การพัฒนาโปรแกรมพฤติกรรมการดูแลสุขภาพหญิงตั้งครรภ์ที่มีภาวะน้ำตาลในเลือดสูง

Ratchaya  Rattanatavorn; Sunisa  Khoakon; Chananchida  Butkumchote

Authors

Ratchaya Rattanatavorn School of Nursing, Eastern Asia University
Sunisa Khoakon School of Nursing, Eastern Asia University
Chananchida Butkumchote School of Nursing, Eastern Asia University

Keywords:

pregnant women with hyperglycemia, self-management, health care behaviors

Abstract

This participatory action research employed a one-group pretest-posttest quasi-experimental design with two objectives: to develop a health care behavior program for pregnant women with hyperglycemia, and to compare mean health care behavior scores and mean blood glucose levels before and after program participation. A purposive sample of 50 pregnant women with hyperglycemia was recruited from the antenatal care clinics at Khlong Luang Hospital and Thanyaburi Hospital in Pathum Thani Province, Thailand. The intervention program was theoretically grounded in the constructs of self-management, self-efficacy, and social support, and was implemented over 24 weeks through the Participatory Action-Oriented Research (PAOR) process. Program delivery modalities comprised group meetings, home visits, and telephone follow-up. Research instruments included the health care behavior program, a health manual and self-monitoring diary, assessment tools for self-management, self-efficacy, and social support, a personal and health data questionnaire, a health care behavior questionnaire, and a blood glucose recording form. All instruments underwent content validity verification, with Cronbach’s alpha coefficients ranging from .76 to .84. Data were analyzed using descriptive statistics and the dependent t-test.
The findings revealed that following program participation, participants demonstrated significantly higher mean health care behavior scores compared with baseline (M = 4.24, SD = .56 vs. M = 2.94, SD = .59, respectively; t = - 25.92, p < .05). Mean blood glucose levels were also significantly reduced post-intervention (M = 118.42 mg/dL, SD = 14.76 vs. M = 142.36 mg/dL, SD = 18.52, respectively; t = - 12.84, p < .05). Furthermore, scores across all three psychosocial domains- self-management, self-efficacy, and social support- improved significantly from moderate to high levels (p < .05). These findings demonstrate that the PAOR-based health care behavior program effectively promotes health-protective behaviors and achieves clinically meaningful glycemic control among pregnant women with hyperglycemia. The program warrants broader implementation across community and clinical settings as a replicable, evidence-based intervention for this at-risk population.

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References

American Diabetes Association Professional Practice Committee (2022). 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2022. Diabetes care, 45(Suppl 1), S17–S38. https://doi.org/10.2337/dc22-S002

Bandura, A. (Ed.). (1997). Self-efficacy in changing societies. Cambridge university press.

Churos, S., Kasinang, P., & Kaeokhieo, B. (2023). Pregnancy with gestational diabetes mellitus: Contributing factors and barriers to self-care. Singburi Hospital Journal. 32(2), A1-A16.

Creer, T. L. (2000). Self-management of chronic illness. In Handbook of self-regulation (pp. 601-629). Academic Press.

Ferrara, A. (2020). Translating research on diabetes and obesity in pregnancy into prevention: The 2019 Norbert Freinkel Award Lecture. Diabetes Care, 43(11), 2653-2642. https://doi.org/10.2337/dci19-0040

Gitlin, E. S., Demetres, M., Vaidyanathan, A., Palmer, N., Lee, H., Loureiro, S., Radwan, E., Tuschman, A., Mathad, J., & Chebrolu, P. (2024). The prevalence of gestational diabetes among underweight and normal weight women worldwide: A scoping review. Frontiers in Clinical Diabetes and Healthcare, 5, 1415069. https://doi.org/10.3389/fcdhc.2024.1415069

House, J. S. (1981). Work stress and social support. Reading, MA: Addison-Wesley.

Kanfer, F. H., & Gaelick-Buys, L. (1991). Self-management methods. In F. Kanfer & A. Goldtein (Eds.), Helping people change: A text book of methods (4th ed.). New York, NY: Pergamonpress.

Huang, Y., Li, S., Lu, X., Chen, W., & Zhang, Y. (2024). The effect of self-management on patients with chronic diseases: A systematic review and meta-analysis. Healthcare, 12(21), 2151. https://doi.org/10.3390/healthcare12212151

International Diabetes Federation (IDF). (2024). IDF Diabetes Atlas (11th ed.). Brussels, Belgium: International Diabetes Federation.

McIntyre, H. D., Fuglsang, J., Kampmann, U., Knorr, S., & Ovesen, P. (2022). Hyperglycemia in pregnancy and women’s health in the 21st century. International Journal of Environmental Research and Public Health, 19(24), 16827. https://doi.org/10.3390/ijerph192416827

Medical Service Department, Bangkok Metropolitan. (2025). Number of pregnant women diagnosed with gestational diabetes.

Netimetee, S., & Boobpamala, S. (2022). nursing care for pregnant women with gestational diabetes mellitus during pregnancy. Journal of Health and Nursing Education, 28(1), e256658.

Panmuang, S., Sutthiprapa, A., & Phuakphan, W. (2023). The development of self-care program for pregnant women with gestational diabetes mellitus. Journal of Health Research and Development, Nakhon Ratchasima Provincial Public Health Office, 9(1), 130-144.

Polit, D., & Beck, C. (2020). Essentials of nursing research: Appraising evidence for nursing practice. Lippincott Williams & Wilkins.

Singtan, J. (2022). Factors predicting diabetes prevention behaviors among postpartum women with gestational diabetes mellitus (Master of nursing science program). Faculty of Nursing, Burapha University, Chonburi.

Szekér, L., Gaudiino, M., Van den Broeck, A., Lenaerts, K., Vandekerckhove, S., Vanmarcke, S., . . . Riso, S. (2023). Psychosocial risks to workers' well-being: Lessons from the COVID-19 pandemic. Psychosocial risks to workers' well-being: Lessons from the COVID-19 pandemic, 1-90. Retrieved from https://kuleuven.limo.libis.be/discovery/search?query=any,contains,LIRIAS4123375&tab=LIRIAS&search_scope=lirias_profile&vid=32KUL_KUL:Lirias&offset=0

World Health Organization (WHO). (2016). WHO recommendations on antenatal care for a positive pregnancy experience. Geneva: WHO.