scholarly journals “If I Don’t Eat Enough, I Won’t Be Healthy”. Women’s Experiences with Gestational Diabetes Mellitus Treatment in Rural and Urban South India

2020 ◽  
Vol 17 (9) ◽  
pp. 3062
Author(s):  
Karoline Kragelund Nielsen ◽  
Thilde Vildekilde ◽  
Anil Kapur ◽  
Peter Damm ◽  
Veerasamy Seshiah ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Social Support ◽  
Health Care ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Health Care Providers ◽  
Care Providers ◽  
Women’S Experiences ◽  
Women's Experiences ◽  
Rural And Urban

Gestational diabetes mellitus (GDM) is associated with a range of adverse pregnancy outcomes as well as increased risk of future type 2 diabetes and cardiovascular disease. In India, 10%–35% of pregnant women develop GDM. In this study, we investigated women’s experiences with the dietary and pharmaceutical treatment for GDM in rural and urban Tamil Nadu, India. Semi-structured interviews were conducted with 19 women diagnosed with GDM. Data were analyzed using qualitative content analysis. Three overall aspects were discovered with several sub-aspects characterizing women’s experiences: emotional challenges (fear and apprehension for the baby’ health and struggling to accept a treatment seen as counterintuitive to being safe and healthy), interpersonal challenges (managing treatment in the near social relations and social support, and coordinating treatment with work and social life), and health system-related challenges (availability and cost of treatment, interaction with health care providers). Some aspects acted as barriers. However, social support and positive, high-quality interactions with health care providers could mitigate some of these barriers and facilitate the treatment process. Greater efforts at awareness creation in the social environment and systemic adjustments in care delivery targeting the individual, family, community and health system levels are needed in order to ensure that women with GDM have the opportunity to access treatment and are enabled and motivated to follow it as well.

scholarly journals Health Care Providers’ Perceptions of Responsibilities and Resources to Reduce Type 2 Diabetes Risk After Gestational Diabetes Mellitus

2018 ◽  
Vol 36 (2) ◽  
pp. 160-167
Author(s):  
Sumali S. Hewage ◽  
Shweta R. Singh ◽  
Claudia Chi ◽  
Jerry K.Y. Chan ◽  
Tong Wei Yew ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Health Care ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Health Care Providers ◽  
Diabetes Risk ◽  
Care Providers

scholarly journals Health Care Professionals’ Perspectives On Screening And Management Of Gestational Diabetes Mellitus In Public Hospitals Of South India – A Qualitative Study

2020 ◽  
Author(s):  
Biswamitra Sahu ◽  
Giridhara R Babu ◽  
Kaveri Siddappa Gurav ◽  
Maithili Karthik ◽  
R Deepa ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Health Care ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Health Care Providers ◽  
Public Hospitals ◽  
Effective Management ◽  
Care Providers ◽  
Management Services

Abstract Background Women developing Gestational Diabetes Mellitus are subsequently at a higher risk of developing Type 2 Diabetes later in life. Screening and effective management of women with GDM is essential in preventing progression to type 2 diabetes mellitus. Although the burden of Gestational Diabetes Mellitus is high in India, Gestational Diabetes Mellitus screening and management is suboptimal in public hospitals. We aimed to explore the perspectives of healthcare providers regarding the barriers and facilitators from the health system context that restrict the timely screening and effective management of Gestational Diabetes Mellitus. Methods We conducted six in-depth interviews of health care providers- four with nurses and two with obstetricians in the public hospitals in India's major city (Bengaluru). The interviews were conducted in the preferred language of the participants ( Kannada for nurses, English for the obstetricians) and audio-recorded. All Kannada interviews were transcribed and translated into English for analysis. The primary data were analyzed using grounded theory approach by NVivo 12 plus Results Health care providers recognized and supported the need for design and implementation of Gestational Diabetes Mellitus screening and management services. While obstetricians were aware of the national guidelines regarding screening and management; nurses mentioned that they had unmet training needs in health promotion. Barriers identified to timely screening and management of Gestational Diabetes Mellitus included unmet training needs of nurses regarding Gestational Diabetes Mellitus, delay in screening of pregnant women accessing antenatal care at private clinics initially and subsequently reporting at public hospital in late gestation, migration of pregnant women due to delivery of first born at natal home, lack of follow up system of deferred cases for gestational diabetes screening, resource deficit, and long waiting hours. Conclusion Provided the fact that there is effectiveness of Gestational Diabetes Mellitus screening and management services, there is a pressing need to develop and improve existing Gestational Diabetes Mellitus Screening and Management services to tackle the growing burden of Gestational Diabetes Mellitus in India. With the urgent need for these services, it needs to be extended to public hospitals.

