Affiliation:
1. Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
2. Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
Abstract
OBJECTIVE | Treatment of gestational diabetes mellitus and type 2 diabetes during pregnancy can improve maternal and neonatal outcomes; yet, self-care burdens for pregnant women with diabetes are high, particularly for low-income and minority women. Although prior studies have investigated patient-perceived barriers and facilitators to diabetes self-management during pregnancy, little work investigates the perspectives of health care providers (HCPs) on these factors. The objective of this study was to investigate HCPs’ perspectives on patient barriers and facilitators to diabetes care during pregnancy.
METHODS | In this qualitative investigation, focus groups were conducted using a semistructured interview guide designed to elicit HCPs’ perceptions of patient barriers and facilitators to successful diabetes-related self-care. HCPs included physicians, nurses, health educators, and other personnel who care for low-income pregnant women with diabetes. Interviews were transcribed verbatim. Transcripts were analyzed using the constant comparative technique to identify themes and subthemes, using the Social Ecological Model as a theoretical framework.
RESULTS | Participants (n = 29) identified barriers and facilitators to women’s achievement of optimal diabetes self-care according to six levels (environment, access, institution, interpersonal, knowledge, and individual). Example subthemes included inflexible work schedule, poor access to medication and supplies, overburdened clinic, perceived patient “policing,” and low health literacy. Individual factors included self-efficacy, motivation, and engagement. HCPs identified barriers, but not facilitators, for each theme.
CONCLUSION | HCPs described facilitators and barriers to diabetes care at all levels of the Social Ecological Model. These data can inform interventions to dismantle barriers patients face and thus create meaningful health care interventions to improve outcomes for low-income pregnant women with diabetes.
Publisher
American Diabetes Association
Subject
Endocrinology, Diabetes and Metabolism,Internal Medicine
Cited by
10 articles.
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