Application Of Family Fupport Interventions Based On Mobile Health Care In The Self-management Of Patients With Gestational Diabetes Mellitus

BackgroundGestational diabetes mellitus is one of the common metabolic complications during pregnancy,which has a profound impact on the mother and the fetus,and the incidence rate at home and abroad increases year after year.At present,the intervention methods for GDM patients are primarily based on outpatient multidisciplinary teamwork and group health care that occurs during pregnancy,there are fewer family members involved in the intervention,lack of continuity and continuity of interventions,the impact of family support on patient self-management is the overlooked.Mobile health care will provide interactive,continuous and convenient real-time intervention.Therefore,this study combined mobile health care and family support to explore the application effect of family support interventions based on mobile health care in the self-management of GDM patients.ObjectiveBy investigating the status quo of the self-management behvior and family support in GDM patients,analyzing the correlation between family support and self-management behavior,constructing an intervention program based on mobile medical family support,and discussing the applicability of this program in GDM patients,in order to improve the self-management behavior of GDM patients,and provide a reference for effective blood sugar control.Methods1.General information questionnaires 、the Family Support Scale（PSS-Fa）and Diabetes Self-Care Scale（DSCS）were used to investigate the 132 patients who met the criteria in two tertiary hospitals in Xinxiang GDM patients,to explore the influencing factors of self-management behavior,and the correlation between self-management behavior and family support,it is important to provide for the formulation of intervention programs.2.Based on the results of previous literature reviews and cross-sectional surveys,an initial intervention plan based on mobile medical home support was constructed,and two rounds of expert group meetings were used to revise the scheme,determine the final intervention scheme and apply it to the next phase of the intervention process.100 patients with GDM who were filed in two hospitals in Xinxiang City from August 2020 to December 2021 and had regular prenatal examinations were selected as the research objectives of the study.They were divided into intervention groups and control groups according to the order of time periods in which were tested,the control group was given routine prenatal guidance,and the intervention group was given a mobile medical-based family support program on the basis of routine prenatal guidance.Before the intervention,PSS-Fa,DSCS,The Self-efficacy for Diabetes（SED）,and the Pregnancy-related Anxiety Questionnaire（PAQ）were used to conduct a baseline survey,and fasting blood glucose（fasting blood sugar）was used to conduct a baseline survey,and the results of fasting plasma glucose（FPG）and 2-hours postprandial glucose（2h PG）were collected.After 8weeks of intervention,PSS-Fa,DSCS,SED,and PAQ questionnaires were issued again to evaluate the patients,the patients’ FPG and 2h PG indexes were collected for comparison.Results1.The DSCS score of GDM patients is 57.28±13.04,and the PSS-Fa score is10.96±2.02.PSS-Fa was positively correlated with the DSCS total score and each dimension（P<0.05）.Multiple linear regression analysis shows that age,educational level,family monthly income per capita,family history of diabetes,history of adverse pregnancy and childbirth,and family support are the main influencing factors of self-management behavior.2.After 2 rounds of expert group meetings,8 experts in medical,nursing and other fields revised the intervention plan and formed the final plan for intervention.Before the intervention,comparing the general data and baseline data of GDM patients and their spouses showed that the difference was not statistically significant（P>0.05）.3.After the intervention,the PSS-Fa score of the two groups of patients was compared: the PSS-Fa score of the intervention group was 13.37±1.62,and the PSS-Fa score of the control group was 10.98±1.94,and the difference between the two groups was statistically significant（t=6.592,P <0.05）.The results of intra-group comparison showed that the scores of the intervention group after the intervention were significantly higher than those before the intervention,and the difference was statistically significant（t=6.510,P<0.05）.4.Comparison of DSCS scores between the two groups after the intervention:Comparing the DSCS dimensions and total scores between the intervention group and the control group,the intervention group scored significantly higher than the control group,and the difference was statistically significant.（z=-3.733,z=-3.104,z=-3.744,z=-2.370,z=-4.234,P<0.05）。Comparing the difference scores between the intervention group and the control group before and after the intervention,it was found that the difference was statistically significant（t=6.510,P<0.05）.5.Comparison of FPG and 2h PG between the two groups after intervention: the FPG index of the intervention group was 5.29±0.76,and the FPG index of the intervention group was 5.70±0.78,and the difference was statistically significant（t=-2.612,P<0.05）;The 2h PG of the intervention group and the control group were 5.99±0.84 and 6.97±1.16 respectively,and the difference was statistically significant（t=-4.771,P<0.05）.6.After the intervention,the SED and PAQ scores of the two groups of patients were compared: the SED scores of the intervention group and the control group were37.08±8.75 and 30.52±6.15 respectively,and the difference was statistically significant（z=-5.909,P<0.05）.The PAQ scores of the intervention group and the control group were21.90±5.29 and 25.08±5.04,respectively.The scores of the intervention group were significantly lower than those of the control group,and the difference was statistically significant（t=4.075,P<0.05）.Conclusions1.The self-management behavior and family support of GDM patients were all at a moderate level,and the self-management behavior was higher in patients with higher education levels,higher monthly family support income,older age,higher family support level,family history of diabetes and adverse pregnancy and childbirth histories.2.The family support interventions based on mobile health care can improve the patient’s family support level,enhance the patient’s self-efficacy,reduce anxiety,improve self-management behavior,and achieve the effect of effective blood sugar control.