The experiences in the self-management of gestational diabetes: A qualitative study based on pender’s health promotion model
Nuran Nur Aypar Akbağ 1 * ,
Merlinda Aluş Tokat 2 More Detail
1 Midwifery Department, Faculty of Health Sciences, Sinop University, Sinop, Turkey
2 Obstetric and Gynecologic Nursing Department, Faculty of Nursing, Dokuz Eylul University, İzmir, Turkey
* Corresponding Author
J CLIN MED KAZ, Volume 20, Issue 5, pp. 22-30.
OPEN ACCESS
936 Views
929 Downloads
ABSTRACT
Aim: Cultural differences, facilitators or barriers affect lifestyle changes in women with GDM. This descriptive qualitative study examined experiences in self-management of Gestational Diabetes Mellitus (GDM) through Pender’s Health Promotion Model (HPM) of the nursing theories that develop cultural care models.
Material and methods: The qualitative descriptive research was designed based on a deductive qualitative content analysis, within the framework of the Health Promotion Model. A total of 23 women, who were diagnosed with GDM, participated in semi-structured interviews. Data were analyzed a deductive qualitative directed content analysis.
Results: Three themes that reflected “Behavior-specific cognitions and affect” component of HPM were obtained: perceptual changes, emotional changes, and changes in the support system. Sub-themes such as believing in the benefit of implementation and succeeding, monitoring the implementation, positive support were determined as the facilitating sub-themes. The difficulty of implementations, serious dimension in treatment, believing in failing, fear, stress, sadness, confusion and negative support were identified as barriers in GDM self-management.
Conclusion: This study highlighted on the value of the intervention based on Pender’s Model shall guide healthcare professionals in improving and to perform individualized GDM self-management. Also, the educational based on nursing models can increase self-efficacy and motivation in women.
CITATION
Aypar Akbağ NN, Aluş Tokat M. The experiences in the self-management of gestational diabetes: A qualitative study based on pender’s health promotion model. J CLIN MED KAZ. 2023;20(5):22-30.
REFERENCES
- American Diabetes Association (ADA). Management of Diabetes in Pregnancy: Standards of Medical Care in Diabetes. Diabetes Care. 2020;43(1):183–192. https://doi.org/10.2337/dc20-S014
- International Diabetes Federation (IDF). Diabetes Atlas. Ninth Edition. 2019. ISBN: 978-2-930229-87-4. https://www.diabetesatlas.org/en/
- Karaçam Z, Çelik D. The prevalence and risk factors of gestational diabetes mellitus in Turkey: a systematic review and meta-analysis. The Journal of Maternal-Fetal & Neonatal Medicine. 2019;34(8):1331-1341. https://doi.org/10.1080/14767058.2019.1635109
- Endocrinology and Metabolism Association of Turkey. Guideline for diagnosis, treatment and follow-up of diabetes mellitus and complications. 2020. Ankara: Bayt Printing Press. [Turkish] Retrieved from https://temd.org.tr/admin/uploads/tbl_kilavuz/20200625154506-2020tbl_kilavuz86bf012d90.pdf
- Aluş Tokat M, Sancı M, Girgeç S, Kulhan NG, Özcan ÇY. Postpartum education and lifestyle changes for preventing type 2 diabetes in Turkish women with previous gestational diabetes: a retrospective study. International Journal of Nursing Practice. 2016;22(5):427–35. https://doi.org/10.1111/ijn.12452
- Carolan-Olah M, Sayakhot P. A randomized controlled trial of a web-based education intervention for women with gestational diabetes mellitus. Midwifery. 2019;68:39-47. https://doi.org/10.1016/j.midw.2018.08.019
- Nicholson WK et al. The Gestational Diabetes Management System (GooDMomS): development, feasibility and lessons learned from a patient-informed, web-based pregnancy and postpartum lifestyle intervention. BMC pregnancy and childbirth. 2016;16(1):277. https://doi.org/10.1186/s12884-016-1064-z
- Şen E, Şirin A. The Effect of Gestatıonal Dıabetes Mellıtus Traınıng upon Metabolıc Control, Maternal and Neonatal Outcomes. International Journal of Caring Sciences. 2014;7(1):313–23.
