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Luo X, Pan J, Jiang C, Li X, Li P. The influence of Chinese culture and customs on the beliefs and health-related behaviours of Chinese women with gestational diabetes mellitus: A qualitative study. Int J Nurs Pract 2024; 30:e13234. [PMID: 38273651 DOI: 10.1111/ijn.13234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 12/04/2023] [Accepted: 12/12/2023] [Indexed: 01/27/2024]
Abstract
OBJECTIVE The study aimed to explore the influence of Chinese culture and customs on the beliefs and health-related behaviours of Chinese women with gestational diabetes mellitus (GDM). METHODS This descriptive qualitative study conducted semi-structured interviews with 15 Chinese women between November 2022 and January 2023. The interview data were analysed using thematic analysis. RESULTS Three major themes are found: (1) beliefs in health, (2) beliefs in illness and GDM and (3) beliefs in health-related behaviours. They worried about the negative effects of GDM on the infant and family, so they actively sought medical advice to maintain health. However, it is challenging for them to balance adhering to healthcare professionals' advice and avoiding practical difficulties in the impact of the Chinese sociocultural context. CONCLUSION This study emphasizes the influence of Chinese culture and customs on the beliefs and health-related behaviours of women with GDM. Healthcare providers should recognize the influence of Chinese culture, customs and beliefs on women with GDM and their families, in order to provide individualized education to help them maintain health-related behaviours.
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Affiliation(s)
- Xiuwen Luo
- Master of Birmingham City University, Birmingham, UK
- Nursing Department, The Second People's Hospital of Foshan, Foshan, Guangdong Province, China
| | - Jie Pan
- Foshan University, Foshan, Guangdong Province, China
| | - Cailing Jiang
- Bachelor of Southern Medical University, Guangzhou, Guangdong Province, China
- Obstetrics Department of The Second People's Hospital of Foshan, Foshan, Guangdong Province, China
| | - Xiaoxiao Li
- Nursing Department, The Second People's Hospital of Foshan, Foshan, Guangdong Province, China
- Master of Jinan University, Guangzhou, Guangdong Province, China
| | - Peiling Li
- Bachelor of Guangdong Pharmaceutical University, Guangzhou, Guangdong Province, China
- Endocrinology Department of The Second People's Hospital of Foshan, Foshan, Guangdong Province, China
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Sohmaran C, Bte Mohamed Rahim A, Chua JYX, Shorey S. Perceptions of primiparous women diagnosed with gestational diabetes mellitus: A descriptive qualitative study. Midwifery 2023; 125:103802. [PMID: 37657131 DOI: 10.1016/j.midw.2023.103802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 08/13/2023] [Accepted: 08/25/2023] [Indexed: 09/03/2023]
Abstract
OBJECTIVE To understand the perceptions of primiparous women recently diagnosed with Gestational Diabetes Mellitus (GDM) in Singapore. DESIGN A descriptive qualitative study design. SETTING An outpatient women's health clinic in a tertiary hospital in Singapore. PARTICIPANTS Twelve English-speaking primiparous women (aged 27-44 years old) who were diagnosed with GDM were recruited via purposive sampling to participate in this study. METHODS Face-to-face interviews were carried out with study participants in a private room at the outpatient clinic from December 2019 to May 2021. All interviews were audio-recorded and transcribed verbatim on the same day. Data analysis was guided by Braun and Clarke's thematic analysis framework. FINDINGS Four main themes were identified from this study's findings: (1) Life leading to GDM: A 'hint' that something was wrong, (2) Reactions to diagnosis: Shock or acceptance, (3) Learning to cope: Facing internal and external challenges, and (4) Living with GDM: A way forward. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Primiparous women with GDM require comprehensive informational, practical, and emotional support to help them manage and accept their condition. Healthcare providers are encouraged to provide individualised and holistic care to these women using a humanistic approach. Accessible online educational resources and peer support services could be considered. Public campaigns to increase the general public's awareness of GDM would also allow future women and their families to be more familiar with the condition and hence more prepared to cope with it.
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Affiliation(s)
- Chithrra Sohmaran
- Nursing Division, KK Women's and Children's Hospital, 100 Bukit Timah Road, 229899, Singapore
| | - Asmira Bte Mohamed Rahim
- Nursing Division, Obstetric Day Assessment Centre, KK Women's and Children's Hospital, 100 Bukit Timah Road, 229899, Singapore
| | - Joelle Yan Xin Chua
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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Haigh C, Lau HWR, Weir T, Glastras S. The experiences of women from culturally and linguistically diverse backgrounds with gestational diabetes mellitus: A mixed methods systematic review. Endocrinol Diabetes Metab 2023:e421. [PMID: 37139646 DOI: 10.1002/edm2.421] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 01/27/2023] [Accepted: 03/25/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is experienced at a higher rate in women from culturally and linguistically diverse (CALD) backgrounds. The aim of this systematic review is to describe the experiences of women with GDM from CALD backgrounds and compare their experiences to women with GDM from non-CALD backgrounds. MATERIALS AND METHODS MEDLINE, EMBASE, PsycINFO, Scopus, WOS and CINAHL databases were searched for qualitative and quantitative studies which included data on the experiences of CALD background women with GDM during all stages of pregnancy. Quality appraisal utilized checklists for analytical cross-sectional studies and qualitative research. Thematic analysis was performed using nVivo software. RESULTS Of the 3054 studies identified, 24 studies met the inclusion criteria. Data synthesis produced five key themes: (1) Response to diagnosis, (2) Experiences with self-management, (3) Interactions with the healthcare system, (4) Mental health challenges and (5) Facilitators and barriers to support. Women with GDM from CALD and non-CALD backgrounds similarly expressed mental health challenges, feeling burdened by recommendations, and challenges interacting with healthcare professionals (HCP). The major difference in experience was the cultural relevance of recommendations, especially related to diet recommendations. CONCLUSION Gestational diabetes mellitus is a burdensome diagnosis for CALD and non-CALD women, with CALD women uniquely experiencing a lack of culturally relevant recommendations for self-management. The similarities and differences in experience call for optimisation of GDM management and support for women with GDM.
