Prioritizing the Psychosocial Support Needs of Mothers with Gestational Diabetes: A Delphi Study

Nahid Javadifar, Shahla Faal Siahkal, Mahin Najafian, Mina Iravani, Mehrnoosh Zakerkish, Rasoul Heshmati

Abstract


Background: Gestational diabetes is the most common medical complication in pregnancy, and the psychosocial health of women suffering from this condition affects their adherence to treatment and self‑efficacy. However, since it is not possible to design interventions dealing with all of these needs, the aim of this study was to prioritize the psychosocial supportive needs of women with gestational diabetes. Materials and Methods: This was a modified Delphi design study involving 22 experts who were selected using purposive and snowball sampling methods. The study was conducted between April 2021 and June 2021. First, the psychosocial needs of diabetic pregnant women were extracted through a qualitative study involving interviews with multidisciplinary specialists and diabetic pregnant mothers (22 participants) and a systematic review of reputable scientific databases. Throughout the two Delphi stages, the questionnaire was classified, quantified, and analyzed. Results: Based on the results of this study, the following are the top priorities when addressing the psychosocial needs of mothers with gestational diabetes: paying attention to and identifying the mother’s worries and anxiety, husband and family support for diabetic pregnant women, the inclusion of specialized nutrition counseling services in mothers’ treatment plan, timely education of mothers about diabetes and its complications, and proper nutrition for diabetic mothers. Conclusions: The priorities of the supportive needs obtained in this study can be used to design interventions aimed at promoting psychosocial health, reducing stress and anxiety, and improving medication adherence in women with gestational diabetes.



Keywords


Delphi study, gestational diabetes, psychosocial support system

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References


Choudhury AA, Rajeswari VD. Gestational diabetes mellitus a metabolic and reproductive disorder. Biomed Pharmacother 2021;143:112183.

Zhu Y, Zhang C. Prevalence of gestational diabetes and risk of progression to type 2 diabetes: A global perspective. Curr Diab Rep 2016;16:7.

Darbandi M, Rezaeian S, Dianatinasab M, Yaghoobi H, Soltani M, Etemad K, et al. Prevalence of gestational diabetes and its association with stillbirth, preterm birth, macrosomia, abortion and cesarean delivery: A national prevalence study of 11 provinces in Iran. J Prev Med Hyg 2021;62:E885 91.

Etminan Bakhsh M, Tadi S, Hatami M, Darabi R. Prevalence of gestational diabetes mellitus and its associated risk factors in Boo Ali hospital, Tehran. Galen Med J 2020;9:e1642.

Zangeneh M, Mohamadi N, Kolahi T, Roshanei G, Khodaveisi M, Shayan A. Prevalence of gestational diabetes mellitus in perganant women rreferred totheraputic and health centers in Hammadan Town, Iran in the 2015 . Iranian Journal of Diabetes and Metabolism (ijdld) 2018;17:139 46.

Rashidi H, Rezaianzadeh A, Tabatabaee SHR, Mousavi SA. Prevalence and risk factors of gestational diabetes mellitus in Yazd province, Iran. Journal of Midwifery and Reproductive Health (JMRH) 2021;9:2828 33.

Krishnan DR, Menakath GP, Radhakrishnan A, Himavarshini Y, Aparna A, Mukundan K, et al., editors. Evaluation of predisposing factors of diabetes mellitus post gestational diabetes mellitus using machine learning techniques. 2019 IEEE Student Conference on Research and Development (SCOReD). IEEE; 2019.

Zietlow AL, Nonnenmacher N, Reck C, Ditzen B, Müller M. Emotional stress during pregnancy associations with maternal anxiety disorders, infant cortisol reactivity, and mother child interaction at pre school age. Front Psychol 2019;10:2179.

