Reasons for women's non-participation in follow-up screening after gestational diabetes |
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| Institution: | 1. Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej, 14, 9220 Aalborg Øst, Denmark;2. Department of Midwifery, University College of Northern Denmark, Selma Lagerløfs Vej 2, 9220 Aalborg Øst, Denmark;1. Faculty of Social Sciences, Department of Health Studies, University of Stavanger, Stavanger, Norway;2. Institute of Health and Care Sciences, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden;1. Health Policy and Research, Health and Social Development, American Institutes for Research, Silver Spring, Maryland;2. Obesity Prevention Program, Department of Population Medicine Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts;3. Social & Scientific Systems, Inc., Silver Spring, Maryland;1. Australian Research Centre for Health of Women and Babies (ARCH), Robinson Research Institute, School of Paediatrics and Reproductive Health, The University of Adelaide, 72 King William Road, North Adelaide, 5006, Adelaide, SA, Australia;2. Liggins Institute, The University of Auckland, Private Bag 92019 Victoria Street West, Auckland 1142 West Auckland 1142, New Zealand;1. Women''s College Research Institute, Women''s College Hospital, Toronto, Ontario, Canada;2. Faculty of Health Sciences, Western University, Arthur and Sonia Labatt Health Sciences Building, London, Ontario, Canada;3. Division of Endocrinology and Metabolism, St. Michael''s Hospital, Toronto, Ontario, Canada;4. Department of Medicine, University of Toronto, Toronto, Ontario, Canada;5. Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada;6. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada;1. Robinson Research Institute, The University of Adelaide, Australia;2. Liggins Institute, The University of Auckland, New Zealand |
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| Abstract: | BackgroundDue to the increased risk of type 2 diabetes, follow-up screening after birth is recommended to women with previous gestational diabetes. Low participation in such screening has been shown to delay detection of diabetes with potentially serious consequences for the women's future health. The women's experiences of treatment and care during their pregnancies may affect participation.AimThis study aimed at understanding the women's experiences with treatment and care during pregnancy and to understand how these experiences influence participation in follow-up screening.MethodsA qualitative study was undertaken drawing on a phenomenological methodology. Seven women treated for gestational diabetes at a university hospital in the North Denmark Region participated in interviews.FindingsThe women experienced lack of continuity in care between hospital departments and health sectors. We identified the following causes for low participation in follow-up screening: poor coordination, little elaboration of information, a lack of clear coordination of responsibility for follow-up screening among health care professionals and absence of focus and inclusion of their individual needs and preferences.ConclusionThe women wished to be reminded of screening to increase their sense of safety. The women's experiences seem to reflect a lack of patient-centeredness during the pregnancy, which may be remedied by increasing the focus on the women's need for improved continuity in treatment and care. Participation in follow-up screening after gestational diabetes may be increased by sending reminders to the women. Raised awareness of the women's individual needs and preferences for treatment and care offers potential for improvement. |
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| Keywords: | Gestational diabetes Patient compliance Patient-centred care Decision-making Reminder systems |
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