#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Experiences of lifestyle change among women with gestational diabetes mellitus (GDM): A behavioural diagnosis using the COM-B model in a low-income setting


Autoři: Lorrein Shamiso Muhwava aff001;  Katherine Murphy aff001;  Christina Zarowsky aff002;  Naomi Levitt aff001
Působiště autorů: Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa aff001;  Chronic Diseases Initiative for Africa, Cape Town, South Africa aff002;  University of Montreal, Hospital Research Centre and University of Montreal School of Public Health, Montreal, Canada aff003;  School of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa aff004
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0225431

Souhrn

Background

Lifestyle change can reduce the risk of developing type 2 diabetes among women with prior gestational diabetes mellitus (GDM). While understanding women’s lived experiences and views around GDM is critical to the development of behaviour change interventions to reduce this risk, few studies have addressed this issue in low- and middle- income countries. The aim of the study was to explore women’s lived experiences of GDM and the feasibility of sustained lifestyle modification after GDM in a low-income setting.

Methods

This was a descriptive qualitative study on the lived experiences of women with prior GDM, who received antenatal care at a public sector tertiary hospital in Cape Town, South Africa. Nine focus groups and five in-depth interviews were conducted with a total of thirty-five women. Data were analysed using content analysis and the COM-B (Capabilities, Opportunities, Motivations and Behaviour) model to identify factors influencing lifestyle change during and beyond the GDM pregnancy.

Results

The results suggest that the COM-B model’s concepts of capability (knowledge and skills for behaviour change), opportunity (resources for dietary change and physical activity) and motivation (perception of future diabetes risk) are relevant to lifestyle change among GDM women in South Africa. The results will contribute to the design of a postpartum health system intervention for women with recent GDM.

Conclusion

Our findings highlight the need for health services to improve counselling and education for women with GDM in South Africa. Support from family and health professionals is essential for women to achieve lifestyle change. The experience of GDM imposed a significant psychological burden on women, which affected motivation for lifestyle change. To achieve long-term lifestyle change, behaviour interventions for women with prior GDM need to address their capability, opportunity and motivation for lifestyle change during and beyond pregnancy.

Klíčová slova:

Health care providers – Pregnancy – Physical activity – Behavior – Behavioral and social aspects of health – Motivation


Zdroje

1. Lachat C, Otchere S, Roberfroid D, Abdulai A, Seret FM, Milesevic J, et al. Diet and physical activity for the prevention of noncommunicable diseases in low- and middle-income countries: a systematic policy review. PLoS Med. 2013;10(6):e1001465. doi: 10.1371/journal.pmed.1001465 23776415

2. Statistics South Africa. Mortality and causes of death in South Africa, 2016: Findings from death notification. Pretoria: Statistics South Africa 2017.

3. Peer N, Kengne AP, Motala AA, Mbanya JC. Diabetes in the Africa Region: an update. Diabetes Res Clin Pract. 2014;103(2):197–205. doi: 10.1016/j.diabres.2013.11.006 24315460

4. Macaulay S, Ngobeni M, Dunger DB, Norris SA. The prevalence of gestational diabetes mellitus amongst black South African women is a public health concern. Diabetes Res Clin Pract. 2018;139:278–287. doi: 10.1016/j.diabres.2018.03.012 29526682

5. Martin B, Sacks DA. The global burden of hyperglycemia in pregnancy–Trends from studies in the last decade. Diabetes Res Clin Pract. 2018.

6. Zhu Y, Zhang C. Prevalence of Gestational Diabetes and Risk of Progression to Type 2 Diabetes: a Global Perspective. Curr Diab Rep. 2016;16(1):7. doi: 10.1007/s11892-015-0699-x 26742932

7. Stage E, Ronneby H, Damm P. Lifestyle change after gestational diabetes. Diabetes Res Clin Pract. 2004;63(1):67–72. doi: 10.1016/j.diabres.2003.08.009 14693414

8. Bellamy L, Casas JP, Hingorani AD, Williams D. Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis. Lancet. 2009;373(9677):1773–1779. doi: 10.1016/S0140-6736(09)60731-5 19465232

