participants were randomly assigned to the intervention group (n = 56) or the control group (n = 56). The intervention group received a 6-month nurse-led, web-based health management program as well as consultations conducted via the LINE mobile app. Anthropometric and metabolic measures were assessed at baseline (Time 0, prior to 28 weeks of gestation), Time 1 (36–40 weeks of gestation), and Time 2 (6–12 weeks of postpartum). Maternal and neonatal outcomes were assessed at delivery. Clinical trial was registered. Results Analysis using the general estimating equation models found that anthropometric and metabolic measures were significantly better in the intervention group than the control group and varied with time. At Time 1, the levels of diastolic pressure (β = −4.981, p = .025) and triglyceride (TG; β = −33.69, p = .020) were significantly lower in the intervention group than the control group, and at Time 2, the incidence of MS in the intervention group was lower than that in the control group (χ2 = 6.022, p = .014). The number of newborns with low birth weight in the intervention group was lower than that in the control group (χ2 = 6.729, p = .012). Conclusion/Implications for Practice This nurse-led, web-based health management was shown to be effective in improving MS outcomes and may play an important role and show feasible clinical value in changing the current pregnancy care model.
Aim Gestational diabetes mellitus (GDM) has become the most common complication in women during pregnancy in Taiwan. Since several clinical trials have demonstrated benefits of aggressive treatment, which rely heavily on self‐management. The present study was conducted to explore the self‐management experience of women with first‐time diagnosed GDM. Design A qualitative descriptive approach was applied to conduct this study. Methods Purposive sampling was used to recruit patients with first‐time diagnosed GDM from the maternity outpatient clinics of medical centre in Taiwan. A total of three focus groups interviews with 22 women were conducted to collect the data. Content analysis was applied to analyse the data. Results Four themes were identified: (1) unexpectedly having a high‐risk pregnancy, (2) different perceptions for self‐management, (3) implementation predicament of self‐management and (4) maternal duty to ensure the safety of mother and child.
Background: At present, most research related to GDM investigates disease control from the perspective of medical care givers. Medical professionals often lack understanding of the life context of GDM, which not only alienates them from the experience of patients with GDM but also leads to the provision of health care and the formulation of policies that are not appropriate for women. The objective of the present study was to explore the perceptions and experience of women with GDM in Taiwan.Methods: A descriptive phenomenological approach was applied to conduct this study. Purposive sampling was utilized to select 22 women with GDM from a medical centre in northern Taiwan. Data were collected from October 2017 and July 2018 through in-depth interviews using semi-structured and open-ended questions. Data were analysed according to Giorgi’s phenomenological method.Results: Four themes emerged from the data: Unexpectedly having a high-risk pregnancy, Beliefs of effects of blood glucose control, Perceived obstacles of implementing blood glucose control and Maternal duty to ensure the safety of mother and child.Conclusions: Health professionals must be able to understand the experience and perception of women with GDM. In addition to the medical care needs for women with GDM, their culture, the emotional impact of the disease, and their feelings and difficulties in the face of the disease must be considered to ensure that women receive comprehensive perinatal care.
Obstructive sleep apnea (OSA) is a pervasive sleep disorder. An epidemiological study reported that an estimated 425 million adults aged 30-69 years have moderate to severe OSA globally with negative health impacts (Benjafield et al., 2019). The prevalence of OSA in the adult population is 3%-17%; OSA increases with age (Punjabi, 2008;Senaratna et al., 2017), with a higher prevalence in men and those with a high body mass index (Senaratna et al., 2017). OSA has been shown to be closely associated with chronic diseases, such as hypertension (Hou et al., 2018), type 2 diabetes (Wang et al., 2013) and cardiovascular disease (Bradley & Floras, 2009).
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