- Yağcan H, Uludağ E, Aypar Akbağ NN, Özberk H. Do Pregnant Women's Information Sources Affect their Attitudes toward the Oral Glucose Tolerance Test? A Descriptive Cross-Sectional Study. Asian Women. 2021;37(2). https://doi.org/10.14431/aw.2021.6.37.2.95
- Craig L, Sims R, Glasziou P, Thomas R. Women’s experiences of a diagnosis of gestational diabetes mellitus: a systematic review. BMC pregnancy and childbirth. 2020;20(1):76. https://doi.org/10.1186/s12884-020-2745-1
- Hjelm K, Bard K, Apelqvist JA. Qualitative study of developing beliefs about health, illness and healthcare in migrant African women with gestational diabetes living in Sweden. BMC Women’s Health. 2018;18(1):34. https://doi.org/10.1186/s12905-018-0518-z
- Carolan-Olah M, Duarte-Gardea M, Lechuga J, Salinas-Lopez S. The experience of gestational diabetes mellitus (GDM) among Hispanic women in a U.S. border region. Sexual & reproductive healthcare: official journal of the Swedish Association of Midwives. 2017;12:6–23. https://doi.org/10.1016/j.srhc.2016.11.003
- Draffin CR et al. Exploring the needs, concerns and knowledge of women diagnosed with gestational diabetes: a qualitative study. Midwifery. 2016;40:141–47. https://doi.org/10.1016/j.midw.2016.06.019
- Khooshehchin TE, Keshavarz Z, Afrakhteh M, Shakibazadeh E, Faghihzadeh S. Perceived needs in women with gestational diabetes: A qualitative study. Electronic physician. 2016;8(12):3412. https://doi.org/10.19082/3412
- Youngwanichsetha S, Phumdoung S. Lived experience of blood glucose self-monitoring among pregnant women with gestational diabetes mellitus: A phenomenological research. Journal of Clinical Nursing. 2016;26,2915–21. https://doi.org/10.1111/jocn.13571
- Yee LM, McGuire JM, Taylor SM, Niznik CM, Simon MA. Social and Environmental Barriers to Nutrition Therapy for Diabetes Management Among Underserved Pregnant Women: a qualitative analysis. Journal of Nutrition Education and Behavior. 2016;48(3):170–80. https://doi.org/10.1016/j.jneb.2015.11.003
- Dayyani I, Terkildsen Maindal H, Rowlands G, Lou S. A qualitative study about the experiences of ethnic minority pregnant women with gestational diabetes. Scandinavian Journal of Caring Sciences. 2019;33:621–631. https://doi.org/10.1111/scs.12655
- Darkhor S, Estebsari F, Hosseini M, Charati JY, Vasli P. Effect of health promotion intervention on Nurses’ healthy lifestyle and health-promoting behaviors: RCT study. Journal of advanced pharmacy education & research. 2018;8(1):109.
- Khodaveisi M, Omidi A, Farokhi S, Soltanian AR. The effect of Pender’s health promotion model in improving the nutritional behavior of overweight and obese women. International journal of community based nursing and midwifery. 2017;5(2):165. https://doi.org/10.1136/bmjopen-2016-015415.131
- Heydari A, Khorashadizadeh F. Pender’s health promotion model in medical research. Studies. 2014;41(59):1067-1074.
- Jalili Bahabadi F, Estebsari F, Rohani C, Rahimi Khalifeh Kandi Z, Sefidkar R, Mostafaei, D. Predictors of Health-Promoting Lifestyle in Pregnant Women Based on Pender's Health Promotion Model. International journal of women's health. 2020;12, 71–77. https://doi.org/10.2147/IJWH.S235169
- Pender NJ, Murdaugh C, Parsons MA. Health Promotion in Nursing Practice. 4th Edition, Prentice-Hall Health, Inc., USA. 2002. Page:140-145.
- Sakraida TJ. Health Promotion Model. Nursing theorists and their work. In Alligood MR. 8th edition, Mosby, an imprint of Elsevier Inc., USA. 2014;396-416.
- Cardwell MS. Improving medical adherence in women with gestational diabetes through self-efficacy. Clinical Diabetes. 2013; 31(3):110-115. https://doi.org/10.2337/diaclin.31.3.110
- Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qualitative health research. 2005;15(9):1277-1288. https://doi.org/10.1177/1049732305276687
- Booth A, Hannes K, Harden A, Noyes J, Harris, J, Tong A. COREQ (consolidated criteria for reporting qualitative studies). Guidelines for reporting health research: a user's manual. 2014; 214–26. https://doi.org/10.1002/9781118715598.ch21
- Fusch PI, Ness LR. Are we there yet? Data saturation in qualitative research. The Qualitative Report. 2015;20(9):1408–1416. https://doi.org/10.46743/2160-3715/2015.2281
- Nowell LS, Norris JM, White DE, Moules NJ. Thematic analysis: Striving to meet the trustworthiness criteria. International journal of qualitative methods. 2017;16(1): 1609406917733847. https://doi.org/10.1177/1609406917733847
- McParlin C, Hodson K, Barnes AC, Taylor R, Robson SC, Araujo-Soares V. Views, experience and adherence among pregnant women with gestational diabetes participating in a weight loss study (WELLBABE). Diabetic Medicine. 2019;36:195–202. https://doi.org/10.1111/dme.13788
- Kraschnewski JL, Chuan CH. “Eating for Two”: Excessive Gestational Weight Gain and the Need to Change Social Norms. Womens Health Issues. 2014;24(3):257–59. https://doi.org/10.1016/j.whi.2014.03.004