| ObjectiveTo develop a dietary compliance scale and investigate the current situation of dietary compliance in patients with GDM and analyze its influencing factors,through the SFEE diet management intervention based on health empowerment theory,and finally improve patients’ dietary compliance.MethodsTaking the planned behavior theory as the theoretical framework,the first draft of dietary compliance scale for patients with GDM was developed through evidence summary,expert consultation and expert group discussion.The reliability and validity of the scale were tested by on-the-spot questionnaire.A total of 320 GDM patients in the obstetrics clinic of a third-class hospital in Nanchang from June 2021 to August 2021 were investigated with general data questionnaire,GDM knowledge questionnaire,maternal self-management scale,perceived social support scale and dietary compliance scale of GDM patients,and the influencing factors of dietary compliance were analyzed.A total of 64 GDM patients in the nutrition clinic of a third-class hospital in Nanchang from September 2021 to December 2021 were randomly divided into the control group and the intervention group by the method of throwing hard coins,and the patients in both groups were given routine nursing.On this basis,the intervention group was given SFEE diet management intervention based on the theory of health empowerment(28-40 weeks gestation).Before and 3months after the intervention,GDM dietary compliance scale,GDM knowledge questionnaire,maternal self-management scale,perceived social support scale and were used to measure the patients’ dietary compliance,disease knowledge level,self-management ability and perceived social support level to evaluate the intervention effect.Results1.The results of the scale study showed that the Cronbach’s α coefficient of the total scale was 0.825 and the test-retest reliability was 0.989 after 2 weeks.RMSEA=0.052,CMIN/df=1.803,CFI=0.949,GFI=0.894,IFI=0.950,TLI=0.936,AGFI=0.866,the fitting index of confirmatory factor analysis.The final dietary compli-ance scale of GDM patients includes three dimensions: dietary treatment attitude,dietary treatment compliance motivation and dietary therapy behavior regulation,with a total of 13 items.2.The results of a cross-sectional survey showed that the score of dietary compliance of GDM patients was(45.79±5.79).The promoting factors of dietary compliance of GDM patients were older age,higher education,higher income,health insurance,cooking food at home,first pregnancy,GDM history,abnormal fasting blood glucose results,high level of disease knowledge,strong self –manage-ment ability and high level of perceived social support.The hindering factors were young age,low education,low income,no health insurance,access to food outside,multiple pregnancies,no history of GDM,normal fasting blood glucose,low level of disease knowledge,poor self-management ability and low level of perceived social support.3.The results of the intervention study showed that:(1)Before intervention,the general demographic data,GDM knowledge,pregnant women’s self-management ability,perceived social support and dietary compliance between the two groups showed no difference(P>0.05).The baseline data were comparable.(2)After intervention,the results of intra-group comparison showed that in the control group,the scores of GDM knowledge,self-management,perceived social support and dietary compliance increased by 13.00,3.63,5.20 and 4.10 respectively before and after intervention,and the differences were statistically significant(P<0.05).In the intervention group,the scores of GDM knowledge,self-management ability,perceived social support and dietary compliance increased by 21.50,18.73,13.93 and 11.77 respectively before and after intervention,and the differences were statistically significant(P<0.05).(3)After intervention,the scores of GDM knowledge in control group and interv-ention group were(66.17±6.91)and(75.00(70.00,75.00))respectively(P<0.05),and the scores of self-management ability of pregnant women in control group and intervention group were(100.40±5.54)and(116.50±2.37)respectively(P<0.05).The scores of perceived social support in control group and intervention group were(75.00(73.00,80.00)and(83.00(81.75,84.00))respectively(P<0.05),and the scores of dietary compliance in control group and intervention group were(51.43±4.67)and(61.23±1.77)respectively(P<0.05).ConclusionThe dietary compliance scale for GDM patients developed in this study has good validity and reliability,can evaluate the dietary compliance of GDM patients.At present,the dietary compliance of patients with gestational diabetes mellitus is at a low and medium level.The influencing factors include patients’ age,education level,family per capita monthly income,payment method of medical expenses,breakfast source,pregnancy and birth history,DM family history,GDM history,fasting blood glucose,GDM knowledge,pregnant women’s self-management ability and perceived social support.The SFEE diet management intervention based on the theory of health empowerment can improve the dietary compliance of patients. |
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