Mmabojalwa Mathibe-Neke J, Suzan Masitenyane S. Psychosocial Antenatal Care: A Midwifery Context [Internet]. Selected Topics in Midwifery Care. IntechOpen; 2019. Available from: http://dx.doi.org/10.5772//intechopen.80394. [Last accessed on 2023 Aug 29].

OuYang H, Chen B, Abdulrahman A M, Li L, Wu N. Associations between gestational diabetes and anxiety or depression: A systematic review. Diabetes Res 2021;2021:9959779. doi: 10.1155/2021/9959779.

Egan AM, Dunne FP, Lydon K, Conneely S, Sarma K, McGuire BE. Diabetes in pregnancy: Worse medical outcomes in type 1 diabetes but worse psychological outcomes in gestational diabetes. QJM 2017;110:721 7.

Miller NE, Curry E, Laabs SB, Manhas M, Angstman K. Impact of gestational diabetes diagnosis on concurrent depression in pregnancy. J Psychosom Obstet Gynaecol 2021;42:190 3.

Keeney S, Hasson F, McKenna H. The Delphi Technique in Nursing and Health Research. Wiley-Blackwell, United Kingdom 2017.

Al Hashmi I, Hodge F, Nandy K, Thomas E, Brecht M L. The effect of a self efficacy enhancing intervention on perceived self efficacy and actual adherence to healthy behaviours among women with gestational diabetes mellitus. Sultan Qaboos Univ Med J 2018;18:e513 9.

Li H, Lin C, Duan X, Lin Y. The effect of disease knowledge training on pregnancy outcome in gestational diabetes. Biomed Res (India) 2017;28:10128 31.

Zaheri H, Najar S, Abbaspoor Z. Effectiveness of cognitive behavioral stress management on psychological stress and glycemic control in gestational diabetes: A randomized controlled trial. J Matern Fetal Neonatal Med 2016;30:1 17.

Jelsma JGM, van Poppel MNM, Smith BJ, Cinnadaio N, Bauman A, Tapsell L, et al. Changing psychosocial determinants of physical activity and diet in women with a history of gestational diabetes mellitus. Diabetes Metab Res Rev 2018;34. doi: 10.1002/dmrr.2942.

Nielsen K, Damm P, Bygbjerg IC, Kapur A. Barriers and facilitators for implementing programmes and services to address hyperglycaemia in pregnancy in low and middle income countries: A systematic review. Diabetes Res Clin Pract 2018;145:102 18.

United Nations (UN). Political declaration of the third high level meeting of the General Assembly on the prevention and control of non communicable diseases. UN. General Assembly (73rd sess: 2018 2019). Available from: https://www.un.org/en/ga/ search/view_doc.asp?symbol=A/RES/73/2.

Paz Pascual C, Artieta Pinedo I, Grandes G; ema.Q Group. Consensus on priorities in maternal education: Results of Delphi and nominal group technique approaches. BMC Pregnancy Childbirth 2019;19:264.

Terwindt F RD, Soucat A. Chapter 4. Priority Setting for National Health Policies, Strategies and Plans. Geneva: World Health Organization; 2016.

Avella JR. Delphi panels: Research design, procedures, advantages, and challenges. Int J Dr Stud 2016;11:305 21.

Faal Siahkal S, Javadifar N, Najafian M, Iravani M, Zakerkish M, Heshmati R. Psychosocial needs of inpatient women with gestational diabetes mellitus: A qualitative study. J Reprod Infant Psychol 2022:1 17. doi: 10.1080/02646838.2022.2110221.

Faal Siahkal S, Javadifar N, Najafian M, Iravani M, Zakerkish M, Heshmati R. The psychosocial challenges associated with gestational diabetes mellitus: A systematic review of qualitative studies. Prim Care Diabetes 2022;16:11 26.

Ayman G, Strachan JA, McLennan N, Malouf R, Lowe Zinola J, Magdi F, et al. The top 10 research priorities in diabetes and pregnancy according to women, support networks and healthcare professionals. Diabet Med 2021;38:e14588.

