{"title":"Barriers and facilitators to self-management among women with gestational diabetes: A systematic review using the COM-B model","authors":"","doi":"10.1016/j.midw.2024.104141","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Gestational diabetes mellitus is a common complication during pregnancy, and its prevalence rates have increased dramatically in recent years. Treatment of gestational diabetes requires the active self-management, however, this can be challenging. Understanding the barriers and facilitators of adherence to self-management recommendations is essential for designing effective interventions.</p></div><div><h3>Aim</h3><p>To identify and synthesize barriers and facilitators to self-management of gestational diabetes reported by pregnant women.</p></div><div><h3>Methods</h3><p>This was a mixed-methods systematic review, including qualitative, quantitative, and mixed-methods studies. A literature search was conducted in four databases (PubMed, Embase, CINAHL, and the Web of Science). Eligible studies explored the barriers and/or facilitators, experiences and/or perceptions to engage in self-management in women with gestational diabetes. The Capability, Opportunity, Motivation, Behaviour model was used to classify barriers and facilitators affecting self-management.</p></div><div><h3>Results</h3><p>Thirty-six studies (23 qualitative, 11 quantitative, and 2 mixed-methods) met the inclusion criteria. We identified barriers and facilitators relating to capability (e.g., physical discomforts and constraints; lack of knowledge of GDM and self-management behaviours; forgetfulness), opportunity (e.g., limited education and resources; social support from family, friends, and peer groups; conflict with existing lifestyles or cultural norms), and motivation (e.g., perceived negative consequence of self-management behaviours or not perceived benefits; negative emotion; concern the health of the baby).</p></div><div><h3>Conclusion</h3><p>In this study, we identified the barriers and facilitators of self-management in women with gestational diabetes, which were explained by relevant theoretical models. Interventions should be developed with full consideration of these findings to ensure that pregnant women have the correct knowledge and confidence to self-manage their complications.</p></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":null,"pages":null},"PeriodicalIF":2.6000,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Midwifery","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0266613824002249","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NURSING","Score":null,"Total":0}
引用次数: 0
Abstract
Background
Gestational diabetes mellitus is a common complication during pregnancy, and its prevalence rates have increased dramatically in recent years. Treatment of gestational diabetes requires the active self-management, however, this can be challenging. Understanding the barriers and facilitators of adherence to self-management recommendations is essential for designing effective interventions.
Aim
To identify and synthesize barriers and facilitators to self-management of gestational diabetes reported by pregnant women.
Methods
This was a mixed-methods systematic review, including qualitative, quantitative, and mixed-methods studies. A literature search was conducted in four databases (PubMed, Embase, CINAHL, and the Web of Science). Eligible studies explored the barriers and/or facilitators, experiences and/or perceptions to engage in self-management in women with gestational diabetes. The Capability, Opportunity, Motivation, Behaviour model was used to classify barriers and facilitators affecting self-management.
Results
Thirty-six studies (23 qualitative, 11 quantitative, and 2 mixed-methods) met the inclusion criteria. We identified barriers and facilitators relating to capability (e.g., physical discomforts and constraints; lack of knowledge of GDM and self-management behaviours; forgetfulness), opportunity (e.g., limited education and resources; social support from family, friends, and peer groups; conflict with existing lifestyles or cultural norms), and motivation (e.g., perceived negative consequence of self-management behaviours or not perceived benefits; negative emotion; concern the health of the baby).
Conclusion
In this study, we identified the barriers and facilitators of self-management in women with gestational diabetes, which were explained by relevant theoretical models. Interventions should be developed with full consideration of these findings to ensure that pregnant women have the correct knowledge and confidence to self-manage their complications.
背景:妊娠糖尿病是孕期常见的并发症,近年来发病率急剧上升。妊娠糖尿病的治疗需要积极的自我管理,但这可能具有挑战性。了解坚持自我管理建议的障碍和促进因素对于设计有效的干预措施至关重要。目的:确定并综合孕妇报告的妊娠糖尿病自我管理的障碍和促进因素:这是一项混合方法的系统性综述,包括定性、定量和混合方法研究。我们在四个数据库(PubMed、Embase、CINAHL 和 Web of Science)中进行了文献检索。符合条件的研究探讨了妊娠糖尿病妇女参与自我管理的障碍和/或促进因素、经验和/或认知。研究采用能力、机会、动机、行为模型对影响自我管理的障碍和促进因素进行分类:36项研究(23项定性研究、11项定量研究和2项混合方法研究)符合纳入标准。我们确定了与能力(如身体不适和制约因素;缺乏对 GDM 和自我管理行为的了解;健忘)、机会(如教育和资源有限;来自家庭、朋友和同龄群体的社会支持;与现有生活方式或文化规范的冲突)和动机(如认为自我管理行为会带来负面影响或没有感觉到好处;负面情绪;对婴儿健康的担忧)有关的障碍和促进因素:在这项研究中,我们确定了妊娠糖尿病妇女自我管理的障碍和促进因素,并通过相关理论模型对其进行了解释。在制定干预措施时,应充分考虑到这些发现,以确保孕妇拥有正确的知识和信心来自我管理并发症。