Health care professionals' perspectives on screening and management of gestational diabetes mellitus in public hospitals of South India - a qualitative study.
Health care professionals' perspectives on screening and management of gestational diabetes mellitus in public hospitals of South India - a qualitative study.
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DOI：
10.1186/s12913-021-06077-0
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发表时间：
2021-02-12
影响因子：
2.8
通讯作者：
Kinra S
中科院分区：
文献类型：
--
作者：
Sahu B;Babu GR;Gurav KS;Karthik M;Ravi D;Lobo E;John DA;Oakley L;Oteng-Ntim E;Nadal IP;Kinra S
患有妊娠糖尿病 (GDM) 的女性在以后的生活中患 2 型糖尿病的风险更高。对患有 GDM 的女性进行筛查和有效管理对于预防进展为 2 型糖尿病至关重要。我们旨在探讨医疗保健提供者对卫生系统环境中限制 GDM 及时筛查和有效管理的障碍的看法。我们对印度主要城市（班加罗尔）公立医院的医疗保健提供者进行了六次深度访谈，其中四次采访了护士，两次采访了产科医生。访谈以参与者的首选语言（护士为卡纳达语，产科医生为英语）进行并进行录音。所有卡纳达语采访均被转录并翻译成英语进行分析。主要数据通过 NVivo 12 plus 使用扎根理论方法进行分析。使用社会生态模型对研究结果进行透视。医疗保健提供者发现，延迟就诊公立医院和强调家庭责任是个人层面 GDM 筛查的障碍。此外，除了卫生系统障碍（例如未满足的护士培训需求、等待时间长、权力动态不平衡、缺乏后续行动、资源稀缺和缺乏支持性监督）之外，孕妇在第一次怀孕期间迁回娘家也是一个文化障碍。 GDM 管理的障碍包括未报告的妇女进行随访、药物和血糖自我监测不规律、训练有素的工作人员短缺、追踪无效以及缺乏标准化方案。迫切需要开发和改进现有的 GDM 筛查和管理服务，以应对印度公立医院日益增长的 GDM 负担。在线版本包含可在 10.1186/s12913-021-06077-0 获取的补充材料。
Women developing Gestational Diabetes Mellitus (GDM) are subsequently at a higher risk of developing Type 2 Diabetes later in life. Screening and effective management of women with GDM are essential in preventing progression to type 2 diabetes mellitus. We aimed to explore the perspectives of healthcare providers regarding the barriers from the health system context that restrict the timely screening and effective management of GDM. We conducted six in-depth interviews of health care providers- four with nurses and two with obstetricians in the public hospitals in India’s major city (Bengaluru). The interviews were conducted in the preferred language of the participants (Kannada for nurses, English for the obstetricians) and audio-recorded. All Kannada interviews were transcribed and translated into English for analysis. The primary data were analyzed using the grounded theory approach by NVivo 12 plus. The findings are put into perspective using the socio-ecological model. Health care providers identified delayed visits to public hospitals and stress on household-level responsibilities as barriers at the individual level for GDM screening. Also, migration of pregnant women to their natal homes during first pregnancy is a cultural barrier in addition to health system barriers such as unmet nurse training needs, long waiting hours, uneven power dynamics, lack of follow-up, resource scarcity, and lack of supportive oversight. The barriers for GDM management included non-reporting women to follow - up visits, irregular self-monitoring of drug and blood sugar, trained staff shortage, ineffective tracking, and lack of standardized protocol. There is a pressing need to develop and improve existing GDM Screening and Management services to tackle the growing burden of GDM in public hospitals of India. The online version contains supplementary material available at 10.1186/s12913-021-06077-0.
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影响因子：
3.4
作者：
Vidler M;Ramadurg U;Charantimath U;Katageri G;Karadiguddi C;Sawchuck D;Qureshi R;Dharamsi S;Joshi A;von Dadelszen P;Derman R;Bellad M;Goudar S;Mallapur A;Community Level Interventions for Pre-eclampsia (CLIP) India Feasibility Working Group
通讯作者：
Community Level Interventions for Pre-eclampsia (CLIP) India Feasibility Working Group
影响因子：
5.1
作者：
Agarwal, Mukesh M.;Boulvain, Michel;Samad, Noorjahan
通讯作者：
Samad, Noorjahan
影响因子：
3.9
作者：
Babu, Giridhara R.;Deepa, R.;Murthy, G. V. S.
通讯作者：
Murthy, G. V. S.
DOI：
10.1111/1471-0528.15847
发表时间：
2019-08-16
影响因子：
5.8
作者：
Nagraj, S.;Hinton, L.;Hirst, J.
通讯作者：
Hirst, J.
影响因子：
2.3
作者：
Chun Tie, Ylona;Birks, Melanie;Francis, Karen
通讯作者：
Francis, Karen