9. Song C, Lyu Y, Li C, Liu P, Li J, Ma RC,et al. Long-term risk of diabetes in women at varying durations after gestational diabetes: a systematic review and meta-analysis with more than 2 million women. Obes Rev. 2018;19(3):421–429. doi: 10.1111/obr.12645 29266655

10. Alouki K, Delisle H, Bermudez-Tamayo C, Johri M. Lifestyle Interventions to Prevent Type 2 Diabetes: A Systematic Review of Economic Evaluation Studies. J Diabetes Res. 2016; 1–14. doi: 10.1155/2016/2159890 26885527

11. Dunkley AJ, Bodicoat D. H., Greaves C. J., Russell C., Yates T., Davies M. J., et al. Diabetes Prevention in the Real World: Effectiveness of Pragmatic Lifestyle Interventions for the Prevention of Type 2 Diabetes and of the Impact of Adherence to Guideline Recommendations. Diabetes Care. 2014;37:922–933.

12. Ferrara A, Hedderson MM, Albright CL, Ehrlich SF, Quesenberry CP Jr., Peng T, et al. A pregnancy and postpartum lifestyle intervention in women with gestational diabetes mellitus reduces diabetes risk factors: a feasibility randomized control trial. Diabetes Care. 2011;34(7):1519–1525. doi: 10.2337/dc10-2221 21540430

13. Gilinsky AS, Kirk AF, Hughes AR, Lindsay RS. Lifestyle interventions for type 2 diabetes prevention in women with prior gestational diabetes: A systematic review and meta-analysis of behavioural, anthropometric and metabolic outcomes. Prev Med Rep. 2015;2:448–461. doi: 10.1016/j.pmedr.2015.05.009 26844102

14. Tuomilehto J, Lindstrom J, Eriksson JG, Valle TT, Hamalainen H, Ilanne-Parikka P, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001;344(18):1343–1350. doi: 10.1056/NEJM200105033441801 11333990

15. Morrison MK, Lowe JM, Collins CE. Perceived risk of Type 2 diabetes in Australian women with a recent history of gestational diabetes mellitus. Diabet Med. 2010;27(8):882–886. doi: 10.1111/j.1464-5491.2010.03032.x 20653745

16. Gray M H C; Kiel L; Dublin S. "It’s a Very Big Burden on Me": Women’s Experiences Using Insulin for Gestational Diabetes. Matern Child Health J. 2017;21(8):1678–1685. doi: 10.1007/s10995-017-2261-8 28092062

17. Draffin CR, Alderdice FA, McCance DR, Maresh M, Harper R, McSorley O, et al. Exploring the needs, concerns and knowledge of women diagnosed with gestational diabetes: A qualitative study. Midwifery. 2016 Sep 1;40:141–7. doi: 10.1016/j.midw.2016.06.019 27553869

18. Lie ML, Hayes L, Lewis-Barned NJ, May C, White M, Bell R. Preventing type 2 diabetes after gestational diabetes: women’s experiences and implications for diabetes prevention interventions. Diabet Med. 2013;30(8):986–993. doi: 10.1111/dme.12206 23534548

19. Parsons J, Sparrow K, Ismail K, Hunt K, Rogers H, Forbes A. Experiences of gestational diabetes and gestational diabetes care: a focus group and interview study. BMC Pregnancy Childbirth. 2018;18(1):25. doi: 10.1186/s12884-018-1657-9 29325518

20. Siad FM, Fang XY, Santana MJ, Butalia S, Hebert MA, Rabi DM. Understanding the Experiences of East African Immigrant Women with Gestational Diabetes Mellitus. Can J Diabetes. 2018.

21. Hjelm K, Bard K, Apelqvist J. A qualitative study of developing beliefs about health, illness and healthcare in migrant African women with gestational diabetes living in Sweden. BMC Women’s Health. 2018;18(1).