scholarly journals Health Care Professionals’ Perspectives on Screening and Management of Gestational Diabetes Mellitus in Public Hospitals of South India – a Qualitative Study

2020 ◽  
Author(s):  
Biswamitra Sahu ◽  
Giridhara R Babu ◽  
Kaveri Siddappa Gurav ◽  
Maithili Karthik ◽  
R Deepa ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Health Care ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Health System ◽  
Health Care Providers ◽  
Resource Scarcity ◽  
Public Hospitals ◽  
Care Providers

Abstract Background Women developing Gestational Diabetes Mellitus (GDM) have a higher risk of developing Type 2 Diabetes later in life. We aimed to explore the perspectives of healthcare providers regarding the barriers from the health system context that restrict the timely screening and effective management of GDM. Methods We conducted six in-depth interviews of health care providers- four with nurses and two with obstetricians in the public hospitals in India's major city (Bengaluru). The interviews were conducted in the preferred language of the participants ( Kannada for nurses, English for the obstetricians), and audio-recorded. All Kannada interviews were transcribed and translated into English for analysis. The primary data were analyzed using grounded theory approach by NVivo 12 plus. The findings are put into perspective using the socio-ecological model. Results Health care providers identified delayed visits to public hospitals and stress on household-level responsibilities as barriers at the individual level for GDM screening. Also, migration of pregnant women to natal home during first pregnancy is a cultural barrier in addition to health system barriers such as unmet nurse training needs, long waiting hours, uneven power dynamics, lack of follow-up, resource scarcity, and lack of supportive oversight. The barriers for GDM management included non-reporting women to follow - up visits, irregular self-monitoring of drug and blood sugar, trained staff shortage, ineffective tracking, and lack of standardized protocol. Conclusion There is a pressing need to develop and improve existing GDM Screening and Management services to tackle the growing burden of GDM in public hospitals of India.

An Indigenous and Western paradigm to understand gestational diabetes mellitus: Reflections and insights

2020 ◽  
pp. 147675032096082
Author(s):  
Joanne Whitty-Rogers ◽  
Brenda Cameron ◽  
Vera Caine
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
First Nations ◽  
Relational Ethics ◽  
Indigenous Women ◽  
Mutual Trust ◽  
Women’S Experiences ◽  
Women's Experiences ◽  
New Knowledge

Indigenous women face many barriers to maternal care during pregnancy in Canada. A participatory study was conducted in two First Nations Communities in Nova Scotia, Canada to gain new knowledge about Mi’kmaw women’s experiences of living with gestational diabetes mellitus (GDM). Relational ethics helped guide this journey. In this paper we describe how Indigenous and Western approaches were used to understand Mi’kmaw women’s experiences with GDM. It was important to us that the research methodology facilitated building relationship and trust. This led to an openness and willingness of the women to express their concerns and offer ways to address GDM in their communities. The challenges of blending Indigenous approaches with Western research are also discussed in the paper. The foundational principles that were used during this research included: 1) Staying true to my word; 2) Mutual Trust; 3) Mutual Respect; 4) Being Flexible; 5) Being Non judgemental; 6) Working in partnership; 7) Taking time to explain; 8) Promoting autonomy; and 9) Genuine connectiveness. The findings revealed that the research assisted the Mi’kmaw women in understanding their experiences in new ways and helped to build capacity so that they could take action to improve their health, while sustaining their Mi’kmaw culture.

scholarly journals Implementation of a new program of gestational diabetes screening and management in Morocco: A qualitative exploration of health workers’ perceptions

2020 ◽  
Author(s):  
Bettina Utz ◽  
Bouchra Assarag ◽  
Touria Lekhal ◽  
Wim Van Damme ◽  
Vincent De Brouwere
Keyword(s):  
Diabetes Mellitus ◽  
Health Care ◽  
Gestational Diabetes ◽  
Antenatal Care ◽  
Health Care Providers ◽  
Management Approach ◽  
Care Providers ◽  
Diabetes Screening ◽  
Primary Level ◽  
Care Services

