Development of A System to Promote Self-Care Behaviors among Pregnant Women with Gestational Diabetes Mellitus in Antenatal Care Clinic, Wang Chin Hospital

Abstract

This is a research and development. The objectives of this research were to: 1) study current situation and problems of pregnant women with gestational diabetes mellitus and services provided in antenatal care clinic at Wang Chin Hospital; 2) develop a system to promote self-care behaviors among pregnant women with gestational diabetes mellitus 3) examine the outcomes of implementing the system. The research was conducted in three phases involving 11 multidisciplinary in Wang Chin Hospital including hospital director, head of nursing department, doctors and nurses in antenatal care clinic, physical therapists, nutritionist and 20 pregnant women with non-insulin-dependent diabetes, aged between 12-28 weeks, who received care in the antenatal clinic at Wang Chin Hospital during the research period from January to September 2023. Data collection was conducted using focus group, semi-structured interviews, knowledge assessment tests, self-care behavior assessment forms, system quality assessment forms, blood sugar level records, satisfaction surveys for pregnant women and service providers. The data were analyzed using percentage, mean, standard deviation and content analysis. The analysis of the research data revealed the following findings: 1) Currently, the care of pregnant women with gestational diabetes mellitus is lacking teamwork and family involvement in treatment planning and self-health promotion for these women. Pregnant women with gestational diabetes mellitus cannot control their blood sugar levels due to a lack of knowledge, awareness, guidance on self-care and follow-up or support for self-care behaviors by nurses. 2) The system for promoting self-care behaviors among pregnant women with gestational diabetes mellitus in antenatal care clinic at Wang Chin Hospital consists of (1) input factors: disease screening and diagnosis to collect a database; (2) process factors: planning and following a 5-step self-care guideline: assessment, advice, agree, arrange, and assist; (3) outcomes: increased knowledge, improved self-care behaviors, and blood sugar control; and (4) feedback: telephone follow-ups, home visits, and information through Line Open Chat. 3) The result of the system implementation showed that the pregnant women with gestational diabetes mellitus had more knowledge about diabetes, exhibited higher self-care behaviors, and could control their blood sugar levels. Both pregnant women and service providers were highest satisfied with the system.