Challenges and support factors in managing type 2 diabetes among pregnant women in Thailand: A convergent mixed-methods study
Background: Sociocultural and behavioral factors have a multifaceted impact on maternal health. In Thailand, cultural influences significantly shape behaviors of diabetes self-management in women. However, the experience of self-managing diabetes in pregnant women with preexisting Type 2 Diabetes Me...
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| Format: | Article |
| Language: | English |
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Belitung Raya Foundation
2025-01-01
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| Series: | Belitung Nursing Journal |
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| Online Access: | https://www.belitungraya.org/BRP/index.php/bnj/article/view/3639 |
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| author | Ratchanok Phonyiam Chiao-Hsin Teng Catherine Sullivan Aunchalee Palmquist Eric Hodges Yamnia Cortés Marianne Baernholdt |
| author_facet | Ratchanok Phonyiam Chiao-Hsin Teng Catherine Sullivan Aunchalee Palmquist Eric Hodges Yamnia Cortés Marianne Baernholdt |
| author_sort | Ratchanok Phonyiam |
| collection | DOAJ |
| description | Background: Sociocultural and behavioral factors have a multifaceted impact on maternal health. In Thailand, cultural influences significantly shape behaviors of diabetes self-management in women. However, the experience of self-managing diabetes in pregnant women with preexisting Type 2 Diabetes Mellitus (T2DM) remains unclear.
Objectives: The study aimed to explore challenges and support factors of diabetes self-management among pregnant women with preexisting T2DM in Thailand, and to compare these factors between women in two groups (optimal and suboptimal maternal health outcomes).
Methods: A convergent mixed-methods study was conducted at a tertiary hospital (March to October 2022). Eligible participants were Thai pregnant women, aged 20-44, diagnosed with T2DM. Participants first completed a questionnaire and then were interviewed about diabetes self-management. Maternal health outcomes (i.e., gestational weight gain and glycated hemoglobin [HbA1c]) were reviewed and extracted. Descriptive statistics were used for quantitative analysis, while directed content analysis was used for qualitative data. Side-by-side matrices were used to describe the qualitative subthemes with quantitative results.
Results: Twelve Thai pregnant women participated in the study, aged 27 to 40 years, with gestational ages ranging from 7 to 38 weeks and T2DM diagnoses spanning from 3 weeks to 10 years. Half of the participants were obese before pregnancy. Weight gain patterns revealed that 41.67% had inadequate gain, 33.33% had optimal gain, and 25% had excessive gain. HbA1C levels indicated that 75% had good glycemic control. Three women achieved optimal weight gain and glycemic control, while nine exhibited suboptimal health outcomes. We identified six main themes: 1) challenges at the individual level in managing diabetes, 2) support factors at the individual level for diabetes management, 3) challenges at the interpersonal level in controlling diet, 4) interpersonal support factors for managing diabetes, 5) challenges at the societal level in accessing healthcare, and 6) societal support factors for healthcare access.
Conclusion: The findings suggest that managing diabetes during pregnancy necessitates dynamic, patient-centered care throughout the pregnancy journey. Regarding the clinical implication, it is important to tailor approaches to the Thai context and to prioritize education and boost women’s confidence in managing diabetes throughout pregnancy.