Abstract Background: Gestational diabetes mellitus (GDM) is associated with an increased risk for a future type 2 diabetes mellitus in women and their children. As linkage between maternal health and non-communicable diseases, antenatal care plays a key role in the primary and secondary prevention of GDM associated adverse outcomes. While implementing a locally adapted GDM screening and management approach through antenatal care services at the primary level of care, we assessed its acceptability by the implementing health care providers. Methods : As part of a larger implementation effectiveness study assessing a decentralized gestational diabetes screening and management approach in the prefecture of Marrakech and the rural district of Al Haouz in Morocco, we conducted four focus group discussions with 29 primary health care providers and seven in-depth interviews with national and regional key informants. After transcription of data, we thematically analysed the data using a combined deductive and inductive approach. Results: The intervention of screening and managing women with gestational diabetes added value to existing antenatal care services but presented an additional workload for first line health care providers. An existing lack of knowledge about gestational diabetes in the community and among private health care physicians required of public providers to spend more time on counselling women. Nurses had to adapt recommendation on diet to the socio-economic context of patients. Despite the additional task, especially nurses and midwives felt motivated by their gained capacity to detect and manage gestational diabetes, and to take decisions on treatment and follow-up. Conclusions : Detection and initial management of gestational diabetes is an acceptable strategy to extend the antenatal care service offer in Morocco and to facilitate service access for affected pregnant women. Despite its additional workload, gestational diabetes management can contribute to the professional motivation of primary level health care providers.

scholarly journals Implementation of a new program of gestational diabetes screening and management in Morocco: A qualitative exploration of health workers’ perceptions

2019 ◽  
Author(s):  
Bettina Utz ◽  
Bouchra Assarag ◽  
Touria Lekhal ◽  
Wim Van Damme ◽  
Vincent De Brouwere
Keyword(s):  
Diabetes Mellitus ◽  
Health Care ◽  
Gestational Diabetes ◽  
Antenatal Care ◽  
Health Care Providers ◽  
Management Approach ◽  
Care Providers ◽  
Diabetes Screening ◽  
Primary Level ◽  
Care Services

Abstract Background Gestational diabetes mellitus (GDM) is associated with an increased risk for a future diabetes mellitus in women and their children. As linkage between maternal health and non-communicable diseases, antenatal care plays a key role in the primary and secondary prevention of GDM associated adverse outcomes. While implementing a locally adapted GDM screening and management approach through antenatal care services at the primary level of care, we assessed its acceptability by the implementing health care providers. Methods As part of a larger implementation effectiveness study assessing a decentralized gestational diabetes screening and management approach in the prefecture of Marrakech and the rural district of Al Haouz in Morocco, we conducted four focus group discussions with 29 primary health care providers and seven in-depth interviews with national and regional key informants. Looking at the main themes screening, diagnosis, treatment and service organization, we thematically analyzed the data using a combined de- and inductive approach. Results The intervention of screening and managing women with gestational diabetes added value to existing antenatal care services but presented an additional workload for first line health care providers. Lack of knowledge about gestational diabetes in the community but also by private health care providers demanded more time for counseling. Nurses had to adapt recommendation on diet to the socio-economic context of patients. Despite the additional task, especially nurses and midwives felt motivated by their gained capacity to detect and manage gestational diabetes and the ability to take decisions on follow-up. Conclusions Detection and initial management of gestational diabetes is an acceptable strategy to extend the antenatal care service offer in Morocco and to facilitate service access for affected pregnant women. Despite its additional workload, gestational diabetes management can contribute to the professional motivation of primary level health care providers.

scholarly journals Implementation of a new program of gestational diabetes screening and management in Morocco: A qualitative exploration of health workers’ perceptions

2020 ◽  
Author(s):  
Bettina Utz ◽  
Bouchra Assarag ◽  
Touria Lekhal ◽  
Wim Van Damme ◽  
Vincent De Brouwere
Keyword(s):  
Diabetes Mellitus ◽  
Health Care ◽  
Gestational Diabetes ◽  
Antenatal Care ◽  
Health Care Providers ◽  
Management Approach ◽  
Care Providers ◽  
Diabetes Screening ◽  
Primary Level ◽  
Care Services

