Diagnosis of gestational diabetes in Uganda: The reactions of women, family members and health workers.
Diagnosis of gestational diabetes in Uganda: The reactions of women, family members and health workers.
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诊断乌干达妊娠糖尿病：妇女，家庭成员和卫生工作者的反应。
DOI：
10.1177/17455065211013769
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发表时间：
2021-01
期刊：
影响因子：
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通讯作者：
Oakley L
中科院分区：
文献类型：
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作者：
Zalwango F;Seeley J;Namara A;Kinra S;Nyirenda M;Oakley L
在乌干达，与许多其他低收入和中等收入国家一样，妊娠期糖尿病筛查不理想，很少纳入常规产前护理。我们描述了乌干达妇女的经历，她们接受了妊娠期糖尿病筛查，并在家庭成员的反应和与卫生工作者的互动中被诊断出患有这种疾病。年龄在18岁或以上，妊娠24至28周的孕妇于2018年6月13日至2019年10月31日期间从五家医院之一的产前诊所入组。研究对象为10名妊娠期糖尿病患者、10名家庭成员和6名医务人员。采用访谈和焦点小组讨论来收集有关影响乌干达妊娠糖尿病及时筛查和有效管理的社会文化和卫生系统因素的数据。数据按主题进行分析。妇女普遍反映了妊娠糖尿病筛查的重要性，并认为早期诊断有助于她们得到及时的医疗照顾，大多数人报告说，保健工作者提供的护理是积极的。然而，被诊断患有妊娠糖尿病的妇女报告说感到恐惧和焦虑，有些人担心这种情况可能危及生命。许多妇女报告说，他们感到不安，基本上没有准备接受妊娠糖尿病的诊断。妊娠期糖尿病的诊断不仅激起了妇女强烈的恐惧和焦虑感，而且还影响了她们的配偶和其他家庭成员。许多男性伴侣表示同情并愿意提供支持。我们的研究结果强调，需要了解伴随妊娠糖尿病诊断的感知和情绪，以最好地支持妇女及其家庭成员。对这些因素的进一步认识可以为制定有效的妊娠期糖尿病筛查和管理方案提供信息。
In Uganda, as in many other low- and middle-income countries, screening for gestational diabetes mellitus is suboptimal and is rarely embedded in routine antenatal care. We describe the experiences of women in Uganda who underwent screening for gestational diabetes mellitus and were diagnosed with the condition as they navigate both the reaction of family members and their interaction with health workers. Pregnant women aged 18 years or older and between 24 and 28 weeks of gestation were enrolled from the antenatal clinics at one of the five hospitals between 13 June 2018 and 31 October 2019. Ten women with gestational diabetes mellitus, ten family members and six health workers were purposively selected to take part. Interviews and focus group discussions were used to collect data on the socio-cultural and health system factors that influence timely screening and effective management of gestational diabetes mellitus in Uganda. Data were analysed thematically. Women generally reflected on the importance of gestational diabetes mellitus screening and felt that an early diagnosis helped them to get timely medical attention, and most reported a positive experience of the care provided by health workers. However, women who were diagnosed with gestational diabetes mellitus reported feeling fearful and anxious, and some were worried that the condition might be life-threatening. Many women reported that they were upset and largely unprepared to receive a gestational diabetes mellitus diagnosis. A gestational diabetes mellitus diagnosis not only stirred intense feelings of fear and anxiety in women but also affected their spouses and other family members. Many male partners were sympathetic and willing to provide support. Our findings highlight the need to understand the perceptions and emotions that accompany a gestational diabetes mellitus diagnosis to best support women and their family members. An improved recognition of these factors can inform the development of effective gestational diabetes mellitus screening and management programmes.