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Affiliation(s)
- Claire Haigh
- Kolling Institute and North Precinct, The University of Sydney, Sydney, New South Wales, Australia
| | - Hiu Wing Rachel Lau
- Kolling Institute and North Precinct, The University of Sydney, Sydney, New South Wales, Australia
| | - Tessa Weir
- Kolling Institute and North Precinct, The University of Sydney, Sydney, New South Wales, Australia
- Department of Diabetes, Endocrinology & Metabolism, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Sarah Glastras
- Kolling Institute and North Precinct, The University of Sydney, Sydney, New South Wales, Australia
- Department of Diabetes, Endocrinology & Metabolism, Royal North Shore Hospital, St Leonards, New South Wales, Australia
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de-Graft Aikins A, Sanuade O, Baatiema L, Adjaye-Gbewonyo K, Addo J, Agyemang C. How chronic conditions are understood, experienced and managed within African communities in Europe, North America and Australia: A synthesis of qualitative studies. PLoS One 2023; 18:e0277325. [PMID: 36791113 PMCID: PMC9931108 DOI: 10.1371/journal.pone.0277325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 10/24/2022] [Indexed: 02/16/2023] Open
Abstract
This review focuses on the lived experiences of chronic conditions among African communities in the Global North, focusing on established immigrant communities as well as recent immigrant, refugee, and asylum-seeking communities. We conducted a systematic and narrative synthesis of qualitative studies published from inception to 2022, following a search from nine databases-MEDLINE, EMBASE, PsycINFO, Web of Science, Social Science Citation Index, Academic Search Complete, CINAHL, SCOPUS and AMED. 39 articles reporting 32 qualitative studies were included in the synthesis. The studies were conducted in 10 countries (Australia, Canada, Denmark, France, Netherlands, Norway, Sweden, Switzerland, United Kingdom, and the United States) and focused on 748 participants from 27 African countries living with eight conditions: type 2 diabetes, hypertension, prostate cancer, sickle cell disease, chronic hepatitis, chronic pain, musculoskeletal orders and mental health conditions. The majority of participants believed chronic conditions to be lifelong, requiring complex interventions. Chronic illness impacted several domains of everyday life-physical, sexual, psycho-emotional, social, and economic. Participants managed their illness using biomedical management, traditional medical treatment and faith-based coping, in isolation or combination. In a number of studies, participants took 'therapeutic journeys'-which involved navigating illness action at home and abroad, with the support of transnational therapy networks. Multi-level barriers to healthcare were reported across the majority of studies: these included individual (changing food habits), social (stigma) and structural (healthcare disparities). We outline methodological and interpretive limitations, such as limited engagement with multi-ethnic and intergenerational differences. However, the studies provide an important insights on a much-ignored area that intersects healthcare for African communities in the Global North and medical pluralism on the continent; they also raise important conceptual, methodological and policy challenges for national health programmes on healthcare disparities.
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Affiliation(s)
- Ama de-Graft Aikins
- Institute of Advanced Studies, University College London, London, United Kingdom
- * E-mail:
| | - Olutobi Sanuade
- Department of Population Health Sciences, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, Utah, United States of America
| | - Leonard Baatiema
- Department of Health Policy, Planning and Management, School of Public Health, University of Ghana, Legon, Accra, Ghana
| | - Kafui Adjaye-Gbewonyo
- Faculty of Education, Health and Human Sciences, University of Greenwich, London, United Kingdom
| | - Juliet Addo
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Charles Agyemang
- Department of Public Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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Kragelund Nielsen K, Davidsen E, Husted Henriksen A, Andersen GS. Gestational Diabetes and International Migration. J Endocr Soc 2022; 7:bvac160. [DOI: 10.1210/jendso/bvac160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Indexed: 11/18/2022] Open
Abstract
Abstract
In many countries, immigrant women constitute a substantial proportion of women giving birth. With gestational diabetes being one of the most common complications in pregnancy, understanding gestational diabetes in the context of international migration becomes increasingly relevant. Here, we examine the current evidence related to international migration and gestational diabetes, including short- and long-term adverse outcomes and the experiences of immigrant women with gestational diabetes care and long-term follow-up. Existing evidence focuses on immigrants in high-income countries, and has mainly examined differences in the risk of developing gestational diabetes, or on the experiences of immigrant women diagnosed with gestational diabetes. Studies suggest that the risk of gestational diabetes may be influenced by migration and that immigrant women likely experience particular barriers to care and follow-up. Current research on perinatal outcomes is inconclusive and studies on long-term outcomes are practically absent. Future research should include data on country of origin and examine the role of premigration and postmigration factors in developing gestational diabetes and its associated short- and long-term outcomes. Understanding these factors will provide useful insights into improving the health and health care needs of migrating populations and enable inclusion of culturally appropriate health care practices, thereby improving the health of our current and future generations.
