| Objective1.Construct a nursing intervention program for pregnant women at high risk of gestational diabetes based on cross-theoretical model2.To explore the application effect of nursing intervention program based on cross-theoretical model in pregnant women with high risk of gestational diabetes,in order to provide new reference for the health management of pregnant women with high risk of gestational diabetes during pregnancy and primary prevention of gestational diabetes.Methods1.Guided by a cross-theoretical model,on the basis of literature review and group discussion,this study formulated the first draft of the nursing intervention plan for pregnant women at high risk of gestational diabetes Opinions to revise and improve the intervention plan;conduct a pre-test,and further revise and optimize the intervention plan based on the results of the pre-test,and form the final draft of the nursing intervention plan for pregnant women at high risk of gestational diabetes based on a cross-theoretical model.2.The convenience sampling method was used to select 88 cases of pregnant women at high risk of gestational diabetes who underwent obstetric examination in the obstetrics clinic of a class A hospital in Qingdao as the research object,and 44 cases in the intervention group and the control group.The intervention group and the control group were divided according to the time of delivery.The pregnant women at high risk of gestation diabetes mellitus who underwent delivery in the obstetrical clinic from August to October 2020 were the control group,and the pregnant women at high risk of gestation diabetes mellitus who underwent delivery in the obstetrical clinic from January 2021 to March 2021 were the intervention group.The control group carried out routine nursing intervention,and the intervention group carried out TTM nursing intervention on the basis of routine nursing intervention.Before intervention,research team members used behavioral change stage questionnaire to assess the stage of behavior change in pregnant women at high risk of gestational diabetes,and implemented nursing interventions matching their stage of behavior change.During the intervention,the intervention of the previous action change stage will be automatically entered into the next stage after the completion of the intervention,and the time of each intervention is about 20-30 minutes.After intervention,the chi-square test was used to compare the difference in the incidence and outcome of gestational diabetes between the two groups,and t test or rank-sum test was used to compare the difference in glucose tolerance test blood glucose level,gestational diabetes self-management ability and self-efficacy between the two groups.Results1.Construction of intervention programsTwo rounds of expert letter consultation were conducted in this study,and the effective recovery rate of the questionnaire in both rounds was 100%.The expert authority coefficients of the two rounds of expert letter consultation were 0.939 and 0.942,respectively.The coordination coefficients of expert opinions in the two rounds of expert letter consultation were 0.271 and 0.332,respectively(P < 0.05).According to the expert opinions and the feedback of the pre-test,the final draft of the nursing intervention program for pregnant women at high risk of gestational diabetes was formed based on the cross-theoretical model.The intervention program consists of 5 behavior change stages,9 behavior change methods and 15 interventions.2.Application of intervention programs(1)After intervention,the incidence of gestational diabetes was 13.95% in the intervention group and 19.05% in the control group.Although the incidence of gestational diabetes in the intervention group was lower than that in the control group,there was no statistical significance between the two groups(P > 0.05).(2)After intervention,there were no significant differences in fasting blood glucose and 1h blood glucose level between the two groups(P > 0.05),and 2h blood glucose level in the intervention group was significantly lower than that in the control group,the difference was statistically significant(P < 0.05).(3)After intervention,the scores and total scores of all dimensions of gestational diabetes self-management ability in the intervention group were significantly higher than those in the control group,with statistical significance(P < 0.05).(4)After intervention,the level of self-efficacy of pregnant women in the intervention group was significantly higher than that in the control group,with statistical significance(P < 0.05).(5)After intervention,there was no significant difference in the incidence of macrosomia,cesarean section,premature delivery and postpartum hemorrhage between the two groups(P > 0.05).Conclusion1.The TTM-based nursing intervention program for pregnant women at high risk of gestational diabetes constructed in this study,each item is important and expert opinions tend to be consistent,which is scientific,reliable and feasible.2.Compared with routine nursing interventions,nursing interventions based on transtheoretical models can better improve the self-management ability of pregnant women at high risk of gestational diabetes,help them do a good job in health management during pregnancy,enhance their self-efficacy in preventing gestational diabetes,and improve Its postprandial blood glucose level,but its effect in reducing the incidence of GDM and improving pregnancy outcomes still needs further research. |
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