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임신성 당뇨병 산모를 위한 산후관리 프로그램이 자기효능감, 자가 관리 및 혈당 조절에 미치는 영향

Effects of a Postnatal Care Program on Self-efficacy, Self-management, and Glycemic Control in Women with Gestational Diabetes Mellitus

  • 투고 : 2018.08.28
  • 심사 : 2018.11.07
  • 발행 : 2018.12.20

초록

Purpose: To examine effects of a postnatal care program on self-efficacy, self-management, and glycemic control in women with gestational diabetes mellitus (GDM). Methods: A non-equivalent control group non-synchronized quasi-experimental design was used. Sixty-two women with GDM were enrolled and assigned to either an experimental group (n=30) or a control group (n=32). The experimental group received an intervention which was postnatal care program for women with GDM. The postnatal care program for GDM included an individual education with leaflet and mobile web-based video with three times of telephone counseling. Effects of the intervention were measured with self-efficacy, self-management questionnaire, and a 75 g oral glucose tolerance test (75g OGTT). Statistical significance was examined using independent t-test and $x^2-test$. Results: Although there was no significant difference in 75g OGTT ($x^2=.11$, p=.748) or self-management (t=-1.28, p=.206), there was a statistically significant increase in self-efficacy (t=-2.02, p=.048) in the experimental group compared to that in the control group. Conclusion: A postnatal care program is needed for women with GDM to improve their self-efficacy. Further studies are warranted to improve self-management and glycemic control through tailored education for GDM postpartum women.

