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当前中国为 1 型糖尿病女性提供妊娠护理的实践、态度和观点:一项定性研究。

Current practice, attitude and views of providing pregnancy care for women with type 1 diabetes in China: a qualitative study.

机构信息

Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, China.

Department of Endocrinology and Metabolism, the Third Affiliated Hospital of Sun Yat-sen University, Guangdong Diabetes Prevention and Control Research Center, Guangdong Provincial Key Laboratory of Diabetology, Guangzhou, China.

出版信息

BMJ Open. 2022 Nov 7;12(11):e061657. doi: 10.1136/bmjopen-2022-061657.

Abstract

OBJECTIVE

Data are sparse on healthcare needs related to pregnancy among Chinese women with type 1 diabetes (T1D) or the gap between the needs and healthcare provision in China. We aimed to identify their needs and the gaps in pregnancy care provision.

DESIGN

This is a qualitative, face-to-face, one-to-one in-depth interview study. We recruited our participants using a purposive sampling strategy. Semistructural outlines were used to guide the interviews. The interviews were digitally recorded, transcribed and analysed using a thematic framework method with NVivo V.10.0.

SETTING

Guangdong Province in China.

PARTICIPANTS

This study involved three key stakeholders of pregnancy care for women with T1D: 29 women with T1D of childbearing age (aged 18-50 years), 16 family members (husbands, parents and parents-in-law of women with T1D) and 35 relevant healthcare providers (HCPs).

RESULTS

We found that women with T1D and the family members had a more pessimistic attitude towards pregnancy outcomes, which was different from the more positive view of HCPs. However, all three stakeholders shared the following perspectives regarding pregnancy-related care for women with T1D: (1) lack of knowledge and access to education, (2) lack of multidisciplinary cooperation, (3) education should be started earlier in adulthood, (3) positive role of peer support, and (4) hope for future training of HCPs for relevant knowledge and skills specified for T1D and pregnancy with T1D.

CONCLUSIONS

An immense gap was identified between the needs of women with T1D regarding pregnancy-related care and current care provision in China. These findings suggest that education be provided to patients and HCPs, and the role of professional and multidisciplinary support should be enhanced to optimise pregnancy care for women with T1D in China.

摘要

目的

关于中国 1 型糖尿病(T1D)女性的妊娠相关医疗需求数据稀缺,以及这些需求与中国妊娠医疗服务之间存在差距。本研究旨在确定她们的需求以及妊娠护理服务方面的差距。

设计

这是一项定性、面对面、一对一的深入访谈研究。我们采用目的性抽样策略招募参与者。使用半结构式大纲指导访谈。使用 NVivo V.10.0 以主题框架方法对访谈进行数字记录、转录和分析。

地点

中国广东省。

参与者

本研究涉及妊娠 T1D 女性护理的三个关键利益相关者:29 名生育年龄的 T1D 女性(年龄 18-50 岁)、16 名家庭成员(T1D 女性的丈夫、父母和公婆)和 35 名相关医疗保健提供者(HCPs)。

结果

我们发现,T1D 女性及其家庭成员对妊娠结局持更悲观的态度,这与 HCPs 的更积极观点不同。然而,所有三个利益相关者都对 T1D 女性的妊娠相关护理有以下看法:(1)缺乏知识和获取教育的机会,(2)缺乏多学科合作,(3)应该在成年早期开始教育,(3)同伴支持的积极作用,以及(4)希望未来对 HCPs 进行相关知识和技能的培训,专门针对 T1D 和 T1D 妊娠。

结论

确定了 T1D 女性对妊娠相关护理的需求与中国当前护理服务之间存在巨大差距。这些发现表明,应向患者和 HCPs 提供教育,并应加强专业和多学科支持的作用,以优化中国 T1D 女性的妊娠护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e42f/9644323/07cfadc179f7/bmjopen-2022-061657f01.jpg

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