The Impact Of Conversation Map Tool On The Patients With Gestational Diabetes Mellitus

Objective: The objective of this study is to evaluate the impact ofconversation map tool empowerment education mode on the pregnant women withgestational diabetes mellitus. It compared the effect of conversation map tool andtraditional health education mode on empowerment ability, general self-efficacy, bloodglucose level, pregnancy outcomes like postoperative exsufflation time, the time of bedleaving and sleeping quality for24hours; Apgar score, blood glucose, headcircumference, weight and complication rate of newborns, and so on.Methods: The clinical randomized controlled trials and quantitative research wereused. The selection of pregnant women with gestational diabetes mellitus in obstetricaldepartment of the First Affiliated Hospital of Dalian Medical University from Jan toNovember in2012was based on the informed consent, inclusion and exclusion criteria.80pregnant women were selected to complete the preliminary test, which was used tosurvey the internal consistency reliability of the Chinese-Diabetes EmpowermentScale-Short Form. Then the pregnant women were divided into experimental group andcontrol group by the table of random numbers. Experimental group and control groupwere intervened with the conversation map tool and traditional health education mode.The group with conversation map tool empowerment education mode includedresearcher and nurses of obstetrical department, who used conversation map tool to thepregnant women at their first day in hospital. The health education of control group wasimplemented by responsible nurses of obstetrical department, and the education ofgestational diabetes mellitus was given one-to-one by stages from the first day inhospital including diet, exercise, blood glucose monitoring, and so on.Self-designed general information questionnaire of gestational diabetes mellitus,blood glucose monitoring record table and postpartum pregnant women and newbornsstatus record table were used to record the demographic data, blood glucose while inhospital and monitoring indexes of postpartum pregnant women and newborns of two groups. The Chinese-Diabetes Empowerment Scale-Short Form and GeneralSelf-Efficacy Scale were used to survey the two groups before the intervention of thefirst time in hospital and before the delivery of the second time in hospital. These wereused to discuss and evaluate the effect of conversation map tool empowermenteducation mode on each ability and objective indicator of pregnant women withgestational diabetes mellitus.Date was arranged and analyzed with SPSS13.0. The Cronbach’s alpha coefficientwas used to analyze the internal consistency reliability of Chinese-DiabetesEmpowerment Scale-Short Form. Statistical methods included descriptive statistics, ttest, and chi square test.Results:After the second time in hospital of pregnant women before their delivery,47pregnant women of experimental group and45pregnant women of control group wereselected for statistical data according to inclusion and exclusion criteria.1.The internal consistency reliability of Chinese-Diabetes EmpowermentScale-Short FormThe C-DES-SF includes8items. According to the analysis of the reliability, theCronbach’s alpha coefficient of the questionnaire is0.874.2. Comparative result of empowerment ability and general self-efficacy of twogroups（1）The t-test was used to compare the empowerment ability before and after theintervention. Difference of the empowerment ability between two groups before theintervention had no statistical significance(P>0.05). Difference of the empowermentability between two groups after the intervention had statistical significance(P<0.05),and the comparison of each group before and after the intervention had statisticaldifference(P<0.05).（2）The t-test was used to compare the general self-efficacy before and after theintervention. Difference of the general self-efficacy between two groups before theintervention had no statistical significance(P>0.05). Difference of the generalself-efficacy between two groups after the intervention had statistical significance(P<0.05), and the comparison of each pregnant woman of two groups before and afterthe intervention had statistical difference(P<0.05).3. Comparative result of blood glucose level of two groups （1）The t-test was used to compare the fasting,2h after breakfast,2h after lunch,2hafter dinner blood-glucose of experimental group and control group(P<0.05). Thedifference between the two groups had statistical significance.（2）After getting the mean value of fasting plasma glucose of each group, the resultshowed that the plasma glucose rangeability of experimental group was less than thecontrol group at the first time in hospital and leave hospital, at the second time inhospital and the day before delivery, the fasting plasma glucose fluctuation ofexperimental group was more stable than the control group.4. Comparative result of postpartum pregnant women and newborns status of twogroupsThe t-test was used to compare the monitoring indexes of postpartum pregnantwomen and newborns of two groups. Difference of postoperative exsufflation time, thetime of bed leaving, sleep quality for24hours, weight and complication rate ofnewborns had statistical significance(P<0.05). And there was no statistical difference ofcomplication rate of pregnant women, Apgar score, blood glucose and headcircumference of newborns(P>0.05).Conclusion:1. The conversation map tool empowerment education mode can help the pregnantwomen to manage the gestational diabetes mellitus during the second and third trimesterof pregnancy effectively.2. The empowerment ability and general self-efficacy of experimental group issuperior than control group after the intervention.3. Blood glucose level of experimental group is superior than control group afterthe intervention; the stability of fasting plasma glucose of the experimental groupwas superior to the control group.4. Postoperative recover of the pregnant women and newborns in experimentalgroup is superior than control group.5. The conversation map tool empowerment education mode was accepted bypregnant women with gestational diabetes mellitus and has great significance ofpopularizing.