22. Ge L, Wikby K, Rask M. Lived experience of women with gestational diabetes mellitus living in China: a qualitative interview study. BMJ Open. 2017;7(11):e017648. doi: 10.1136/bmjopen-2017-017648 29187411

23. Youngwanichsetha S, Phumdoung S. Lived experience of blood glucose self-monitoring among pregnant women with gestational diabetes mellitus: a phenomenological research. J Clin Nurs. 2017;26(19–20):2915–2921. doi: 10.1111/jocn.13571 27603420

24. Bhurosy T, Jeewon R. Overweight and Obesity Epidemic in Developing Countries: A Problem with Diet, Physical Activity, or Socioeconomic Status? Sci. World J. 2014;2014:1–7.

25. Kaiser B, Razurel C, Jeannot E. Impact of health beliefs, social support and self-efficacy on physical activity and dietary habits during the post-partum period after gestational diabetes mellitus: study protocol. BMC Pregnancy Childbirth. 2013;13:133. doi: 10.1186/1471-2393-13-133 23800121

26. Van Ryswyk E, Middleton P, Shute E, Hague W, Crowther C. Women’s views and knowledge regarding healthcare seeking for gestational diabetes in the postpartum period: A systematic review of qualitative/survey studies. Diabetes Res Clin Pract. 2015;110(2):109–122. doi: 10.1016/j.diabres.2015.09.010 26421361

27. Bennett WL, Ennen CS, Carrese JA, Hill-Briggs F, Levine DM, Nicholson WK, et al. Barriers to and Facilitators of Postpartum Follow-Up Care in Women with Recent Gestational Diabetes Mellitus: A Qualitative Study. J. Womens Health. 2011;20(2):239–245.

28. Keely E, Clark H, Karovitch A, Graham I. Screening for type 2 diabetes following gestational diabetes: family physician and patient perspectives. Can Fam Physician. 2010;56(6):558–563. 20547525

29. Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M, Medical Research Council G. Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ. 2008;337:a1655. doi: 10.1136/bmj.a1655 18824488

30. Jackson C, Eliasson L, Barber N, Weinman J. Applying COM-B to medication adherence: a suggested framework for research and interventions. European Health Psychologist. 2014;1;16(1):7–17.

31. Muhwava LS, Murphy K, Zarowsky C, Levitt N. Policies and clinical practices relating to the management of gestational diabetes mellitus in the public health sector, South Africa–a qualitative study. BMC Health Serv Res. 2018;18(1).

32. Michie S, van Stralen MM, West R. The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci. 2011;6:42. doi: 10.1186/1748-5908-6-42 21513547

33. Barker F, Atkins L, de Lusignan S. Applying the COM-B behaviour model and behaviour change wheel to develop an intervention to improve hearing-aid use in adult auditory rehabilitation. Int J Audiol. 2016;55 Suppl 3:S90–98.

34. Olander EK, Darwin ZJ, Atkinson L, Smith DM, Gardner B. Beyond the ‘teachable moment’—A conceptual analysis of women’s perinatal behaviour change. Women Birth. 2016;29(3):e67–71. doi: 10.1016/j.wombi.2015.11.005 26626592

35. Handley MA, Harleman E, Gonzalez-Mendez E, Stotland NE, Althavale P, Fisher L, et al. Applying the COM-B model to creation of an IT-enabled health coaching and resource linkage program for low-income Latina moms with recent gestational diabetes: the STAR MAMA program. Implement Sci. 2016;11(1).

36. Elo S, Kyngas H. The qualitative content analysis process. J Adv Nurs. 2008;62(1):107–115. doi: 10.1111/j.1365-2648.2007.04569.x 18352969

37. Howlett N, Schulz J, Trivedi D, Troop N, Chater A. A prospective study exploring the construct and predictive validity of the COM-B model for physical activity. J Health Psychol. 2017; 1359105317739098.

38. Michie S, Atkins L, West R. The behavior change wheel: a guide to designing interventions. Great Britain: Silverback Publishing 2014.

39. Hirst JE, Tran TS, Do MA, Rowena F, Morris JM, Jeffery HE. Women with gestational diabetes in Vietnam: a qualitative study to determine attitudes and health behaviours. BMC pregnancy and childbirth. 2012 Dec;12(1):81.

40. Carolan M, Gill GK, Steele C. Women’s experiences of factors that facilitate or inhibit gestational diabetes self-management. BMC Pregnancy and Childbirth. 2012;12.

