Type 1 diabetes women's views about preconception care: A qualitative study†
Keywords:Type 1 diabetes, Women's view, Preconception care, Pregnancy outcomes
Background: Pregnancy in women with Type 1 diabetes mellitus (T1DM) is associated with increased complications for both baby and mother; such complications can be reduced with careful pregnancy planning. Preconception care (PCC) enhances pregnancy outcomes by helping women to optimize their glycaemic control, through supportive intervention. However, despite these benefits, the uptake and adherence to PCC is low. This qualitative study aimed to generate a better understanding as to why women may not utilize PCC, by eliciting the views and experiences of women with T1DM in relation to PCC.
Methods/sample: A sample of six women of reproductive age with T1DM undertook semi-structured interviews exploring their views on PCC. These interviews were tape-recorded, transcribed (verbatim) and analysed using interpretative phenomenological analysis to elicit themes that explicated the women's orientation and behaviour in relation to PCC.
Results: The analysis identified five key themes: the fear of complications (both for the mother and the baby); the style of communication from health care professionals (HCPs); the support of significant others; personal autonomy; and women's beliefs about PCC.
Conclusion: Overall, the findings suggest that women's uptake of, and engagement with, PCC is enhanced when HCPs adopt a supportive and positive approach, which addresses their anxieties in pregnancy preparation and encourages the health behaviours necessary for a good outcome for their baby.
Vargas R, Repke J, Ural SH. Type 1 diabetes mellitus and pregnancy. Rev Obstet Gynaecol. 2010;3(3):92–100. doi: 10.3909/riogo114.
Lavender T, Platt J, Tsekiri E, Casson I, Byrom S, Baker L, et al. Women's perceptions of being pregnant and having pregestational diabetes. Midwifery. 2010;26(6):589–595. doi: 10.1016/j.midw.2009.01.003
Loureiro L. Orientações Teórico -Metodológicas para aplicação do Método Fenomenológico na Investigação em Enfermagem. Rev Referência. 2002;(8):5–16.
Minayo MCS (org.), Deslandes SF, Gomes R. Pesquisa social: teoria, método, criatividade. 31ª Ed. São Paulo. Petrópolis: Editora vozes; 2012.
Murphy HR, Temple RC, Ball VE, Roland JM, Steel S, Simmons D, et al. Personal experiences of women with diabetes who do not attend pre-pregnancy care. Diabet Med. 2010;27(1):92–100. doi: 10.1111/j.1464-5491.2009.02890.x
Ray M. A Riqueza da Fenomenologia: Aspectos Filosóficos, Teóricos e Metodológicos. In: Morse J, editor. Metodologia de Investigação Qualitativa. Coimbra: Formasau; 2007.
Mc Corry N, Hughe C, Spence D, Harper R. Pregnancy planning and diabetes: a qualitative exploration of women's attitudes toward preconception care. J Midwifery Women's Health. 2012;57(4)July/August:396–402. doi: 10.1111/j.1542-2011.2011.00143.x
Tuomainen H, Cross-Bardell L, Bhoday M, Qureshi N, Kai J. Opportunities and challenges for enhancing preconception health in primary care: qualitative study with women from ethnically diverse communities. Br Med J Open. 2013;3:e002977. doi:10.1136/bmjopen-2013-002977. Accessed on September 2013.
Lawrence J. Women with diabetes in pregnancy: different perceptions and expectations. Best Pract Res Clin Obstet Gynaecol. 2011;25:15–24. doi:10.1016/j.bpobgyn.2010.10.003
Cormack D. The research process in nursing. 4th ed. Oxford, Great Britain: Blackwell Science ltd.; 2000.
Serrano G. Investigación cualitativa. Retos e interrogantes. – I. Métodos. Madrid: Ed. La Muralla; 2004.
Smith JA, Flowers P, Larkin M. Interpretative phenomenological analysis: theory, method and research. London: SAGE; 2009.
Smith JA, Osborn M. Interpretative phenomenological analysis. In: Smith JA, editor. Qualitative psychology. A practical guide to research methods. 2nd ed. (Chapter 4). London: Sage Publications; 2008. p. 53–80.
Smith & Eatough. Análise fenomenológica interpretativa. In: Willig C, Rogers S, editors. The sage handbook of qualitative research in psychology. (Chapter 16). London: SAGE Publications; 2008. p. 322–339.
American Diabetes Association. Management of diabetes in pregnancy. Sec.12. Stand. Med. Care Diab. Diab Care. 2015;38(Supplement 1)January 2015:S77–S79. Available at:http://care.diabetesjournals.org/content/38/Supplement_1/S77.full.pdf+html
NICE. National Institute for Health and Clinical Excellence. Diabetes in pregnancy: management of diabetes and its complications from pre-conception to the postnatal period. London: NICE, 2008. Available at www.nice.org
Wahabi HA, Alzeidan RA, Bawazeer GA, Alansari LA, Esmaeil SA. Preconception care for diabetic women for improving maternal and fetal outcomes: a systematic review and meta-analysis. BMC Pregnancy Childbirth.2010;10(1):1047–00. doi: 10.1186/1471-2393-10-63
Janz NK, Herman WH, Becker MP, Charron-Prochownik D, Shayna VL, Lesnick TG, et al. Diabetes and pregnancy: factors associated with seeking pre-conception care. Diabetes Care. 1995;18(2):157–165. doi: 10.2337/diacare.18.2.157
Griffiths F, Lowe P, Boardman F, Ayre C, Gadsby R. Becoming pregnant: exploring the perspectives of women living with diabetes. Br J Gen Pract. 2008;58(548):184–190. doi: 10.3399/bjgp08X277294
Direção Geral da Saúde (DGS). Relatório do Consenso sobre a diabetes e Gravidez. 2011. Available at: http://www.dgs.pt/?cr=17156. (accessed on Jan 2015)
Direção Geral da Saúde (DGS). Plano Nacional de Saúde Reprodutiva. 2008. Available at: http://www.saudereprodutiva.dgs.pt/pnsr.aspx. (accessed on Feb 2015)
Moretto VL. Gestantes portadoras de diabetes: Características e vivências durante a gestação. 2001. 109 f. Dissertação (Mestrado) – Programa de Pós-graduação em Enfermagem, Universidade Federal do Rio Grande do Sul, Porto Alegre.
Spence M, Alderdice F, Harper R, McCancet D, Holmes V. Education and psychological aspects: an exploration of knowledge and attitudes related to pre-pregnancy care in women with Diabetes. Diabet Med. 2010;27:1385–1391. doi: 10.1111/j.1464-5491.2010.03117.x
Temple RC, Aldridge VJ, Murphy HR. Prepregnancy care and pregnancy outcomes in women with type 1 diabetes. Diabet Care. 2006;29(8):1744–1749. doi: 10.2337/dc05-2265
Xaverius PK, Salas J, Kiel D. Differences in pregnancy planning between women aged 18–44, with and without diabetes: behavioral risk factor surveillance system analysis. Diabetes Res Clin Pract. 2013;99(1):63–68. doi: 10.1016/j.diabres.2012.09.029
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