Preventing Type 2 diabetes after gestational diabetes: women's experiences and implications for diabetes prevention interventions
Preventing Type 2 diabetes after gestational diabetes: women's experiences and implications for diabetes prevention interventions
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DOI：
10.1111/dme.12206
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发表时间：
2013-08-01
影响因子：
3.5
通讯作者：
Bell, R.
中科院分区：
文献类型：
--
作者：
Lie, M. L. S.;Hayes, L.;Bell, R.
目的探讨妊娠期糖尿病患者产后健康行为的影响因素，并探讨妇女对产后2年内生活方式干预预防糖尿病的可行性看法。方法采用半结构化访谈法对妊娠期糖尿病患者进行定性研究。在第一阶段（31名妇女），访谈探讨了妊娠糖尿病的经历、对未来糖尿病风险的看法以及影响产后健康相关行为的因素。总结了妇女对改变生活方式以预防糖尿病的看法。在第二阶段（14名妇女），访谈探讨了时间的推移如何促成健康行为的变化，并利用这些陈述形成对糖尿病干预措施的看法。结果女性意识到自己患糖尿病的风险，但并不总是采取行动。怀孕促使行为改变以有利于未出生的孩子，但分娩后这些改变往往无法维持。疲劳、母亲依恋和托儿需求是产后早期的主要障碍。后来，工作、家庭和儿童发展成为更大的障碍。许多女性在断奶前后更容易接受健康饮食的信息。女性对于自我管理以降低糖尿病风险的长期支持持积极态度。结论：妊娠期糖尿病妇女产后2型糖尿病风险有降低的潜力。制定干预措施时，必须考虑到环境因素和相互竞争的需求，灵活并对妇女的个人情况作出反应。这些干预措施的随机试验是有必要的。
Aims To explore factors influencing post-natal health behaviours following the experience of gestational diabetes, and to elicit women's views about the feasibility of lifestyle intervention to prevent diabetes during the first 2 years after childbirth.Methods Qualitative study using semi-structured interviews with women who had gestational diabetes. In phase 1 (31 women), interviews explored the experience of gestational diabetes, ideas about future risk of diabetes and factors influencing post-natal health-related behaviours. Statements were developed summarizing women's views of lifestyle change to prevent diabetes. In phase 2 (14 women), interviews explored how the passage of time had contributed to changes in health behaviour, and the statements were used to develop views about diabetes interventions.Results Women were aware of their risk of developing diabetes, but did not always act on such knowledge. Pregnancy motivated behaviour changes to benefit the unborn child, but after delivery these changes were often not maintained. Tiredness, maternal attachment and childcare demands were prominent barriers in the early post-natal months. Later, work, family and child development became more significant barriers. Many women became more receptive to healthy eating messages around the time of weaning. Women were positive about long-term support for self-management to reduce their diabetes risk.Conclusions There is potential to reduce the risk of Type 2 diabetes post-natally among women with gestational diabetes. Interventions need to be developed that take into account contextual factors and competing demands, are flexible and respond to women's individual circumstances. Randomized trials of such interventions are warranted.