妊娠期糖尿病患者血糖管理促进与阻碍因素质性研究的Meta整合
Meta-integration of Qualitative Studies on Factors Promoting and Hindering Glycemic Control in Women with Gestational Diabetes Mellitus
潘瑶 1邸铁涛 2张瑶瑶 2张春玲 2陈露 2吴和香 1张翼美1
作者信息
- 1. 550025 贵州省贵阳市，贵州中医药大学护理学院
- 2. 550003 贵州省贵阳市，贵州中医药大学第二附属医院
- 折叠
摘要
背景 近年来，妊娠期糖尿病发病人数增多，严重危及母婴健康，通过规范化血糖管理，可有效改善母婴不良结局。当前质性研究虽深入探讨患者血糖管理行为与体验，但相对零散，亟需通过Meta整合全面了解患者血糖管理的促进与阻碍因素。目的 系统整合妊娠期糖尿病患者血糖管理促进与阻碍因素的质性研究，为优化管理策略提供循证依据。方法 检索PubMed、Web of Science、Embase、CINAHL、Cochrane Library、中国知网、万方数据知识服务平台、维普网和中国生物医学文献数据库中关于妊娠期糖尿病患者血糖管理促进与阻碍因素的质性研究文献，检索时限为建库至2025-06-30。2名研究者独立采用澳大利亚JBI循证卫生保健中心质性研究质量评价标准评价文献质量，并使用NoteExpress软件进行文献筛选，运用汇集性整合方法整合结果。结果 共纳入20篇文献，提炼44个研究结果，归纳为10个类别，综合为2个整合结果：促进因素，包括母婴健康责任感、积极的自我调节、多元化社会支持、医疗支持与干预；阻碍因素，包括内源性认知障碍与外源性污名压力、情绪负担与心理调适困难、孕期血糖管理面临多重实践困境、医疗服务体系尚不完善、血糖监测执行障碍、社会经济与文化环境挑战。结论 妊娠期糖尿病患者血糖管理受个体认知、医疗体系和社会支持等多因素影响，医护人员应通过激发患者自我管理内驱力、强化认知情绪干预、整合多元支持资源，全面提升患者血糖管理水平。
Abstract
BackgroundIn recent years, the incidence of gestational diabetes mellitus has increased, posing a serious threat to maternal and infant health. Standardized glycemic management can effectively improve adverse maternal and infant outcomes. While current qualitative studies have explored patients' blood glucose management behaviors and experiences in depth, the findings are relatively fragmented.Therefore, a meta-synthesis is urgently needed to comprehensively understand the facilitating and hindering factors for patients' blood glucose management. ObjectiveTo systematically synthesize qualitative studies on factors promoting and hindering blood glucose management in patients with gestational diabetes, providing evidence-based guidance for optimizing management strategies. MethodsWe searched PubMed, Web of Science, Embase, CINAHL, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, VIP Database, and China Biomedical Literature Database for qualitative studies on factors promoting and hindering blood glucose management in patients with gestational diabetes. The search period spanned from database inception to June 30, 2025.Two researchers independently assessed study quality using the Joanna Briggs Institute(JBI) Australian Centre for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research.Literature screening was conducted using NoteExpress software, and results were synthesized using a meta-synthesis approach.ResultsA total of 20 studies were included, yielding 44 research findings categorized into 10 themes and synthesized into 2 integrated results: Facilitating factors included maternal-infant health responsibility, proactive self-regulation, diverse social support, and medical support and interventions.Barriers factors included endogenous cognitive impairments and exogenous stigma pressures, emotional burdens and difficulties in psychological adaptation, multiple practical challenges in managing blood glucose during pregnancy, an imperfect healthcare system, obstacles in implementing blood glucose monitoring, and socioeconomic and cultural environmental challenges. ConclusionBlood glucose management in women with gestational diabetes mellitus is influenced by multiple factors, including individual cognition, the healthcare system, and social support. Healthcare providers should enhance patients' blood glucose management by fostering patients' intrinsic motivation for self-management, strengthening cognitive and emotional interventions, and integrating diverse support resources.关键词
妊娠期糖尿病/血糖管理/促进因素/阻碍因素/质性研究/Meta 整合引用本文复制引用
潘瑶,邸铁涛,张瑶瑶,张春玲,陈露,吴和香,张翼美.妊娠期糖尿病患者血糖管理促进与阻碍因素质性研究的Meta整合[EB/OL].(2026-03-19)[2026-03-22].https://chinaxiv.org/abs/202603.00109.学科分类
医学研究方法/妇产科学
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