41. Mukona D, Munjanja SP, Zvinavashe M, Stray-Pederson B. Barriers of adherence and possible Solutions to nonadherence to antidiabetic therapy in women with diabetes in pregnancy: Patients’ Perspective. J Diabetes Res. 2017;2017:3578075. doi: 10.1155/2017/3578075 28828389

42. Tierney M, O’Dea A, Danyliv A, Noctor E, McGuire B, Glynn L, et al. Factors influencing lifestyle behaviours during and after a gestational diabetes mellitus pregnancy. Health Psychol Behav Med. 2015;3(1):204–216.

43. Collier SA, Mulholland C, Williams J, Mersereau P, Turay K, Prue C. A qualitative study of perceived barriers to management of diabetes among women with a history of diabetes during pregnancy. J Womens Health (Larchmt). 2011;20(9):1333–1339.

44. Nielsen KK, de Courten M, Kapur A. Health system and societal barriers for gestational diabetes mellitus (GDM) services—lessons from World Diabetes Foundation supported GDM projects. BMC Int Health Hum Rights. 2012;12:33. doi: 10.1186/1472-698X-12-33 23217159

45. Muzigaba M, Kolbe-Alexander TL, Wong F. The perceived role and influencers of physical activity among pregnant women from low socioeconomic status communities in South Africa. J Phys Act Health. 2014;11(7):1276–1283. doi: 10.1123/jpah.2012-0386 24184664

46. Weir Z, Bush J, Robson SC, McParlin C, Rankin J, Bell R. Physical activity in pregnancy: a qualitative study of the beliefs of overweight and obese pregnant women. BMC Pregnancy Childbirth. 2010;10:18. doi: 10.1186/1471-2393-10-18 20426815

47. Pierce M, Modder J, Mortagy I, Springett A, Hughes H, Baldeweg S. Missed opportunities for diabetes prevention: post-pregnancy follow-up of women with gestational diabetes mellitus in England. Br J Gen Pract. 2011;61(591):e611–619. doi: 10.3399/bjgp11X601316 22152832

48. Mendenhall E, Norris SA. Diabetes care among urban women in Soweto, South Africa: a qualitative study. BMC Public Health. 2015;15(1).

49. Morrison MK, Lowe JM, Collins CE. Australian women’s experiences of living with gestational diabetes. Women Birth. 2014;27(1):52–57. doi: 10.1016/j.wombi.2013.10.001 24183603

50. Eades CE, France EF, Evans JMM. Postnatal experiences, knowledge and perceptions of women with gestational diabetes. Diabet Med. 2018;35(4):519–529. doi: 10.1111/dme.13580 29338094

51. Martis R, Brown J, McAra-Couper J, Crowther CA. Enablers and barriers for women with gestational diabetes mellitus to achieve optimal glycaemic control—a qualitative study using the theoretical domains framework. BMC Pregnancy Childbirth. 2018;18(1):91. doi: 10.1186/s12884-018-1710-8 29642898

52. Barakat S, Martinez D, Thomas M, Handley M. What do we know about gestational diabetes mellitus and risk for postpartum depression among ethnically diverse low-income women in the USA? Arch Womens Ment Health. 2014;17(6):587–592. doi: 10.1007/s00737-014-0460-5 25298252

53. Marchetti D, Carrozzino D, Fraticelli F, Fulcheri M, Vitacolonna E. Quality of Life in Women with Gestational Diabetes Mellitus: A Systematic Review. J Diabetes Res. 2017;2017:7058082. doi: 10.1155/2017/7058082 28326332

54. 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(11):721–727. doi: 10.1093/qjmed/hcx106 29024981


Článok vyšiel v časopise

PLOS One


2019 Číslo 11
Najčítanejšie tento týždeň
Najčítanejšie v tomto čísle
Kurzy

Zvýšte si kvalifikáciu online z pohodlia domova

Aktuální možnosti diagnostiky a léčby litiáz
nový kurz
Autori: MUDr. Tomáš Ürge, PhD.

Všetky kurzy
Prihlásenie
Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.

Prihlásenie

Nemáte účet?  Registrujte sa

#ADS_BOTTOM_SCRIPTS#