Finer S, Robb P, Cowan K, Daly A, Robertson E, Farmer A. Top ten research priorities for type 2 diabetes: Results from the Diabetes UK James Lind alliance priority setting partnership. Lancet Diabetes Endocrinol 2017;5:935 6.

Hirst JE, Tran TS, Do MAT, Rowena F, Morris JM, Jeffery HE. Women with gestational diabetes in Vietnam: A qualitative study to determine attitudes and health behaviours. BMC Pregnancy Childbirth 2012;12:81.

Wah YYE, McGill M, Wong J, Ross GP, Harding AJ, Krass I. Self management of gestational diabetes among Chinese migrants: A qualitative study. Women Birth 2019;32:e17 23.

Alipour Z, Kazemi A, Kheirabadi G, Eslami AA. relationship between marital quality, social support and mental health during pregnancy. Community Ment Health J 2019;55:1064 70.

Yeung R, Boisvenue J, Kaul P, Ryan E. 67 Using deliberative priority-setting to improve gestational diabetes education BMJ Evidence-Based Medicine 2018;23:A33.[Poster].

Dall TM, Yang W, Gillespie K, Mocarski M, Byrne E, Cintina I, et al. The economic burden of elevated blood glucose levels in 2017: Diagnosed and undiagnosed diabetes, gestational diabetes mellitus, and prediabetes. Diabetes Care 2019;42:1661 8.

American Diabetes Association 14. Management of diabetes in pregnancy: Standards of medical care in diabetes—2020. Diabetes Care 2019;43:S183–92.

Park S, Park K. Association between the level of adherence to dietary guidelines and depression among Korean patients with type 2 diabetes mellitus. J Psychosom Res 2021;145:110463.

Godos J, Currenti W, Angelino D, Mena P, Castellano S, Caraci F, et al. Diet and mental health: Review of the recent updates on molecular mechanisms. Antioxidants (Basel) 2020;9:346.

Yelverton CA, Rafferty AA, Moore RL, Byrne DF, Mehegan J, Cotter PD, et al. Diet and mental health in pregnancy: Nutrients of importance based on large observational cohort data. Nutrition 2022;96:111582.

Perrin BM, Raspovic A, Williams CM, Twigg SM, Golledge J, Hamilton EJ, et al. Establishing the national top 10 priority research questions to improve diabetes related foot health and disease: A Delphi study of Australian stakeholders. BMJ Open Diabetes Res Care 2021;9:e002570.

Bennett WL, Robinson KA, Saldanha IJ, Wilson LM, Nicholson WK. High priority research needs for gestational diabetes mellitus. J Womens Health (Larchmt) 2012;21:925 32.

Solhi M, Hazrati S, Shabani M, Nejaddadgar N. Use of PRECEDE model for self care educational need assessment among diabetic patients. J Diabetes Nurs 2017;5:295 306.

Kolivand M, Rahimi MA, Keramat A, Shariati M, Emamian MH. Effect of a new self care guide package on maternal and neonatal outcomes in gestational diabetes: A randomized control trial. J Diabetes 2019;11:139 47.

Amason JS, Lee SY, Aduddell K, Hewell SW, Van Brackle L. Pilot feasibility study of an educational intervention in women with gestational diabetes. J Obstet Gynecol Neonatal Nurs 2016;45:515 27.

Rees SE, Chadha R, Donovan LE, Guitard AL, Koppula S, Laupacis A, et al. Engaging patients and clinicians in establishing research priorities for gestational diabetes mellitus. Can J Diabetes 2017;41:156 63.

Safdari R, Nasli Esfahani E, Rostam Niakan Kalhori S, Mosadeghi Nik M. Informational elements requirements for managed care of diabetic foot patients. Payavard 2018;12:273 85.

Nasa P, Jain R, Juneja D. Delphi methodology in healthcare research: How to decide its appropriateness. World J Methodol 2021;11:116 29.


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