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Affiliation(s)
| | - Emma Davidsen
- Health Promotion Research, Steno Diabetes Center Copenhagen , 2730 Herlev , Denmark
| | | | - Gregers S Andersen
- Clinical Research, Steno Diabetes Center Copenhagen , 2730 Herlev , Denmark
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A scoping review of gestational diabetes mellitus healthcare: experiences of care reported by pregnant women internationally. BMC Pregnancy Childbirth 2022; 22:627. [PMID: 35941555 PMCID: PMC9361509 DOI: 10.1186/s12884-022-04931-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 07/14/2022] [Indexed: 11/16/2022] Open
Abstract
Background Gestational diabetes mellitus (GDM) is a condition associated with pregnancy that engenders additional healthcare demand. A growing body of research includes empirical studies focused on pregnant women’s GDM healthcare experiences. The aim of this scoping review is to map findings, highlight gaps and investigate the way research has been conducted into the healthcare experiences of women with GDM. Methods A systematic search of primary research using a number of databases was conducted in September 2021. Studies were included if they had an explicit aim of focusing on GDM and included direct reporting of participants’ experiences of healthcare. Key data from each study was extracted into a purposely-designed form and synthesised using descriptive statistics and thematic analysis. Results Fifty-seven articles were included in the analysis. The majority of studies used qualitative methodology, and did not have an explicit theoretical orientation. Most studies were conducted in urban areas of high-income countries and recruitment and research was almost fully conducted in clinical and other healthcare settings. Women found inadequate information a key challenge, and support from healthcare providers a critical factor. Experiences of prescribed diet, medication and monitoring greatly varied across settings. Additional costs associated with managing GDM was cited as a problem in some studies. Overall, women reported significant mental distress in relation to their experience of GDM. Conclusions This scoping review draws together reported healthcare experiences of pregnant women with GDM from around the world. Commonalities and differences in the global patient experience of GDM healthcare are identified. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04931-5.
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Watermeyer J, Hume VJ, Seabi T, Nattrass R. Complexities in interdisciplinary community engagement projects: some reflections and lessons from an applied drama and theatre project in diabetes care. MEDICAL HUMANITIES 2021; 47:485-495. [PMID: 33990417 DOI: 10.1136/medhum-2019-011822] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/31/2020] [Indexed: 06/12/2023]
Abstract
There is a growing interest in using drama techniques and theatrical performance to disseminate health information to lay audiences as part of community engagement projects. This process can be challenging for a number of reasons, however. In this paper, we describe the process and pitfalls of an interdisciplinary project involving the development and performance of a play about diabetes mellitus. The play formed part of a long-term, three-way community engagement project between social science, applied drama and a diabetes clinic in South Africa. Building on a framework derived from a number of applied drama methods, we elicited narratives from key 'storytellers' that were developed and embodied by actors in a new performance called Blood Sugars Creating this play provided insight into working in an interdisciplinary space and highlighted the importance of establishing shared goals and joint ownership of the project right from the outset. This was without doubt a challenging project and the complexities of finding common ground across three disciplines are not to be underestimated. In this paper, we explore the collaboration and its challenges, drawing on the framework of complexity theory. In particular, we examine the layers of complexity that emerged as a result of the interdisciplinary nature of the project and the demands of balancing the authenticity of the stories with the perceived requirements of health messaging. We consider the methodological, conceptual and ethical challenges of this type of research, and discuss some recommendations for teams taking on similar complex multidisciplinary research and intervention projects.
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Affiliation(s)
- Jennifer Watermeyer
- Health Communication Research Unit, School of Human and Community Development, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Victoria Jane Hume
- Health Communication Research Unit, School of Human and Community Development, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
- WiSER, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Tshegofatso Seabi
- Health Communication Research Unit, School of Human and Community Development, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
- MRC/Wits Population Health and Health Transition Research Unit (Agincourt), University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Rhona Nattrass
- Health Communication Research Unit, School of Human and Community Development, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
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He J, Chen X, Wang Y, Liu Y, Bai J. The experiences of pregnant women with gestational diabetes mellitus: a systematic review of qualitative evidence. Rev Endocr Metab Disord 2021; 22:777-787. [PMID: 33184736 DOI: 10.1007/s11154-020-09610-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/29/2020] [Indexed: 12/25/2022]
Abstract
Gestational diabetes mellitus (GDM) can have serious adverse effects on pregnant women and their fetuses. The purpose of this systematic review is to explore responses from women diagnosed with GDM and to describe their real-life experiences with self-management during pregnancy. The review provides insight into the physical, psychological, and social experiences of women with GDM; exploring these factors can help identify the challenges of glucose control and may provide targeted care and interventions to improve maternal and child health. Twelve databases were included in the initial article search, which was conducted on February 27, 2019. Two independent reviewers used the JBI Critical Appraisal Checklist for Qualitative Research for methodological validity to assess articles for study inclusion. The final synthesized findings were graded according to the ConQual approach for establishing confidence. Ten studies (totaling 223 pregnant women with GDM), originating from 6 different countries, were included in the review. Of the 223 women, 171 had one pregnancy affected by GDM and 52 had two or more pregnancies affected by GDM. Based on the findings from these studies, three main themes emerged, which were synthesized from 10 separate categories and 46 individual findings: beliefs about illness and health; life-changing experiences and healthy expectations; and difficulties and needs. Both positive and negative experiences of pregnant women with GDM can be understood as a process of "continuous struggle and change". Understanding the experiences of women diagnosed with GDM can provide health care professionals with more knowledge of how women experience GDM and develop feasible interventions to reduce the risk of developing type II diabetes.PROSPERO registration number CRD42019132065.
