妊娠期糖尿病患者孕期血糖管理决策困境质性研究的系统评价

Systematic review of qualitative studies on the decision dilemma of blood glucose management during pregnancy in patients with gestational diabetes mellitus

目的系统评价妊娠期糖尿病患者在孕期血糖管理过程中遇到的决策困境的质性研究,为后续制订促进患者血糖管理最佳决策的干预策略提供参考。方法计算机检索Cochrane Library、CINAHL、EMbase、PubMed、PsycINFO、ProQuest、Web of Science和中国知网、万方、维普、中国生物医学文献数据库中从建库至2022年5月收录的关于妊娠期糖尿病患者孕期血糖管理决策困境的质性研究文献。文献质量评价采用澳大利亚JBI循证卫生保健中心质性研究质量评价标准(2016版),研究结果的整合使用汇集性整合方法。结果共纳入13篇文献,提炼出56个主题,归纳为9个类别,形成了3个整合结果:血糖管理的个性化、专业信息缺乏;担忧血糖管理影响母儿健康;日常生活与血糖管理计划冲突。结论医护人员应对妊娠期糖尿病患者及其家属进行充分的血糖管理健康教育,给予个性化专业信息支持以促使其在孕期进行科学决策,同时也要为其分析不同决策的益处和风险以辅助其做出最佳决策,并强化其外部支持系统帮助落实血糖管理决策。

Objective To systematically evaluate the qualitative studies on the decision dilemma of blood glucose management during pregnancy in patients with gestational diabetes mellitus,so as to provide reference for the subsequent formulation of intervention strategies.Methods The qualitative studies on the decision dilemma of blood glucose management during pregnancy in patients with gestational diabetes mellitus in the Cochrane Library,CINAHL,EMbase,PubMed,PsycINFO,ProQuest,Web of Science,China National Knowledge Internet,Wanfang,VIP and Chinese Biomedical Database were searched from inception to May 2022.The JBI Critical Appraisal Tool for qualitative studies in Australia(2016)was used to evaluate the literature quality,and research results were summarized and integrated by integrating methods.Results A total of 13 studies were included,56 themes were extracted,and they were summarized into 9 categories,forming 3 integrated results as following,lack of personalized and professional information on blood glucose management,worring about the influence of blood glucose management on the health of mothers and children,conflict between daily life and blood glucose management plan.Conclusions Health care workers should provide gestational diabetes mellitus patients with adequate personalized professional information support on blood glucose management to facilitate scientific decision-making during pregnancy,and also analyze the benefits and risks of different decisions for patients to help them make the best decision and strengthen their external support system to help them implement blood glucose management decisions.