A qualitative study exploring women's health behaviours after a pregnancy with gestational diabetes to inform the development of a diabetes prevention strategy

Parsons, Judith; Sparrow, Katherine; Ismail, Khalida; Hunt, Katharine F.; Rogers, Helen; Forbes, Angus

doi:10.1111/dme.13794

Cited by 31 publications

(66 citation statements)

References 28 publications

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“…The first is that GDM is not a serious diagnosis that warrants undue concern. Although there is often an initial strong emotional response to a diagnosis of GDM that has been noted in other studies, this response tends to ease for many women over time, evolving into a view of GDM as a manageable condition [8,9,24]. Postdelivery, as in the present study, this view is then reinforced when women deliver 'happy, healthy' babies with 'no complications'.…”

Section: Discussionsupporting

confidence: 58%

“…In general, despite using a novel methodological approach, our results were not inconsistent with results from other more traditional studies in this area. There was one notable difference in that postpartum abandonment has been an issue that is frequently identified as: eliciting frustration and concern for mothers post-delivery [27]; conveying a sense that the consequences of GDM are not serious enough to warrant follow-up post-delivery [8]; or diminishing the importance of women's own health by seeing them as baby machines [9]. Although some of our users had yet to deliver, it is notable that such abandonment was barely mentioned by any.…”

Section: Discussionmentioning

confidence: 99%

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Analysis of spontaneous, user‐generated data about gestational diabetes on online forums: implications for diabetes prevention

et al. 2020

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Aims To explore the experiences and perceptions of gestational diabetes mellitus reported by women within online parental-support forums and, specifically, to analyse what women say about a diagnosis of gestational diabetes, their future risk of type 2 diabetes, and lifestyle behaviour for management of gestational diabetes and prevention of type 2 diabetes. Methods The discussion boards of two parenting websites (Mumsnet and Netmums) were searched using the search term 'gestational diabetes or GD' in February 2019. Relevant posts made by users with gestational diabetes on or after 1 January 2017 were retained for analysis. Framework analysis using pre-existing framework from a previous study was used to organize and analyse the data. Results A total of 646 posts generated by 282 unique users were included in the analysis. Analysis of the online content identified three important implicit messages that may be being conveyed to readers. The first is that gestational diabetes is not a serious diagnosis that warrants undue concern. Secondly, few users recognized the importance of their own behaviours or lifestyle, with others minimizing personal responsibility or attributing gestational diabetes to nonmodifiable factors. Finally, there was a lack of acknowledgment of heightened risk of type 2 diabetes. These three messages will all directly mitigate against the efforts of clinicians (and others) to encourage women with gestational diabetes to improve their lifestyle behaviours in the longer term. Conclusions These findings highlight messages that are being widely disseminated and that are unlikely to support prevention of type 2 diabetes.

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Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Analysis of spontaneous, user‐generated data about gestational diabetes on online forums: implications for diabetes prevention

et al. 2020

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“…European studies of women who were overweight in pregnancy showed that 91% thought partner support and other social support were important in improving their lifestyle in pregnancy [15]. In qualitative studies of women with PE or GDM, the women state that their partner is important in supporting their lifestyle modification following gestational disease [16,17,33]. Nevertheless, our informants reported that the women had not directly asked their partners for support to change their lifestyle.…”

Section: Discussionmentioning

confidence: 90%

Implementing a healthy postpartum lifestyle after gestational diabetes or preeclampsia: a qualitative study of the partner’s role

Almli

Haugdahl

Sandsæter

et al. 2020

BMC Pregnancy Childbirth

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Background: Women with preeclampsia (PE) and gestational diabetes mellitus (GDM) are at increased risk for later cardiovascular disease, and lifestyle measures are recommended to prevent subsequent disease. Partner support has been shown to be important in lifestyle modification in other diseases, but there is a lack of knowledge of partner involvement in PE and GDM. The aim of this study was to explore the partner's experiences and knowledge of gestational diseases, and how the partner wishes to contribute to lifestyle change. Methods: A qualitative study with one focus group interview and seven in-depth individual interviews, involving eleven partners of women with a pregnancy complicated by GDM or PE. The interview data were inductively analysed using four-step systematic text condensation, supported by interdependence theory. Results: Partners experienced a strong "we-feeling" and wanted to support the woman in lifestyle changes. At the same time, they felt insecure, worried, foolish and left out and they missed information from clinicians. The partners felt that their involvement was crucial to lasting lifestyle changes and expected that the clinicians would routinely invite them to discuss lifestyle change. Conclusions: Partners considered themselves an important resource for lifestyle changes for women with PE and GDM, but missed being more directly invited, informed and included in maternity care and wanted to participate in the care that followed the gestational disease. This study can help health professionals to realize that partners are an overlooked resource that can make important contributions to improve the health of the whole family if they are involved and supported by health services.

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“…Consequently, health education and training are important for continuous blood glucose management [10]. However, pregnant women who are found to have GDM may not know much about the disease or blood glucose management because they have not experienced the disease before [10], and most pregnant women experience anxiety, depression, fear, and stress about responding to health problems that may negatively affect the fetus [11]. The adaptations required to manage GDM, in addition to the physiological and psychological changes of pregnancy, cause additional stress regarding blood glucose control and disease burden, which can reduce the effectiveness of treatment [12].…”

Section: Introductionmentioning

confidence: 99%

The effects of health care programs for gestational diabetes mellitus in South Korea: a systematic review

Park¹,

Lee

2020

Korean J Women Health Nurs

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The purpose of this study was to investigate the effects and characteristics of health care programs for pregnant women with gestational diabetes mellitus (GDM) in Korea. This study was conducted according to the Cochrane Collaboration’s systematic literature review handbook and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guideline. We searched eight international and domestic electronic databases for relevant studies. Two reviewers independently selected the studies and extracted data. For each study, information on the research method, participants, characteristics of the program, and results were extracted using a previously established coding table. The National Evidence-based Healthcare Collaborating Agency’s risk of bias assessment tool for non-randomized studies was used to assess the risk of bias of the included articles. A qualitative review of the selected studies was performed because the interventions differed considerably and the measured outcomes varied. Out of 128 initially identified papers, seven were included in the final analysis. The risk of bias was evaluated as generally low. Health care programs for pregnant women with GDM showed positive effects on blood glucose control. Anxiety and depression were reduced, and self-management and self-care behavior, self-efficacy, and maternal identity improved. Our study provides clinical evidence for the effectiveness of health care programs for pregnant women with GDM, and its results can be used to support the development of health care programs for GDM. More well-designed research is needed on GDM, especially studies that deal with emotional stress and apply a family-oriented approach.

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A qualitative study exploring women's health behaviours after a pregnancy with gestational diabetes to inform the development of a diabetes prevention strategy

Abstract: This study identified some common drivers that may regulate the health behaviours of women following GDM, and recognized some ways to improve care to impact on this. Interventions for diabetes prevention in this population need to address factors at both the individual and systemic levels.

Cited by 31 publications

References 28 publications

Analysis of spontaneous, user‐generated data about gestational diabetes on online forums: implications for diabetes prevention

Analysis of spontaneous, user‐generated data about gestational diabetes on online forums: implications for diabetes prevention

Implementing a healthy postpartum lifestyle after gestational diabetes or preeclampsia: a qualitative study of the partner’s role

The effects of health care programs for gestational diabetes mellitus in South Korea: a systematic review

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