Women’s experiences of factors that facilitate or inhibit gestational diabetes self-management

Abstract

BackgroundGestational diabetes rates have increased dramatically in the past two decades and this pattern of increase appears to relate primarily to the obesity epidemic, older maternal age and migration from world areas of high GDM risk. Women from disadvantaged and migrant backgrounds are most at risk of developing and of mismanaging this condition. The aim of the study was to explore the factors that facilitated or inhibited gestational diabetes self-management among women in a socially deprived area.MethodsFifteen pregnant women, with a diagnosis of gestational diabetes, were purposively recruited for this study. Qualitative semi structured interviews and 1 focus group were conducted when participants were approximately 28–38 weeks gestation. The study’s theoretical framework was based on interpretative phenomenology and data was analysed using a thematic analysis approach.ResultsWomen in this study identified a number of factors that complicated their task of GDM self-management. Barriers included: (1) time pressures; (2) physical constraints; (3) social constraints; (4) limited comprehension of requirements, and (5) insulin as an easier option. Factors facilitating GDM self-management included: thinking about the baby and psychological support from partners and families.ConclusionWomen from low socio economic and migrant backgrounds often struggle to comprehend GDM self-management requirements. To improve adherence to management plans, these women require educational and supportive services that are culturally appropriate and aimed at a low level of literacy.

The Subjective Impact of a Diagnosis of Gestational Diabetes Among Ethnically Diverse Pregnant Women: A Qualitative Study

“…On the one hand, women felt that the management of GDM added to their multiple competing responsibilities and, for some, it created financial constraints and conflicted somewhat with their cultural food practices. Our findings complement those of another recent qualitative study that identified time pressures, physical and social constraints, and limited comprehension of advice as barriers to GDM management (15).…”

The Challenges and Recommendations for Gestational Diabetes Mellitus Care in India: A Review

“…Myths like “exercise harms the baby” and “pregnant mothers must consume food for two” cause negative strongholds in pregnant women, preventing them from following the instructions of their health-care professionals to exercise and adhere to a certain diet. Some patients are even reluctant to ask questions, suggesting poor interaction with the health-care providers leading to misconceptions (48, 49). Hence, many women remain sedentary during pregnancy because of these perceived barriers.…”

“…Hence, many women remain sedentary during pregnancy because of these perceived barriers. Many women crave certain food items during pregnancy, and the temptation for food that is not necessarily nutritious, especially carbohydrates, is a major obstacle to adherence (48, 49). Although studies suggest that exercise is good in pregnant women, in reality, compliance to diet, exercise, and medications is a major challenge to care in GDM patients, given one’s cultural habits.…”

Health Literacy in Adolescents With Sickle Cell Disease

“…Multiple regression analysis found that current grade level In both the adolescent and adult health literacy literature, socioeconomic status (SES) has been identified as a having a significant association with health literacy. Women with lower SES had more difficulty following gestational diabetes self-management requirements as shown in a qualitative study utilizing focus groups and individual interviews (Carolan et al, 2012). SES was also a predictor of diabetes knowledge in a sample of 349 adolescents (mean age=13 years) with type 1 diabetes (Powell et al, 2013).…”

“…Furthermore, women with lower SES have more difficulty following gestational diabetes selfmanagement requirements as shown in a qualitative study utilizing focus groups and individual interviews (Carolan, Gill, & Steele, 2012). In addition, lower SES is associated with lower health literacy amongst cancer patients (both urban and rural); and, low SES is a strong predictor of limited health literacy in patients on maintenance hemodialysis (Green et al, 2011;Halverson et al, 2013).…”