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Supporting self-management in women with pre-existing diabetes in pregnancy: a mixed-methods sequential comparative case study.
- Source :
- BMC Nursing; 1/2/2024, Vol. 23 Issue 1, p1-11, 11p
- Publication Year :
- 2024
-
Abstract
- Introduction: Maternal glycemia is associated with pregnancy outcomes. Thus, supporting the self-management experiences and preferences of pregnant women with type 1 and type 2 diabetes is crucial to optimize glucose control and perinatal outcomes. Research design and methods: This paper describes the mixed methods integration of a sequential comparative case study. The objectives are threefold, as we integrated the quantitative and qualitative data within the overall mixed methods design: (1) to determine the predictors of glycemic control during pregnancy; (2) to understand the experience and diabetes self-management support needs during pregnancy among women with pre-existing diabetes; (3) to assess how self-management and support experiences helpe to explain glycemic control among women with pre-existing diabetes in pregnancy. The purpose of the mixing was to integrate the quantitative and qualitative data to develop rich descriptive cases of how diabetes self-management and support experiences and preferences in women with type 1 and type 2 diabetes during pregnancy help explain glucose control. A narrative approach was used to weave together the statistics and themes and the quantitative results were integrated visually alongside the qualitative themes to display the data integration. Results: The quantitative results found that women achieved "at target" glucose control (mean A1C of the cohort by the third visit: 6.36% [95% Confidence Interval 6.11%, 6.60%]). The qualitative findings revealed that feelings of fear resulted in an isolating and mentally exhausting pregnancy. The quantitative data also indicated that women reported high levels of self-efficacy that increased throughout pregnancy. Qualitative data revealed that women who had worked hard to optimize glycemia during pregnancy were confident in their self-management. However, they lacked support from their healthcare team, particularly around self-management of diabetes during labour and delivery. Conclusions: The achievement of optimal glycemia during pregnancy was motivated by fear of pregnancy complications and came at a cost to women's mental health. Mental health support, allowing women autonomy, and the provision of peer support may improve the experience of diabetes self-management during pregnancy. Future work should focus on developing, evaluating and implementing interventions that support these preferences. [ABSTRACT FROM AUTHOR]
- Subjects :
- SOCIAL support
CONFIDENCE intervals
SELF-management (Psychology)
GLYCEMIC control
RESEARCH methodology
PREGNANT women
FISHER exact test
INTERVIEWING
MENTAL health
PATIENTS' attitudes
COMPARATIVE studies
T-test (Statistics)
SELF-efficacy
RESEARCH funding
PSYCHOSOCIAL factors
DESCRIPTIVE statistics
CHI-squared test
GESTATIONAL diabetes
NEEDS assessment
DATA analysis software
CONTENT analysis
PEOPLE with diabetes
Subjects
Details
- Language :
- English
- ISSN :
- 14726955
- Volume :
- 23
- Issue :
- 1
- Database :
- Complementary Index
- Journal :
- BMC Nursing
- Publication Type :
- Academic Journal
- Accession number :
- 174544672
- Full Text :
- https://doi.org/10.1186/s12912-023-01659-1