Diabetes care in remote Australia: the antenatal, postpartum and inter-pregnancy period.
Adult
Attitude of Health Personnel
Birth Intervals
/ statistics & numerical data
Cultural Competency
Diabetes, Gestational
/ diagnosis
Female
Focus Groups
Health Services Accessibility
Health Services Needs and Demand
Humans
Infant
Male
Maternal-Child Health Services
/ organization & administration
Native Hawaiian or Other Pacific Islander
/ statistics & numerical data
Northern Territory
Perinatal Care
/ methods
Pregnancy
Pregnancy in Diabetics
/ diagnosis
Antenatal
Diabetes in pregnancy
Healthcare services
Indigenous
Postpartum
Journal
BMC pregnancy and childbirth
ISSN: 1471-2393
Titre abrégé: BMC Pregnancy Childbirth
Pays: England
ID NLM: 100967799
Informations de publication
Date de publication:
28 Oct 2019
28 Oct 2019
Historique:
received:
10
08
2019
accepted:
17
10
2019
entrez:
30
10
2019
pubmed:
30
10
2019
medline:
26
3
2020
Statut:
epublish
Résumé
Aboriginal and Torres Strait Islander women experience high rates of diabetes in pregnancy (DIP), contributing to health risks for mother and infant, and the intergenerational cycle of diabetes. By enhancing diabetes management during pregnancy, postpartum and the interval between pregnancies, the DIP Partnership aims to improve health outcomes and reduce risks early in the life-course. We describe a mixed methods formative study of health professional's perspectives of antenatal and post-partum diabetes screening and management, including enablers and barriers to care. Health professionals involved in providing diabetes care in pregnancy, from a range of health services across the Northern Territory, completed the survey (n = 82) and/or took part in interviews and/or focus groups (n = 62). Qualitative findings highlighted factors influencing the delivery of care as reported by health professionals, including: whose responsibility it is, access to care, the baby is the focus and pre-conception care. The main challenges were related to: disjointed systems and confusion around whose role it is to provide follow-up care beyond six weeks post-partum. Quantitative findings indicated that the majority of health professionals reported confidence in their own skills to manage women in the antenatal period (62%, 40/79) and slightly lower rates of confidence in the postpartum interval (57%, 33/58). These findings regarding whose role it is to provide postpartum care, along with opportunities to improve communication pathways and follow up care have informed the design of a complex health intervention to improve health systems and the provision of DIP related care.
Sections du résumé
BACKGROUND
BACKGROUND
Aboriginal and Torres Strait Islander women experience high rates of diabetes in pregnancy (DIP), contributing to health risks for mother and infant, and the intergenerational cycle of diabetes. By enhancing diabetes management during pregnancy, postpartum and the interval between pregnancies, the DIP Partnership aims to improve health outcomes and reduce risks early in the life-course. We describe a mixed methods formative study of health professional's perspectives of antenatal and post-partum diabetes screening and management, including enablers and barriers to care.
METHODS
METHODS
Health professionals involved in providing diabetes care in pregnancy, from a range of health services across the Northern Territory, completed the survey (n = 82) and/or took part in interviews and/or focus groups (n = 62).
RESULTS
RESULTS
Qualitative findings highlighted factors influencing the delivery of care as reported by health professionals, including: whose responsibility it is, access to care, the baby is the focus and pre-conception care. The main challenges were related to: disjointed systems and confusion around whose role it is to provide follow-up care beyond six weeks post-partum. Quantitative findings indicated that the majority of health professionals reported confidence in their own skills to manage women in the antenatal period (62%, 40/79) and slightly lower rates of confidence in the postpartum interval (57%, 33/58).
CONCLUSION
CONCLUSIONS
These findings regarding whose role it is to provide postpartum care, along with opportunities to improve communication pathways and follow up care have informed the design of a complex health intervention to improve health systems and the provision of DIP related care.
Identifiants
pubmed: 31660892
doi: 10.1186/s12884-019-2562-6
pii: 10.1186/s12884-019-2562-6
pmc: PMC6819653
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
389Subventions
Organisme : National Health and Medical Research Council
ID : 1092968
Organisme : National Health and Medical Research Council
ID : 1078477
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