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Affiliation(s)
- Jing He
- School of Health Sciences, Wuhan University, No.115, Dong Hu Road, Wuhan, 430071, Hubei, China
| | - Xiaoli Chen
- School of Health Sciences, Wuhan University, No.115, Dong Hu Road, Wuhan, 430071, Hubei, China
| | - Yuchen Wang
- School of Health Sciences, Wuhan University, No.115, Dong Hu Road, Wuhan, 430071, Hubei, China
| | - Yanqun Liu
- School of Health Sciences, Wuhan University, No.115, Dong Hu Road, Wuhan, 430071, Hubei, China.
| | - Jinbing Bai
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, 30322, USA
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Migrant Middle Eastern women with gestational diabetes seven years after delivery - positive long-term development of beliefs about health and illness shown in follow-up interviews. Prim Health Care Res Dev 2021; 22:e21. [PMID: 34034848 PMCID: PMC8165453 DOI: 10.1017/s1463423621000232] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
AIM No previous studies have been found focusing on the long-term development of beliefs about health, illness and healthcare in migrant women with gestational diabetes mellitus (GDM). The aim of this study was to explore this and the influence on health-related behaviour (i.e. self-care and care seeking) in migrant women from the Middle East living in Sweden seven years after delivery. BACKGROUND GDM is increasing, particularly in migrant women. The risk of adverse outcomes of GDM for health can be improved by interventions reducing blood glucose and lifestyle modifications which medicalise the woman's pregnancy due to intensive follow-up and demanding self-care. The reactions might have an enduring impact on the women's long-term psychological and physical health and adoption of preventive health behaviours. METHOD Qualitative exploratory study. Semi-structured follow-up interviews 7 years after delivery with women previously interviewed in gestational weeks 34-38 and 3 and 14 months after delivery. Data analysed with qualitative content analysis. FINDINGS Health meant freedom from illness, feeling well and living long to be able to care for the children. The present situation was described either positively, changing to a healthier lifestyle, or negatively, with worries about being affected by type 2 diabetes. Beliefs changed among the majority of women, leading to a healthier lifestyle, and they looked positively back at the time when diagnosed and their reactions to it. With few exceptions, they were confident of being aware of future health risks and felt responsible for their own and their children's health/lifestyle. None except those diagnosed with type 2 diabetes had been in contact with healthcare since the last follow-up a year after delivery. Yet, they still would like and need a healthcare model delivering more information, particularly on developing a healthy lifestyle for children, and with regular check-ups also after the first year after delivery.
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Moore AP, Flynn AC, Adegboye ARA, Goff LM, Rivas CA. Factors Influencing Pregnancy and Postpartum Weight Management in Women of African and Caribbean Ancestry Living in High Income Countries: Systematic Review and Evidence Synthesis Using a Behavioral Change Theoretical Model. Front Public Health 2021; 9:637800. [PMID: 33681136 PMCID: PMC7925838 DOI: 10.3389/fpubh.2021.637800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 01/18/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Women of black African heritage living in high income countries (HIC) are at risk of obesity and weight-related complications in pregnancy. This review aimed to synthesize evidence concerning attitudes to weight management-related health behaviors in pregnancy and postpartum, in women of black African ancestry, living in high-income countries. Methods: A systematic review of the literature and thematic evidence synthesis using the Capability-Opportunity-Motivation Behavioral change theoretical model (COM-B). Databases searched included MEDLINE, EMBASE, Web of Science, and Scopus. The CASP tool was used to assess quality. Results: Twenty-four papers met the selection criteria, most of which were from the US. Motivational factors were most commonly described as influencers on behavior. Normative beliefs about "eating for two," weight gain being good for the baby, the baby itself driving food choice, as well as safety concerns about exercising in pregnancy, were evident and were perpetuated by significant others. These and other social norms, including a cultural acceptance of larger body shapes, and daily fast food, created a challenge for healthy behavior change. Women also had low confidence in their ability to lose weight in the postpartum period. Behavior change techniques, such as provision of social support, use of credible sources, and demonstration may be useful to support change. Conclusions: The women face a range of barriers to engagement in weight-related health behaviors at this life-stage. Using a theoretical behavior change framework can help identify contextual factors that may limit or support behavior change.