Abstract Background: Gestational diabetes mellitus (GDM) is associated with an increased risk for a future type 2 diabetes mellitus in women and their children. As linkage between maternal health and non-communicable diseases, antenatal care plays a key role in the primary and secondary prevention of GDM associated adverse outcomes. While implementing a locally adapted GDM screening and management approach through antenatal care services at the primary level of care, we assessed its acceptability by the implementing health care providers. Methods : As part of a larger implementation effectiveness study assessing a decentralized gestational diabetes screening and management approach in the prefecture of Marrakech and the rural district of Al Haouz in Morocco, we conducted four focus group discussions with 29 primary health care providers and seven in-depth interviews with national and regional key informants. After transcription of data, we thematically analysed the data using a combined deductive and inductive approach. Results: The intervention of screening and managing women with gestational diabetes added value to existing antenatal care services but presented an additional workload for first line health care providers. An existing lack of knowledge about gestational diabetes in the community and among private health care physicians required of public providers to spend more time on counselling women. Nurses had to adapt recommendation on diet to the socio-economic context of patients. Despite the additional task, especially nurses and midwives felt motivated by their gained capacity to detect and manage gestational diabetes, and to take decisions on treatment and follow-up. Conclusions : Detection and initial management of gestational diabetes is an acceptable strategy to extend the antenatal care service offer in Morocco and to facilitate service access for affected pregnant women. Despite its additional workload, gestational diabetes management can contribute to the professional motivation of primary level health care providers.

scholarly journals STUDI FENOMENOLOGI TENTANG PENGALAMAN WANITA DI DAERAH PEDESAAN DALAM MENJALANI MASA KEHAMILAN PERTAMA

2014 ◽  
Vol 8 (2) ◽  
pp. 62-69
Author(s):  
Yati Afiyanti
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Pregnancy Loss ◽  
Transition Period ◽  
Care Providers ◽  
Emotional Symptoms ◽  
Women’S Experiences ◽  
Women's Experiences ◽  
Expectant Mothers ◽  
Need For Support

AbstrakKehamilan seringkali dianggap sebagai periode transisi dalam kehidupan seorang wanita. Suatu studi kualitatif secara hermeneutic fenomenologi telah dilakukan untuk mengeksplorasi berbagai pengalaman wanita di daerah pedesaan dengan kehamilan pertamanya termasuk pengalaman mereka menerima pelayanan kesehatan dari para praktisi kesehatan Data studi ini diperoleh dari 9 ibu muda, dikumpulkan melalui wawancara formal tidak berstruktur yang mendalam sebanyak dua kali di rumah partisipan masing-masing. Wawancara direkam kemudian dibuat dalam bentuk transkrip wawancara. Hasil penelitian mengungkapkan berbagai pengalaman wanita yang bervariasi. Kebanyakan ibu muda dalam studi ini mengalami kesulitan mengatasi berbagai ketidaknyamanan fisik dan psikologis akibat kehamilan dan mengalami kecemasan menghadapi proses kelahiran bayi mereka. Mereka membutuhkan dukungan dan bantuan, baik dari para praktisi kesehatan maupun anggota keluarga. Dengan hasil studi ini, diharapkan para praktisi kesehatan akan lebih memahami harapan-harapan seorang ibu hamil untuk dapat menjalani masa kehamilannya dengan sehat dan sejahtera. AbstractPregnancy often assumed as transition period in the woman’s life. A Qualitative studi, using fenomenology hermeunetic was carried out to explore women’s experiences in rural area of their first pregnancy, included their experiences received from the health care provider. Data were obtained from 9 women whose unstructured formal interviews were tape-recorded dan transcribed. Interviews were conducted in the women’s homes on two occasions during pregnancy. The findings reported the women’s experiences were varied and diverse. Most had difficulty coping with the physical and emotional symptoms of pregnancy. Loss of control caused anxiety toward with their childbirth The need for support emerged as important from their family and the health care providers. The findings of this study will provide the health care providers deeper understanding about the expectances of new expectant mothers with their first pregnancy, healthy dan wellness.

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