Experiences of lifestyle change among women with gestational diabetes mellitus (GDM): A behavioural diagnosis using the COM-B model in a low-income setting
Experiences of lifestyle change among women with gestational diabetes mellitus (GDM): A behavioural diagnosis using the COM-B model in a low-income setting
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DOI：
10.1371/journal.pone.0225431
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发表时间：
2019-11-25
期刊：
影响因子：
3.7
通讯作者：
Levitt, Naomi
中科院分区：
文献类型：
--
作者：
Muhwava, Lorrein Shamiso;Murphy, Katherine;Levitt, Naomi
背景生活方式的改变可以降低妊娠期糖尿病（GDM）妇女发生2型糖尿病的风险。虽然了解妇女在GDM方面的生活经历和观点对于制定行为改变干预措施以减少这一风险至关重要，但在低收入和中等收入国家，很少有研究涉及这一问题。该研究的目的是探讨妇女的生活经验的GDM和持续的生活方式的修改后，GDM在低收入setting.MethodsThis的可行性，是一个描述性的定性研究的生活经验的妇女与以前的GDM，谁接受产前保健在公共部门三级医院在开普敦，南非。共对35名妇女进行了9个焦点小组和5次深入访谈。使用内容分析和COM-B对数据进行分析（能力、机会、动机和行为）模型来确定影响GDM妊娠期间和妊娠后生活方式改变的因素。（改变行为的知识和技能），机会（饮食改变和体育活动的资源）和动机（对未来糖尿病风险的看法）与南非GDM妇女的生活方式改变有关。结果将有助于设计一个产后健康系统的干预妇女与最近GDM.ConclusionOur研究结果强调需要卫生服务，以改善咨询和教育的妇女与GDM在南非。家庭和保健专业人员的支持对妇女实现生活方式的改变至关重要。妊娠期糖尿病的经历给妇女带来了巨大的心理负担，影响了她们改变生活方式的动机。为了实现长期的生活方式改变，对既往患有GDM的女性进行行为干预需要解决她们在怀孕期间和怀孕后改变生活方式的能力、机会和动机。
BackgroundLifestyle change can reduce the risk of developing type 2 diabetes among women with prior gestational diabetes mellitus (GDM). While understanding women's lived experiences and views around GDM is critical to the development of behaviour change interventions to reduce this risk, few studies have addressed this issue in low- and middle- income countries. The aim of the study was to explore women's lived experiences of GDM and the feasibility of sustained lifestyle modification after GDM in a low-income setting.MethodsThis was a descriptive qualitative study on the lived experiences of women with prior GDM, who received antenatal care at a public sector tertiary hospital in Cape Town, South Africa. Nine focus groups and five in-depth interviews were conducted with a total of thirty-five women. Data were analysed using content analysis and the COM-B (Capabilities, Opportunities, Motivations and Behaviour) model to identify factors influencing lifestyle change during and beyond the GDM pregnancy.ResultsThe results suggest that the COM-B model's concepts of capability (knowledge and skills for behaviour change), opportunity (resources for dietary change and physical activity) and motivation (perception of future diabetes risk) are relevant to lifestyle change among GDM women in South Africa. The results will contribute to the design of a postpartum health system intervention for women with recent GDM.ConclusionOur findings highlight the need for health services to improve counselling and education for women with GDM in South Africa. Support from family and health professionals is essential for women to achieve lifestyle change. The experience of GDM imposed a significant psychological burden on women, which affected motivation for lifestyle change. To achieve long-term lifestyle change, behaviour interventions for women with prior GDM need to address their capability, opportunity and motivation for lifestyle change during and beyond pregnancy.