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Affiliation(s)
- Amanda P Moore
- Department of Nutrition, Kings College London, London, United Kingdom
| | - Angela C Flynn
- Department of Women and Children's Health, King's College London, London, United Kingdom
| | | | - Louise M Goff
- Department of Nutrition, Kings College London, London, United Kingdom
| | - Carol A Rivas
- UCL Social Research Institute, University College London (UCL), London, United Kingdom
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Craig L, Sims R, Glasziou P, Thomas R. Women's experiences of a diagnosis of gestational diabetes mellitus: a systematic review. BMC Pregnancy Childbirth 2020; 20:76. [PMID: 32028931 PMCID: PMC7006162 DOI: 10.1186/s12884-020-2745-1] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 01/15/2020] [Indexed: 12/17/2022] Open
Abstract
Background Gestational diabetes mellitus (GDM) - a transitory form of diabetes induced by pregnancy - has potentially important short and long-term health consequences for both the mother and her baby. There is no globally agreed definition of GDM, but definition changes have increased the incidence in some countries in recent years, with some research suggesting minimal clinical improvement in outcomes. The aim of this qualitative systematic review was to identify the psychosocial experiences a diagnosis of GDM has on women during pregnancy and the postpartum period. Methods We searched CINAHL, EMBASE, MEDLINE and PsycINFO databases for studies that provided qualitative data on the psychosocial experiences of a diagnosis of GDM on women across any stage of pregnancy and/or the postpartum period. We appraised the methodological quality of the included studies using the Critical Appraisal Skills Programme Checklist for Qualitative Studies and used thematic analysis to synthesis the data. Results Of 840 studies identified, 41 studies of diverse populations met the selection criteria. The synthesis revealed eight key themes: initial psychological impact; communicating the diagnosis; knowledge of GDM; risk perception; management of GDM; burden of GDM; social support; and gaining control. The identified benefits of a GDM diagnosis were largely behavioural and included an opportunity to make healthy eating changes. The identified harms were emotional, financial and cultural. Women commented about the added responsibility (eating regimens, appointments), financial constraints (expensive food, medical bills) and conflicts with their cultural practices (alternative eating, lack of information about traditional food). Some women reported living in fear of risking the health of their baby and conducted extreme behaviours such as purging and starving themselves. Conclusion A diagnosis of GDM has wide reaching consequences that are common to a diverse group of women. Threshold cut-offs for blood glucose levels have been determined using the risk of physiological harms to mother and baby. It may also be advantageous to consider the harms and benefits from a psychosocial and a physiological perspective. This may avoid unnecessary burden to an already vulnerable population.
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Affiliation(s)
- Louise Craig
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Australia
| | - Rebecca Sims
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Australia
| | - Paul Glasziou
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Australia
| | - Rae Thomas
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Australia.
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A qualitative study of developing beliefs about health, illness and healthcare in migrant African women with gestational diabetes living in Sweden. BMC WOMENS HEALTH 2018; 18:34. [PMID: 29402265 PMCID: PMC5800284 DOI: 10.1186/s12905-018-0518-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 01/16/2018] [Indexed: 01/09/2023]
Abstract
Background Gestational diabetes (GDM) is associated with health risks for both mother and child, and is particularly relevant to migrant women and women of African origin. With today’s extensive global migration, contact with the new society and health system confronts the migrant’s culture of origin with the culture of the host country. The question is whether immigrants’ patterns of beliefs about health, illness, and health-related behaviour change over time, as no previous studies have been found on this topic. The purpose was to explore development over time, during and after pregnancy, of beliefs about health, illness and healthcare in migrant women with GDM born in Africa living in Sweden, and study the influence on self-care and care seeking. Methods Qualitative prospective study. Semi-structured interviews, with 9 women (23–40 years), on three different occasions: during pregnancy (gestational weeks 34–38), and 3 and 14 months after delivery managed at an in-hospital diabetes specialist clinic in Sweden. Results Beliefs were rather stable over time and mainly related to individual and social factors. GDM was perceived as a transient condition as health professionals had informed about it, which made them calm. None, except one, expressed worries about relapse and the health of the baby. Instead women worried about being unable to live an ordinary life and being bound to lifestyle changes, particularly diet, developing diabetes and needing insulin injections. Over time knowledge of appropriate diet improved, although no advice was experienced given by the clinic after delivery. The healthcare model was perceived as well functioning with easy access but regular follow-ups were requested as many (decreasing over time) were unsure whether they still had GDM and lacked information about GDM and diet. During pregnancy information was also requested about the healthcare system before/after delivery. Conclusions Beliefs changed to a limited extent prospectively, indicated low risk awareness, limited knowledge of GDM, irrelevant worries about future health, and being unable to live a normal life, associated with problematic lifestyle changes. Beliefs about the seriousness of GDM in health professionals influenced patients’ beliefs and health-related behaviour. The healthcare organisation urgently needs to be improved to deliver appropriate and timely information through competent staff. Electronic supplementary material The online version of this article (10.1186/s12905-018-0518-z) contains supplementary material, which is available to authorized users.
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Ge L, Wikby K, Rask M. Lived experience of women with gestational diabetes mellitus living in China: a qualitative interview study. BMJ Open 2017; 7:e017648. [PMID: 29187411 PMCID: PMC5719331 DOI: 10.1136/bmjopen-2017-017648] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Revised: 10/02/2017] [Accepted: 10/25/2017] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To explore the lived experience of women with gestational diabetes mellitus (GDM) living in China in order to add knowledge about how the Chinese women suffer from GDM. DESIGN A qualitative interpretive interview study. Data were collected with a snowball sampling technique. Phenomenological hermeneutics was used as the analysis method based on Ricoeur's phenomenological hermeneutical interpretation theory. SETTING The study was performed at the participants' work places, or at the obstetric clinics or wards at two provincial hospitals and one municipal hospital in the southeast of China. PARTICIPANTS Inclusion criteria were age ≥18 years, diagnosis of GDM without other pregnancy complications, in 34th gestational weeks-postpartum 4th weeks and speaking Mandarin Chinese without speech impediment. 62 women, who met the inclusion criteria, took part in the study. RESULTS The lived experience of the women with GDM living in China was formulated into a main theme: 'longing for caring care'. The main theme was derived from four themes: being stricken by GDM, wishing to receive caring GDM care, being left alone to struggle with GDM and trying to adjust and adapt to life with GDM. CONCLUSION The eagerness for caring care in China was highlighted. The lack of caring care could be one of the possible reasons why the professional-patient relations were deteriorating in China. It could be useful for health providers and health policymakers to receive education and training about caring care. Using the health metaphor of balance and 'patient participation' and 'patient-centred' approaches may benefit women with GDM and thus improve the quality of care in China.
