EFFECT OF THE PERCEIVED IMPACT OF GESTATIONAL DIABETES ON TREATMENT ADHERENCE AND HELP SEEKING (DIABETES MELLITUS, HELP-SEEKING).
Contributors: University of Pennsylvania.
Published: 1993
Number of pages: 125
Subjects: Health Sciences, Nursing.; Health Sciences, Obstetrics and Gynecology.
Description: Pregnancies complicated by gestational diabetes mellitus (GDM) are considered high risk especially if inadequate glucose control, inadequate fetal surveillance or lack of adherence to the treatment plan complicates the pregnancy. Risk reduction requires extensive behavioral modification potentially increasing the stress experienced by pregnant women beyond the "normal" stress of pregnancy. This study examined the relationship between women's perceptions of the impact of GDM, treatment adherence, professional helpseeking, and outcomes. Perceived impact of GDM was measured with the Impact of Events Scale (Horowitz et al., 1979). Treatment adherence included percentage of: recommended self blood glucose monitoring (SBGM), incidence of hypo- and hyperglycemia, obstetrical visits kept, and dietary adherence. Helpseeking was measured by contacts between subjects and Perinatal Clinical Nurse Specialists (PCNS). Helpseeking episodes were classified using Arnold's (1991) Taxonomy of Nurse Specialist Functions in Transitional Follow Up Care. Outcomes included incidence of preterm labor, type of delivery, neonatal birthweight, gestational age, and neonatal glucose levels.

Twenty-nine subjects were studied from diagnosis of GDM until delivery. Subjects were primarily poor, unmarried African American women. Correlational analyses revealed significant negative correlations between impact and SBGM (r = $-$.38, p =.04) and impact and hypoglycemia (r = $-$.31, p =.10). Positive correlations were noted between adherence to obstetrical visits and SBGM (r =.34, p =.07). The majority of helpseeking episodes were classified as seeking knowledge (46%). Impact and helpseeking were positively correlated (r =.70, p =.03). There were no significant relationships between impact and outcomes.

These results suggest women who perceive GDM to have a great impact on their lives being less adherent to recommended behavioral tasks that can influence blood glucose control, potentially increasing risk. Women who perceive GDM to have a great impact on their lives also sought more help from the PCNS. However, these women were more likely to seek psychological, social and economic help than they were to seek knowledge that would enable them to better care for themselves. These results accentuate needed support for this vulnerable population of women to assist them to resolve emotional, social and financial issues so they can subsequently seek knowledge to provide optimal self care.
Notes: Source: Dissertation Abstracts International, Volume: 54-03, Section: B, page: 1328.

Thesis (PH.D.)--UNIVERSITY OF PENNSYLVANIA, 1993.

School code: 0175.