Holistic Care and Diabetes Management Behaviors among Pregnant Women with Gestational Diabetes Mellitus: Challenges and Opportunities in Nursing Practice.

Abstract

This mixed-methods explanatory sequential study aimed to 1) examine the relationships and predictive influence of holistic care on diabetes self-management behavior among pregnant women with gestational diabetes mellitus (GDM) and 2) explore experiences and contextual factors influencing diabetes self-management behavior from the perspectives of pregnant women and nurses. Phase 1 employed a quantitative correlational design. Participants were 282 pregnant women diagnosed with GDM who attended antenatal care at Surat Thani Hospital and were selected through purposive sampling. Research instruments included a holistic care scale and a diabetes self-management behavior scale, which demonstrated acceptable content validity (IOC = 0.67-1.00) and good internal consistency (Cronbach’s α = 0.84-0.88). Data were analyzed using descriptive statistics, Pearson’s correlation, and multiple regression analysis. Phase 2 consisted of a qualitative study involving in-depth interviews with 10 pregnant women from Phase 1 and 5 nurses providing care for women with GDM. Qualitative data were analyzed using thematic content analysis.

The findings revealed that holistic care was significantly and positively associated with diabetes self-management behavior, particularly in physical, psychological, and social dimensions. Qualitative findings further indicated that family support, continuous nurse follow-up, and understanding women’s life contexts played important roles in enhancing motivation and capacity for diabetes self-management. The results highlight the importance of integrating holistic care into antenatal nursing practice to promote appropriate diabetes self-management behavior in real-world clinical settings.