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Affiliation(s)
- Li Ge
- Nursing College, Fujian University of Traditional Chinese Medicine, Fujian, China
| | - Kerstin Wikby
- Department of Health and Caring Sciences, Linnaeus University, Vaxjo, Sweden
| | - Mikael Rask
- Nursing College, Fujian University of Traditional Chinese Medicine, Fujian, China
- Department of Health and Caring Sciences, Linnaeus University, Vaxjo, Sweden
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Svensson L, Nielsen KK, Maindal HT. What is the postpartum experience of Danish women following gestational diabetes? A qualitative exploration. Scand J Caring Sci 2017; 32:756-764. [PMID: 28856697 DOI: 10.1111/scs.12506] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 06/19/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND Women with gestational diabetes mellitus (GDM) receive acute but short-term care during pregnancy. There is less direct support during the postpartum period; women are offered general advice on how to follow a healthy lifestyle to avoid developing future type 2 diabetes. Observational studies suggest that a substantial proportion of women with prior GDM do not sustain recommended lifestyle changes postpartum. In a qualitative study, we examined how Danish women diagnosed with GDM experience the transition from a GDM-affected pregnancy to the postpartum period. METHODS Semistructured interviews with six women diagnosed with GDM. Data were analysed using qualitative content analysis. RESULTS A GDM diagnosis was accompanied by worries about the health of the woman's baby. This was also the driving force behind the women's motivation to engage in lifestyle changes during pregnancy. The outpatient treatment was perceived to be strict and associated with various challenges, including cravings and discomfort. After the delivery, taking care of the baby became the women's dominant focus. Social and emotional support from partners were needed to maintain motivation and prioritise a healthy lifestyle. The women's experience of the health system varied. However, in the postpartum period all the women experienced limited interaction and initiative from their healthcare providers in supporting them to engage in a healthy lifestyle. CONCLUSIONS This study identified barriers and facilitators to sustaining a healthy lifestyle postpartum. Efforts at multiple levels - including the individual, family and health system - are needed to facilitate and support a healthy lifestyle among women with prior GDM.
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Affiliation(s)
- Line Svensson
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Karoline Kragelund Nielsen
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Helle Terkildsen Maindal
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
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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. Int J Nurs Pract 2016; 22:427-435. [PMID: 27492504 DOI: 10.1111/ijn.12452] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 04/11/2016] [Accepted: 04/30/2016] [Indexed: 01/11/2023]
Abstract
BACKGROUND Women with previous gestational diabetes mellitus (GDM) have at least sevenfold increased risk for developing type 2 diabetes compared with non-GDM mothers. The risk can be decreased by self-care measures. AIM The aim of this study was to explore the postpartum education and lifestyle changes of Turkish women with previous GDM. METHOD This was a retrospective descriptive epidemiological study. A total of 111 women who had given birth within the previous 3-4 years were interviewed by telephone between December 2013 and April 2014. RESULTS The 83.8% of the women with GDM had not received education related to exercise, while 40.5% received no education regarding the importance of diet. More importantly, while 68.5% had been informed about testing blood glucose levels postpartum, a large majority, 69.3%, did not know for how long they would have had to continue testing their glucose levels. However, 31.3% of those who monitored their glucose levels had glucose intolerance. In terms of lifestyle changes, less than half of the women, 48.6%, had made changes in their diet and the majority, 51.4%, were inactive. CONCLUSION Women need access to sustained education and supportive counselling both to motivate and to minimize the risk of type 2 diabetes after GDM.
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Affiliation(s)
- Merlinda Aluş Tokat
- Obstetric and Gynecologic Nursing Department, Dokuz Eylul University Faculty of Nursing, Izmir, Turkey.