키워드

참고문헌

  1. Hunt KJ, Schuller KL. The increasing prevalence of diabetes in pregnancy. Obstetrics and Gynecology Clinics of North America. 2007;34(2):173-199. https://doi.org/10.1016/j.ogc.2007.03.002
  2. Jang HC, Cho YM, Park KS, Kim SY, Lee HK, Kim MY, et al. Pregnancy outcome in Korean women with gestational diabetes mellitus diagnosed by the carpenter-coustan criteria. Journal of Korean Diabetes Association. 2004;28(2):122-130.
  3. Ferrara A. Increasing prevalence of gestational diabetes mellitus: A public health perspective. Diabetes Care. 2007;30(2):141-146. https://doi.org/10.2337/dc07-s206
  4. American Diabetes Association. Management of diabetes in pregnancy. Diabetes Care. 2017;40(Supplement 1):S114-S119. https://doi.org/10.2337/dc17-S016
  5. Kim C, Newton KM, Knopp RH. Gestational diabetes and the incidence of type 2 diabetes: a systematic review. Diabetes Care. 2002;25(10):1862-1868. https://doi.org/10.2337/diacare.25.10.1862
  6. Shah BR, Lipscombe LL, Feig DS, Lowe JM. Missed opportunities for type 2 diabetes testing following gestational diabetes: A population-based cohort study. BJOG: An International Journal of Obstetrics and Gynecology. 2011;118(12):1484-1490. https://doi.org/10.1111/j.1471-0528.2011.03083.x
  7. Cho GJ, An JJ, Choi SJ, Oh SY, Kwon HS, Hong SC, et al. Postpartum glucose testing rates following gestational diabetes mellitus and factors affecting testing non-compliance from four tertiary centers in Korea. Journal of Korean Medical Science. 2015;30(12):1841-1846. https://doi.org/10.3346/jkms.2015.30.12.1841
  8. Lee SS, Park JS, Lee SY, Oh MA, Choi HJ, Song MY. The 2015 national survey on fertility and family health and welfare. Korea Institute for Health and Social Affairs; 2016. p. 201-204.
  9. Lee SY. Prenatal and postnatal care and its policy implications. Health and Welfare Policy Forum. 2016;236:37-50.
  10. Rosenstock IM. The health belief model and preventive health behavior. Health Education Monographs. 1974;2(4):354-386. https://doi.org/10.1177/109019817400200405
  11. Kim SS, Paek KS. Compliance with sick-role behavior and health beliefs according to the level of knowledge in diabetic patients. The Kyungpook University Medical Journal. 1991;32(4):523-533.
  12. Kim C, McEwen LN, Piette JD, Goewey J, Ferrara A, Walker EA. Risk perception for diabetes among women with histories of gestational diabetes mellitus. Diabetes Care. 2007;30(9):2281-2286. https://doi.org/10.2337/dc07-0618
  13. Kaiser B, Jeannot E, Razurel C. Determinants of health behaviors after gestational diabetes mellitus: a prospective cohort study in Geneva. Journal of Midwifery & women's health. 2016;61(5):1484-1490. https://doi.org/10.1111/jmwh.12486
  14. Kaiser B, Razurel C. Determinants of postpartum physical activity, dietary habits and weight loss after gestational diabetes mellitus. Journal of Nursing Management. 2013;21(1):58-69. https://doi.org/10.1111/jonm.12006
  15. 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 and Childbirth. 2013;13:133. https://doi.org/10.1186/1471-2393-13-133
  16. Bandura A, Walters RH. Social learning theory. New York, NY: General Learning Press; 1977. 46 p.
  17. Paek KS. The development of a self-efficacy tool for diabetes millitus patient [dissertation]. Daegu: Kyungpook National University; 1997. 108 p.
  18. O'Reilly SL. Prevention of diabetes after gestational diabetes: better translation of nutrition and lifestyle messages needed. Healthcare (Basel). 2014;2(4):468-491. https://doi.org/10.3390/healthcare2040468
  19. Kim YO. A hypothesized model for self-care behavior in diabetic patients: Based on stress-coping model [dissertation]. Seoul: Yonsei University; 1997. 170 p.
  20. Kim HS. Effects of an integrated self-management program on self-management, glycemic control, and maternal identity in women with gestational diabetes mellitus [dissertation]. Seoul: Yonsei University; 2011. 158 p.
  21. Horsager R, Roberts S, Rogers V, Santiago-Munoz P, Worley K, Hoffman B. Williams obstetrics study giude, 24th ed. New York, NY: McGraw-Hill Education; 2014. 448 p.
  22. Kim YM, Kim MY, Kwon YK, Kim HS, Park SH, Chun MS, et al. Effects of a discharge education program using computerized animation video for post-operative colon cancer patients. Korean Academic Society of Rehabilitation Nursing. 2013;16 (1):37-46. https://doi.org/10.7587/kjrehn.2013.37
  23. Jung MY, Hong IK, Noh HY, Park HS, Son JM, Kim JH, et al. Effects of video-based information provision on anxiety and education satisfaction of thyroid cancer patients undergoing radio-iodine treatment. Journal of Korean Clinical Nursing Research. 2015;21(1):11-20. https://doi.org/10.14371/QIH.2017.23.1.43
  24. Fishman DJ. Telemedicine-bringing the specialist to the patient. Nursing management. 1997;28(7):30-32.
  25. Kim YS, Kim HS, Kim YL. Effects of a web-based self-management program on the behavior and blood glucose levels of women with gestational diabetes mellitus. Telemedicine Journal and e-Health: the Official Journal of the American Telemedicine Association. Forthcoming 2018. https://doi.org/10.1089/tmj.2017.0332
  26. Ko JM, Lee JK. Effects of a coaching program on comprehensive lifestyle modification for women with gestational diabetes mellitus. Journal of Korean Academy of Nursing. 2014;44(6):672-681. https://doi.org/10.4040/jkan.2014.44.6.672
  27. Baek ES, Park HJ. Effects of a case management program on self-efficacy, depression and anxiety in pregnant women with gestational diabetes mellitus. Korean Journal of Women Health Nursing. 2013;19(2):88-98. https://doi.org/10.4069/kjwhn.2013.19.2.88
  28. Fahima K, Lee Tae W, Ela R, Gulshanara B, Pronita R, Kim S. The relationships among postpartum fatigue, depressive mood, self-care agency, and self-care action of first-time mothers in Bangladesh. Korean Journal of Women Health Nursing. 2018;24(1):49-57. https://doi.org/10.4069/kjwhn.2018.24.1.49
  29. Ahn S. Postpartum Health: A comparison of mothers with preterm infants and mothers with full-term infants. Korean Journal of Women Health Nursing. 2002;8(1):7-19.

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  4. Do depression, anxiety, emotional intelligence, and sleep quality affect diabetes management self-efficacy in Korean women with gestational diabetes in pregnancy?: a descriptive correlational study vol.27, pp.4, 2018, https://doi.org/10.4069/kjwhn.2021.11.27