医护人员妊娠糖尿病预防管理认知的质性研究

Cognition of medical and nursing staff on prevention and management of gestational diabetes mellitus:a qualitative study

目的了解医护人员对妊娠糖尿病(GDM)预防管理的认知,为构建规范化的GDM预防管理体系提供参考。方法本研究为描述性质性研究。采用目的抽样法,于2022年6月—2023年11月选取北京市10家三级甲等综合医院及6家社区卫生服务中心从事GDM管理工作的22名临床医疗和护理专家为研究对象。采用半结构化访谈收集资料,并运用主题分析法进行资料分析。结果通过对访谈资料的分析与归纳,共提取出2个主题,分别为GDM预防管理面临的挑战(包括缺乏规范化的管理体系、缺乏质量评价指标、缺乏专业的医护人员、医护人员预防意识薄弱、培训不足);GDM预防管理体系的作用(包括政府的主导作用、医院的责任主体作用、社区卫生服务机构的前哨作用、社会的辅助作用、家庭的协同管理作用、个人的执行主体作用)。结论GDM预防管理实践面临多重挑战,我国应加强GDM预防管理体系的建设,构建质量评价指标体系,加强对医护人员的相关教育培训,同时应注重发挥政府、医院、社区卫生服务机构、家庭及个人在GDM预防管理实践中的作用。

Objective To explore the cognition of medical and nursing staff on prevention and management of gestational diabetes mellitus(GDM),so as to provide reference for the construction of a standardized GDM prevention and management system.Methods This study was a descriptive qualitative study.From June 2022 to November 2023,purposive sampling was used to select 22 clinical medical and nursing experts engaged in GDM management from ten ClassⅢGrade A general hospitals and six community health service centers in Beijing as the research subject.Semi-structured interviews were used to collect data,and thematic analysis was used for data analysis.Results Through the analysis and summarization of interview data,two themes were proposed,namely the challenges faced by GDM prevention and management(lack of standardized management system,lack of quality evaluation indicators,lack of professional medical and nursing staff,weak prevention awareness of medical and nursing staff,insufficient training),and the role of the GDM prevention management system(including the leading role of the government,responsibility subject role of hospitals,outpost role of community health service institutions,auxiliary role of society,collaborative management role of families,execution subject role of individuals).Conclusions GDM prevention management practices face multiple challenges.China should enhance the construction of the GDM prevention and management system,establish a quality evaluation index system,strengthen education and training for medical and nursing staff,and pay attention to the role of government,hospitals,community health service institutions,families and individuals in the GDM prevention and management system.