| | - Muzafer Sancı
- T.C Health Ministry Izmir Tepecik Maternity and Women Health Hospital, Izmir, Turkey
| | - Semra Girgeç
- Obstetric and Gynecologic Nursing Department, Izmir University School of Health, Izmir, Turkey
| | | | - Çiler Yeygel Özcan
- Konya Ticaret Odası Karatay University Scholl of Health Science, Izmir, Turkey
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Ge L, Albin B, Hadziabdic E, Hjelm K, Rask M. Beliefs about health and illness and health-related behavior among urban women with gestational diabetes mellitus in the south east of China. J Transcult Nurs 2016; 27:593-602. [DOI: 10.1177/1043659615594677] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Li Ge
- Linnaeus University, Växjö, Sweden
- Nursing College of Fujian University of Traditional Chinese Medicine, Fuzhou, China
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17
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Ge L, Wikby K, Rask M. 'Is gestational diabetes a severe illness?' exploring beliefs and self-care behaviour among women with gestational diabetes living in a rural area of the south east of China. Aust J Rural Health 2016; 24:378-384. [PMID: 27087496 DOI: 10.1111/ajr.12292] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2016] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE This study explores beliefs about illness and health and self-care behaviour among women with gestational diabetes living in a rural area of the south east of China. DESIGN A qualitative exploratory study using semi-structured interviews and qualitative content analysis. SETTING A hospital located in the outskirts of a city in the south east of China. PARTICIPANTS Seventeen women with gestational diabetes in 34-38th pregnant weeks. RESULTS The beliefs about gestational diabetes among the women in the present study were found to be bidirectional. Some of them feared the illness and its negative influence on health, while others believed that it was not a severe illness and disbelieved the diagnosis of gestational diabetes. They related their illness and health to the individual, social and natural factors. They mainly sought help from the professional sector, but did not fully comply with the professionals' advice. Diet control and exercise were their main self-care measures, but none of them self-monitored their blood glucose. They demonstrated their misunderstanding about diet control and self-monitoring of blood glucose. CONCLUSIONS This study highlighted the serious lack of knowledge, lower level of risk awareness and poor self-care behaviour among women in this group. Health professionals were found to be the most important source of knowledge about gestational diabetes for these women. The influence of Chinese culture was demonstrated. Gestational diabetes among these women can most likely be improved by training the health professionals and by health education involving individuals, families and the rural communities.
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Affiliation(s)
- Li Ge
- Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.,Nursing College of Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Kerstin Wikby
- Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
| | - Mikael Rask
- Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
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Van Ryswyk E, Middleton P, Shute E, Hague W, Crowther C. Women's views and knowledge regarding healthcare seeking for gestational diabetes in the postpartum period: A systematic review of qualitative/survey studies. Diabetes Res Clin Pract 2015; 110:109-22. [PMID: 26421361 DOI: 10.1016/j.diabres.2015.09.010] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 08/30/2015] [Accepted: 09/08/2015] [Indexed: 01/11/2023]
Abstract
AIM To identify factors influencing postpartum healthcare seeking, from the perspective of women who have experienced gestational diabetes mellitus (GDM). METHODS Systematic review that searched PubMed, Web of Science, EMBASE and CINAHL on 27th February 2013. Qualitative studies and surveys, with women as participants, which reported pre-specified outcomes, including barriers and facilitators to healthcare seeking for GDM after birth, were included. Two authors independently extracted data and assessed quality. Results were thematically synthesised. RESULTS Forty-two studies were included, with data from 7949 women in several countries. The diagnosis of GDM was sometimes a concerning or upsetting experience. A need for more specific information about GDM to be available around the time of diagnosis was identified. Women had varied experiences of antenatal GDM care and management, ranging from very positive to difficult and confusing. Non-judgemental and positively focussed care was preferred. While women were often knowledgeable about type 2 diabetes risk and prevention, they faced multiple barriers to undertaking preventive behaviours. A need for lifestyle change support and more pro-active postpartum care was identified. CONCLUSIONS Provision of improved GDM education, as well as positive and pro-active care from diagnosis until postpartum follow-up may increase healthcare seeking by women with recent GDM.
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Affiliation(s)
- Emer Van Ryswyk
- Robinson Research Institute, The University of Adelaide, Australia.
| | | | - Elen Shute
- Robinson Research Institute, The University of Adelaide, Australia
| | - William Hague
- Robinson Research Institute, The University of Adelaide, Australia
| | - Caroline Crowther
- Robinson Research Institute, The University of Adelaide, Australia; Liggins Institute, The University of Auckland, New Zealand
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Brathwaite AC, Lemonde M. Exploring Health Beliefs and Practices of Caribbean Immigrants in Ontario to Prevent Type 2 Diabetes. J Transcult Nurs 2015; 28:15-23. [PMID: 26243716 DOI: 10.1177/1043659615597041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This qualitative study explored the beliefs held by adult Caribbean immigrants regarding type 2 diabetes (T2D) and their practices in preventing it. A purposive sample of 15 immigrants living in Ontario, Canada participated in the study. Semistructured interviews were used to collect data from participants. Four themes emerged from the data: beliefs that protect participants from developing T2D, cultural practices to stay healthy, preserving culture through preparation of meals, and cultural practices determine number of servings of fruit and vegetables per day. Findings indicate how beliefs and cultural practices influence prevention of T2D and the need to design culturally tailored interventions for ethnic groups. Future research should explore health beliefs and cultural practices of other high-risk groups and use their findings to design and evaluate culturally tailored interventions to prevent T2D.
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Affiliation(s)
| | - Manon Lemonde
- University of Ontario Institute of Technology, Oshawa, Ontario, Canada
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Cooper Brathwaite A, Lemonde M. Health Beliefs and Practices of African Immigrants in Canada. Clin Nurs Res 2015; 25:626-645. [PMID: 26025107 DOI: 10.1177/1054773815587486] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
A purposive sample of 14 immigrants living in Ontario, Canada, participated in two focus groups. The researchers used semi-structured interviews to collect data and five themes emerged from the data: beliefs about diabetes were centered on diverse factors, preserving culture through food preferences and preparation, cultural practices to stay healthy, cultural practices determined number of servings of fruit and vegetables per day, and engaging in physical activity to stay healthy. Findings indicated how health beliefs and cultural practices influenced behavior in preventing type 2 diabetes (T2D). Future research should focus on other high-risk minority groups (South Asian, Caribbean, and Latin American) to examine their health beliefs and cultural practices and use these finding to develop best practice guidelines, which should be incorporated into culturally tailored interventions.
