The holistic maternity care needs of women with Gestational Diabetes Mellitus: A systematic review with thematic synthesis.

Consumer needs GDM Gestational diabetes mellitus Holistic care Systematic review

Journal

Women and birth : journal of the Australian College of Midwives
ISSN: 1878-1799
Titre abrégé: Women Birth
Pays: Netherlands
ID NLM: 101266131

Informations de publication

Date de publication:
06 Sep 2023
Historique:
received: 25 05 2023
revised: 16 08 2023
accepted: 17 08 2023
medline: 9 9 2023
pubmed: 9 9 2023
entrez: 8 9 2023
Statut: aheadofprint

Résumé

Models of care for women with gestational diabetes mellitus (GDM) have evolved in an ad hoc way and do not meet women's needs. GDM affects 50,000 Australian women per annum with prevalence quadrupling in the last ten years. Many health services are struggling to provide a quality service. People with diabetes are calling for care that focuses on their wellbeing more broadly. To examine the holistic (emotional, social, economic, and spiritual) care needs of women with GDM. Qualitative and mixed-methods studies capturing the healthcare experiences of women with GDM were searched for in CINAHL, Medline, Web of Science and Scopus. English-language studies published between 2011 and 2023 were included. Quality of studies was assessed using Crowe Critical Appraisal Tool and NVIVO was used to identify key themes and synthesise data. Twenty-eight studies were included, representing the experiences of 958 women. Five themes reflect women's holistic needs through their journey from initial diagnosis to postpartum: psychological impact, information and education, making change for better health, support, and care transition. The biomedical, fetal-centric model of care neglects the woman's holistic wellbeing resulting in high levels of unmet need. Discontinuity between tertiary and primary services results in a missed opportunity to assist women to make longer term changes that would benefit themselves (and their families) into the future. The provision of holistic models of care for this cohort is pivotal to improving clinical outcomes and the experiences of women with GDM.

Sections du résumé

PROBLEM OBJECTIVE
Models of care for women with gestational diabetes mellitus (GDM) have evolved in an ad hoc way and do not meet women's needs.
BACKGROUND BACKGROUND
GDM affects 50,000 Australian women per annum with prevalence quadrupling in the last ten years. Many health services are struggling to provide a quality service. People with diabetes are calling for care that focuses on their wellbeing more broadly.
AIM OBJECTIVE
To examine the holistic (emotional, social, economic, and spiritual) care needs of women with GDM.
METHODS METHODS
Qualitative and mixed-methods studies capturing the healthcare experiences of women with GDM were searched for in CINAHL, Medline, Web of Science and Scopus. English-language studies published between 2011 and 2023 were included. Quality of studies was assessed using Crowe Critical Appraisal Tool and NVIVO was used to identify key themes and synthesise data.
FINDINGS RESULTS
Twenty-eight studies were included, representing the experiences of 958 women. Five themes reflect women's holistic needs through their journey from initial diagnosis to postpartum: psychological impact, information and education, making change for better health, support, and care transition.
DISCUSSION CONCLUSIONS
The biomedical, fetal-centric model of care neglects the woman's holistic wellbeing resulting in high levels of unmet need. Discontinuity between tertiary and primary services results in a missed opportunity to assist women to make longer term changes that would benefit themselves (and their families) into the future.
CONCLUSIONS CONCLUSIONS
The provision of holistic models of care for this cohort is pivotal to improving clinical outcomes and the experiences of women with GDM.

Identifiants

pubmed: 37684120
pii: S1871-5192(23)00259-7
doi: 10.1016/j.wombi.2023.08.005
pii:
doi:

Types de publication

Journal Article

Langues

eng

Informations de copyright

Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.

Auteurs

Deborah Davis (D)

University of Canberra, Faculty of Health, Australia; ACT Government, Health Directorate, Australia. Electronic address: Deborah.davis@canberra.edu.au.

Ella Kurz (E)

University of Canberra, Faculty of Health, Australia.

Mary-Ellen Hooper (ME)

University of Canberra, Faculty of Health, Australia.

Marjorie Atchan (M)

University of Canberra, Faculty of Health, Australia.

Sarah Spiller (S)

Health Care Consumers Association, Australia.

Julie Blackburn (J)

University of Canberra, Faculty of Health, Australia.

Mary Bushell (M)

University of Canberra, Faculty of Health, Australia.

Vivienne Lewis (V)

University of Canberra, Faculty of Health, Australia.

Myra Leung (M)

University of Canberra, Faculty of Health, Australia.

Indira Samarawickrema (I)

University of Canberra, Faculty of Health, Australia.

Cathy Knight-Agarwal (C)

University of Canberra, Faculty of Health, Australia.

Classifications MeSH