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| format | Article |
| id | doaj-art-52871f6380b94498830ef0e643532d0a |
| institution | Kabale University |
| issn | 2477-4073 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Belitung Raya Foundation |
| record_format | Article |
| series | Belitung Nursing Journal |
| spelling | doaj-art-52871f6380b94498830ef0e643532d0a2025-01-26T04:40:20ZengBelitung Raya FoundationBelitung Nursing Journal2477-40732025-01-0111110.33546/bnj.3639Challenges and support factors in managing type 2 diabetes among pregnant women in Thailand: A convergent mixed-methods studyRatchanok Phonyiam0Chiao-Hsin Teng1Catherine Sullivan2Aunchalee Palmquist3Eric Hodges4Yamnia Cortés5Marianne Baernholdt6Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital Mahidol University, Bangkok, ThailandThe University of North Carolina at Chapel Hill, School of Nursing, Chapel Hill, North Carolina, United States | Chang Gung University School of Nursing, Taoyuan, TaiwanDepartment of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United StatesDuke Global Health Institute, Durham, North Carolina, United StatesThe University of North Carolina at Chapel Hill, School of Nursing, Chapel Hill, North Carolina, United StatesUniversity of Iowa, College of Nursing, Iowa City, Iowa, United StatesUniversity of Virginia, School of Nursing, Charlottesville, Virginia, United StatesBackground: Sociocultural and behavioral factors have a multifaceted impact on maternal health. In Thailand, cultural influences significantly shape behaviors of diabetes self-management in women. However, the experience of self-managing diabetes in pregnant women with preexisting Type 2 Diabetes Mellitus (T2DM) remains unclear. Objectives: The study aimed to explore challenges and support factors of diabetes self-management among pregnant women with preexisting T2DM in Thailand, and to compare these factors between women in two groups (optimal and suboptimal maternal health outcomes). Methods: A convergent mixed-methods study was conducted at a tertiary hospital (March to October 2022). Eligible participants were Thai pregnant women, aged 20-44, diagnosed with T2DM. Participants first completed a questionnaire and then were interviewed about diabetes self-management. Maternal health outcomes (i.e., gestational weight gain and glycated hemoglobin [HbA1c]) were reviewed and extracted. Descriptive statistics were used for quantitative analysis, while directed content analysis was used for qualitative data. Side-by-side matrices were used to describe the qualitative subthemes with quantitative results. Results: Twelve Thai pregnant women participated in the study, aged 27 to 40 years, with gestational ages ranging from 7 to 38 weeks and T2DM diagnoses spanning from 3 weeks to 10 years. Half of the participants were obese before pregnancy. Weight gain patterns revealed that 41.67% had inadequate gain, 33.33% had optimal gain, and 25% had excessive gain. HbA1C levels indicated that 75% had good glycemic control. Three women achieved optimal weight gain and glycemic control, while nine exhibited suboptimal health outcomes. We identified six main themes: 1) challenges at the individual level in managing diabetes, 2) support factors at the individual level for diabetes management, 3) challenges at the interpersonal level in controlling diet, 4) interpersonal support factors for managing diabetes, 5) challenges at the societal level in accessing healthcare, and 6) societal support factors for healthcare access. Conclusion: The findings suggest that managing diabetes during pregnancy necessitates dynamic, patient-centered care throughout the pregnancy journey. Regarding the clinical implication, it is important to tailor approaches to the Thai context and to prioritize education and boost women’s confidence in managing diabetes throughout pregnancy. https://www.belitungraya.org/BRP/index.php/bnj/article/view/3639diabetes mellitusself-managementpregnancypregnant womenglycemic controlgestational weight gain |
| spellingShingle | Ratchanok Phonyiam Chiao-Hsin Teng Catherine Sullivan Aunchalee Palmquist Eric Hodges Yamnia Cortés Marianne Baernholdt Challenges and support factors in managing type 2 diabetes among pregnant women in Thailand: A convergent mixed-methods study Belitung Nursing Journal diabetes mellitus self-management pregnancy pregnant women glycemic control gestational weight gain |
| title | Challenges and support factors in managing type 2 diabetes among pregnant women in Thailand: A convergent mixed-methods study |
| title_full | Challenges and support factors in managing type 2 diabetes among pregnant women in Thailand: A convergent mixed-methods study |
| title_fullStr | Challenges and support factors in managing type 2 diabetes among pregnant women in Thailand: A convergent mixed-methods study |
| title_full_unstemmed | Challenges and support factors in managing type 2 diabetes among pregnant women in Thailand: A convergent mixed-methods study |
| title_short | Challenges and support factors in managing type 2 diabetes among pregnant women in Thailand: A convergent mixed-methods study |
| title_sort | challenges and support factors in managing type 2 diabetes among pregnant women in thailand a convergent mixed methods study |
| topic | diabetes mellitus self-management pregnancy pregnant women glycemic control gestational weight gain |
| url | https://www.belitungraya.org/BRP/index.php/bnj/article/view/3639 |
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