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Affiliation(s)
| | - Manon Lemonde
- University of Ontario Institute of Technology, Oshawa, Canada
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Årestedt L, Benzein E, Persson C. Families living with chronic illness: beliefs about illness, family, and health care. JOURNAL OF FAMILY NURSING 2015; 21:206-31. [PMID: 25794513 DOI: 10.1177/1074840715576794] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Beliefs can be described as the lenses through which we view the world. With emerging illness, beliefs about the illness experience become important for nurses to understand to enhance well-being and healing. The aim of this study was to illuminate illness beliefs of families living with chronic illness. A qualitative design was chosen, including repeated narrative research interviews with seven Swedish families living with chronic illness. Hermeneutic analysis was used to interpret the transcribed family interviews. The result described beliefs in families, both within and across families. Both core beliefs and secondary beliefs about illness, family, and health care were revealed. Illness beliefs have importance for how families respond to and manage situations that arise from their encounters with illness. Nurses have to make space for and listen to families' stories of illness to become aware of what beliefs may support and encourage family well-being and healing. The Illness Beliefs Model provides a touchstone whereby nurses can distinguish both individual and shared beliefs within families living with chronic illness and provide ideas for family intervention if needed.
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Affiliation(s)
- Liselott Årestedt
- Faculty of Health and Life Sciences, Linnaeus University, Kalmar/Växjö, Sweden
| | - Eva Benzein
- Faculty of Health and Life Sciences, Linnaeus University, Kalmar/Växjö, Sweden Center for Collaborative Palliative Care, Faculty of Health and Life Sciences, Linnaeus University, Kalmar/Växjö, Sweden
| | - Carina Persson
- Faculty of Health and Life Sciences, Linnaeus University, Kalmar/Växjö, Sweden Center for Collaborative Palliative Care, Faculty of Health and Life Sciences, Linnaeus University, Kalmar/Växjö, Sweden
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Ghiabi E, Matthews DC, Brillant MS. The oral health status of recent immigrants and refugees in Nova Scotia, Canada. J Immigr Minor Health 2015; 16:95-101. [PMID: 23371840 DOI: 10.1007/s10903-013-9785-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
There are no published reports on the oral health status of adult immigrants and refugees in Canada. An oral health interview and clinical oral examination were conducted on 45 recent immigrants and 41 recent Bhutanese refugees, aged 18-67, in Nova Scotia, Canada. Over half (53%) of the immigrants and 85% of the refugees had untreated decay. Most (89% of immigrants; 98% of refugees) had moderate to severe gingivitis and the majority (73% of immigrants; 85% of refugees) had moderate to severe periodontitis. Despite these, 64% of immigrants and 49% of refugees rated their oral health as good, very good or excellent, and most believed they did not need fillings or periodontal treatment. Oral disease among the study sample was higher than the Canadian average and there was a striking discrepancy between self-reported and clinically determined need for dental care.
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Affiliation(s)
- Edmond Ghiabi
- Department of Dental Clinical Sciences, Faculty of Dentistry, Dalhousie University, 5981 University Avenue, PO BOX 15000, Halifax, NS, B3H 4R2, Canada,
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Hunsberger ML, Donatelle RJ, Lindsay K, Rosenberg KD. Physician care patterns and adherence to postpartum glucose testing after gestational diabetes mellitus in Oregon. PLoS One 2012; 7:e47052. [PMID: 23071709 PMCID: PMC3469538 DOI: 10.1371/journal.pone.0047052] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Accepted: 09/07/2012] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE This study examines obstetrician/gynecologists and family medicine physicians' reported care patterns, attitudes and beliefs and predictors of adherence to postpartum testing in women with a history of gestational diabetes mellitus. RESEARCH DESIGN AND METHODS In November-December 2005, a mailed survey went to a random, cross-sectional sample of 683 Oregon licensed physicians in obstetrician/gynecologists and family medicine from a population of 2171. RESULTS Routine postpartum glucose tolerance testing by both family physicians (19.3%) and obstetrician/gynecologists physicians (35.3%) was reportedly low among the 285 respondents (42% response rate). Factors associated with high adherence to postpartum testing included physician stated priority (OR 4.39, 95% CI: 1.69-7.94) and physician beliefs about norms or typical testing practices (OR 3.66, 95% CI: 1.65-11.69). Specialty, sex of physician, years of practice, location, type of practice, other attitudes and beliefs were not associated with postpartum glucose tolerance testing. CONCLUSIONS Postpartum glucose tolerance testing following a gestational diabetes mellitus pregnancy was not routinely practiced by responders to this survey. Our findings indicate that physician knowledge, attitudes and beliefs may in part explain suboptimal postpartum testing. Although guidelines for postpartum care are established, some physicians do not prioritize these guidelines in practice and do not believe postpartum testing is the norm among their peers.
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Affiliation(s)
- Monica L Hunsberger
- University of Gothenburg, Public Health Epidemiology and Community Medicine, Gothenburg, Sweden.
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