Application Of Spouse Synchronous Empowerment Education In Pregnant Women With High Risk Of Gestational Diabetes Mellitus

Objectives1.Through qualitative interviews with high risk pregnant women with gestational diabetes mellitus and their spouses,to explore the characteristics and influencing factors of health management behavior change of high risk pregnant women with gestational diabetes mellitus,which is intend to provide a scientific basis for the next intervention program.2.Taking empowerment education as the theoretical framework,combined with the results of qualitative interviews,this research constructed a spouse synchronous empowerment education program for high risk pregnant women with gestational diabetes mellitus,and verified the application effect of this education program in high risk pregnant women with gestational diabetes mellitus,which is capable of providing basis and practical guidance for controlling the occurrence and development of gestational diabetes mellitus and optimizing clinical health education program.Methods1.Qualitative research:With the help of interview outline,13 pregnant women with high risk of gestational diabetes mellitus and 7 spouses were interviewed semi structurally to explore the characteristics and influencing factors of health management behavior change of pregnant women with high risk of gestational diabetes mellitus,and the interview data were sorted out and analyzed by Colaizzi 7-step analysis method.2.Application of spouse synchronous empowerment education in high risk pregnant women with gestational diabetes mellitus:Based on the literature review and qualitative research results,combined with expert suggestions and the implementation of pre-test,this study constructed the spouse synchronous empowerment education program.From June 2019 to December 2019,among the pregnant women who had been registered for prenatal examination in the outpatient department of Obstetrics Department of a XXX hospital in Qingdao,80 high risk pregnant women with gestational diabetes mellitus who met the inclusion criteria were selected as the research objects.The subjects and their spouses were randomly divided into intervention group(n=40)and control group(n=40),and both groups of pregnant women and their spouses signed informed consent.The pregnant women and their spouses in the control group received routine health education,while the pregnant women and their spouses in the intervention group received spouse empowerment education.One face-to-face intervention(40 min)was given in the first trimester of pregnancy,while during 13～32 weeks of gestation,the patients were intervened once a month(60 min)for 6 times,in addition,the patients were followed up by telephone every two weeks during the intervention.The gestational diabetes incidence rate,oral glucose tolerance test results,perceived social support score and spouses positive feeling score of two groups of pregnant women were collected at 28 weeks of gestation.Before delivery,the total weight gain and perceived social support scores of the two groups were collected,and after delivery,the delivery way and the occurrence of macrosomia were obtained.Microsoft Excel 2019 was used for data entry,and IBM SPSS statistics 26.0 software was used for t testχ~2test,rank sum test,repeated measurement analysis of variance and other statistical analysis.Results1.Qualitative research results:After sorting out and analyzing the interview data,the following four themes are extracted:Lack of knowledge about disease and health management,the health management behaviors of positive control and stage negative coping,disease related uncertainty,the factors influencing the change of health management behavior include:Self-behavior habits,family social support,professional support,environmental factors,etc.2.Application effects of spouse synchronous empowerment education in high risk pregnant women with gestational diabetes mellitus:(1)The baseline data such as general information,clinical data,perceived social support score and positive feeling score of pregnant women and spouse were compared between the two groups,the difference was not statistically significant(P>0.05).(2)The incidence rate of gestational diabetes mellitus:When the intervention lasted for 28 weeks,the incidence of gestational diabetes in intervention group and control group was 7.90%and 29.70%respectively,the difference was statistically significant(χ~2=5.89,P<0.05)(3)Comparison of glucose tolerance test results:After 28 weeks of intervention,the 1h blood glucose(t=-2.84,P<0.05)and 2 h blood glucose(t=-6.03,P<0.05)after taking glucose of the intervention group were lower than those of the control group,the differences were statistically significant.(4)Comparison of the weight gain in pregnancy:the proportion of over-weight growth in pregnant women in intervention group was significantly lower than that of the control group,and the appropriate weight growth rate was higher than that of the control group,there was significant difference in the total weight gain of pregnant women between the two groups(z=-2.42,P<0.05).(5)Comparison of perceived social support scores between the two groups:The results of repeated measurement ANOVA showed that time effect had a significant effect on the total score and each dimension of perceived social support(P<0.05).The inter group effect had no significant effect only on the friend support dimension(F=3.10,P>0.05).The interaction effect had a significant effect on the family support dimension(F=22.69,P<0.05)and the total score(F=20.09,P<0.05).LSD-t test results showed that the family support dimension score and total score of the intervention group were:Before delivery>28 weeks of pregnancy>before intervention(P<0.05).The t test results showed that the family support dimension(t=6.73,P<0.05),other support dimensions(t=2.98,P<0.05)and total score(t=6.85,P<0.05)of the intervention group were higher than those of the control group at 28 weeks of pregnancy and before delivery,and the differences were statistically significant.(6)Comparison of positive feeling scores between the two groups:After 28 weeks of intervention,the scores of self-affirmation dimension(t=-5.12,P<0.05),life prospect dimension(z=-4.07,P<0.05)and total positive feeling score(t=-7.46,P<0.05)of spouses in the intervention group were higher than those in the control group,and the differences were statistically significant.Conclusions1.There are many difficulties and obstacles in the process of health management of high risk pregnant women with gestational diabetes mellitus,which are affected by their self-behavior habits,family social support,professional support and environmental factors.Therefore,it is urgent and essential to explore an efficient and personalized health education program for high risk pregnant women with gestational diabetes mellitus.2.The synchronous empowerment education in the study can improve blood glucose level in pregnant women with high risk of gestational diabetes,reduce the incidence rate of gestational diabetes mellitus,effectively control excessive weight gain during pregnancy,and increase the level of social support and increase the positive feelings of spouses.In short,spouse synchronous empowerment education is a positive and effective health education model,which is worthy of clinical application.