Oral glucose tolerance test-The imperfect gold standard for gestational diabetes screening: A qualitative study involving clinicians in regional, rural and remote areas of Western Australia.

clinical decision making gestational diabetes obstetric clinicians oral glucose tolerance test regional, rural and remote screening women's health

Journal

Health promotion journal of Australia : official journal of Australian Association of Health Promotion Professionals
ISSN: 1036-1073
Titre abrégé: Health Promot J Austr
Pays: Australia
ID NLM: 9710936

Informations de publication

Date de publication:
07 Jul 2024
Historique:
revised: 06 06 2024
received: 17 09 2023
accepted: 17 06 2024
medline: 8 7 2024
pubmed: 8 7 2024
entrez: 8 7 2024
Statut: aheadofprint

Résumé

The oral glucose tolerance test is the 'gold standard' for detecting gestational diabetes in Australian and International guidelines. Test completion in regional, rural and remote regions may be as low as 50%. We explored challenges and enablers for regional, rural and remote antenatal clinicians providing gestational diabetes screening to better understand low oral glucose tolerance test completion. We conducted a qualitative descriptive study using semi-structured interviews. Participants eligible for the study were doctors or midwives providing antenatal care in regional, rural and remote Western Australia, between August 2019 and November 2020. Interviews were recorded digitally and transcribed into a Word document. We conducted a thematic analysis after initial categorisation and deduction of themes through workshops involving the research team. We found a diversity of viewpoints on oral glucose tolerance test reliability for detecting gestational diabetes. Themes that emerged were; good collaboration between antenatal clinicians is required for successful screening; screening occurs throughout pregnancy using various tests; clinicians make significant efforts to address barriers; clinicians prioritise therapeutic relationships. Effective universal screening for gestational diabetes in regional, rural and remote Western Australia is difficult and more complex in practice than guidelines imply. Detecting gestational diabetes requires creative solutions, early identification of at risk women and trust and collaboration between clinicians and women. SO WHAT?: Detection of gestational diabetes in regional, rural and remote Western Australia remains poorly completed. New strategies are required to adequately identify women at risk of adverse birth outcomes relating to hyperglycaemia in pregnancy.

Identifiants

pubmed: 38973209
doi: 10.1002/hpja.899
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024 The Author(s). Health Promotion Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of Australian Health Promotion Association.

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Auteurs

Andrew B Kirke (AB)

The Rural Clinical School of Western Australia, The University of Western Australia, Bunbury, Australia.

Erica Spry (E)

The Rural Clinical School of Western Australia, The University of Western Australia, Broome, Australia.
Kimberley Aboriginal Medical Services, Broome, Australia.

David Atkinson (D)

The Rural Clinical School of Western Australia, The University of Western Australia, Broome, Australia.

Craig Sinclair (C)

School of Psychology, The University of New South Wales, Kensington, Australia.

Julia V Marley (JV)

The Rural Clinical School of Western Australia, The University of Western Australia, Broome, Australia.

Classifications MeSH