Study On Self-efficacy And Self-management Status And Influencing Factors Of Patients With Gestational Diabetes Mellitus In Changsha

Objective:To understand the status of self-efficacy and self-management of patients with gestational diabetes mellitus,exploring the factors related to self-efficacy and self-management,and analyzing the correlation between self-efficacy and self-management,it will provide a theoretical basis for improving clinical nursing.Methods:This study is using stratified cluster sampling method,2 tertiary hospitals and 2 secondary hospitals are selected from public hospitals above Grade 2 and above in Changsha.The patients' general information questionnaire,Self-efficacy questionnaire,Self-management behavioral questionnaire and the Diabetes knowledge test,Social support scale,Pregnancy-related anxiety questionnaire were used to investigate for 238 patients with gestational diabetes mellitus who treated in the above four hospitals between May 2017 and October 2017.Using Epdata3.1 for inputing data and SPSS20.0 statistical software for analyzing data.The statistical' methods are including descriptive analysis,t-test,one-way analysis of variance,pearson correlation analysis,and multiple linear stepwise regression analysis.Results:(1)The score of self-efficacy in gestational diabetes mellitus was(31.55±6.66)points,the score rate was 70.09%.The score of self-management was(57.35 ± 14.39)points and the score rate was 63.33%.(2)The single factor analysis showed that the difference in self-efficacy score was statistically significant(P<0.05)among gestational diabetes patients of different ages,gestational age,place of residence,income level,medical insurance,family history of diabetes,weight gain,parity,fasting blood glucose,2 h postprandial blood glucose,and whether to participate in a day-care clinic;the difference in self-efficacy score was statistically significant(P<0.05)among gestational diabetes patients of gestational age,place of residence,education level,income level,medical insurance,family history of diabetes,weight gain,fasting blood glucose,2 h postprandial blood glucose,and whether to participate in a day-care clinic.(3)The multivariate linear stepwise regression analysis showed that the self-efficacy of gestational diabetes patients are mainly affected by medical insurance,parity,residence,self-management behavior and social support;the self-management behavior of gestational diabetes patients are mainly affected by fasting blood glucose,weight gain,postprandial 2h blood glucose,self-efficacy and social support.(4)The Pearson correlation analysis was performed between the total score of self-efficacy and its four dimensions,and the total score of self-management and its four dimensions.The results showed that there was a positive correlation(r=0.277-0.634,P<0.01)between the total score of self-efficacy and its four dimensions and the total score of self-management and its four dimensions.Conclusions:(1)Gestational diabetes patients have a moderate level of self-efficacy and a moderate level of self-management.(2)The influencing factors of the total self-efficacy of gestational diabetes mellitus including medical insurance,parity,residence,self-management and social support.The influencing factors of the total self-management of gestational diabetes mellitus including self-efficacy,social support,fasting blood glucose,weight gain,and 2 h postprandial blood glucose.(3)The higher the level of self-efficacy in patients with gestational diabetes mellitus,the higher the level of self-management;the higher the level of self-management with patients,the higher the level of self-efficacy,self-efficacy and self-management affect each other.