بررسی تأثیر برنامه خودمدیریتی مبتنی بر الگوی پنج‌آ بر خودکارآمدی زنان مبتلا به دیابت‌بارداری

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 دانشجوی کارشناسی ارشد آموزش مامایی، کمیته‌ی تحقیقات دانشجویی، دانشکده‌ی پرستاری و مامایی، دانشگاه علوم پزشکی کردستان، سنندج، ایران

2 استاد، گروه مامایی، دانشکده‌ی پرستاری و مامایی، مرکز تحقیقات مراقبت بالینی، پژوهشکده‌ی توسعه سلامت، دانشگاه علوم پزشکی کردستان، سنندج، ایران

3 مربی، مرکز تحقیقات مراقبت بالینی، پژوهشکده‌ی توسعه سلامت، دانشگاه علوم پزشکی کردستان، سنندج، ایران

4 دانشیار، گروه اپیدمیولوژی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی کردستان، سنندج، ایران

5 استادیار، گروه مامایی، دانشکده‌ی پرستاری و مامایی، مرکز تحقیقات مراقبت بالینی، پژوهشکده توسعه‌ی سلامت، دانشگاه علوم پزشکی کردستان، سنندج، ایران

10.48305/jims.v42.i788.0928

چکیده

مقاله پژوهشی




مقدمه: دیابت‌بارداری از شایع‌ترین مشکلات دوران بارداری است. جهت کاهش عوارض این بیماری ضرورت دارد که بیماران در کنترل آن مداخله فعال داشته باشند. این مطالعه با هدف تعیین تأثیر برنامه خودمدیریتی مبتنی بر الگوی پنج‌آ بر خودکارآمدی زنان مبتلا به دیابت‌بارداری مراجعه‌کننده به مرکز دیابت بیمارستان توحید سنندج در سال 1401 انجام شد.
روش‌ها: این مطالعه‌ی نیمه‌تجربی بر روی 60 زن باردار واجد شرایط مراجعه‌کننده به مرکز دیابت بیمارستان توحید سنندج انجام شد. اطلاعات توسط فرم مشخصات دموگرافیک و مامایی و پرسشنامه‌ی خودکارآمدی در ارتباط با بیماران مبتلا به دیابت قبل و بعد از انجام مداخله، گردآوری شد. شرکت‌کنندگان بصورت تصادفی در دو گروه مداخله و شاهد قرار گرفتند. برای گروه مداخله، چهار جلسه آموزشی به‌مدت چهار هفته برگزار شد و گروه شاهد، مراقبت‌های معمول را دریافت کردند. آنالیز داده‌ها با نرم‌افزار STATA نسخه‌ی 12 و آزمون‌های مرتبط انجام شد. سطح معنی‌داری کمتر از 05/0 در نظر گرفته شد.
یافته‌ها: بر اساس نتایج، دو گروه از نظر متغیرهای دموگرافیک و مامایی تفاوت آماری معنی‌داری نداشتند (0/05 P >). قبل از مداخله، میانگین نمره‌ی خودکارآمدی در گروه مداخله و شاهد به ترتیب 7/0 ±33/4 و 4/0 ± 33/1 بود که تفاوت آماری معنی‌دار را نشان نداد (0/840 = P) اما در پایان مطالعه، میانگین نمره‌ی خودکارآمدی با اختلاف آماری معنی‌دار در گروه مداخله بیشتر بود (15/1 ± 52 در برابر 4/1 ± 33/9، 0/001 = P).
نتیجه‌گیری: نتایج مطالعه نشان داد که اجرای برنامه‌ی خودمدیریتی مبتنی بر الگوی پنج‌آ در زنان مبتلا به دیابت ‌بارداری می‌تواند منجر به افزایش خودکارآمدی شود، بنابراین می‌توان در برنامه‌ی درمانی و پروتکل‌های مراقبت بارداری استفاده از این برنامه را پیشنهاد داد.

تازه های تحقیق

رنگین فتاح نیا: PubMed

بیژن نوری: PubMed 

فرزانه ظاهری: PubMed, Google Scholar 

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

The Effect of Self-management Program Based on 5A Model on Self-efficacy of Women with Gestational Diabetes

نویسندگان [English]

  • Rangin Fatahnia 1
  • Roonak Shahoie 2
  • Marya Maryam Kalhor 3
  • Bijan Nouri 4
  • Farzaneh Zaheri 5
1 MSc student in Midwifery Education, Department of Midwifery, Faculty of Nursing and Midwifery, Kurdistan University of Medical Sciences, Kurdistan, Iran
2 2 -Professor, Department of Midwifery, School of Nursing and Midwifery, Clinical Care Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
3 Instructor, Clinical Care Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
4 Associate Professor, Department of Epidemiology and Biostatistics, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
5 Assistant Professor, Department of Midwifery, School of Nursing and Midwifery, Clinical Care Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
چکیده [English]

Background: Gestational diabetes is one of the most common problems during pregnancy. To reduce this disease, patients must intervene actively in its control. This study was conducted to determine the effect of the self-management program based on the five-A model on the self-efficacy of women with gestational diabetes referred to the diabetes center of Tohid Hospital in Sanandaj in 2022.
Methods: This semi-experimental study was conducted on 60 eligible pregnant women referred to the diabetes center of Tohid Hospital in Sanandaj. Information was collected using demographic and midwifery profile forms and a self-efficacy questionnaire related to diabetic patients before and after the intervention.  Participants were selected as available and were randomly divided into intervention and control groups. For the intervention group, four training sessions were held for four weeks, while the control group received usual care.
Findings: Based on the results, the two groups had no statistically significant differences in demographic and obstetric variables. Before the intervention, the average self-efficacy score in the intervention and control groups was 33.4 ± 0.7 and 33.1 ± 0.4, respectively (P = 0.840). Finally, the average self-efficacy score at the end of the study was significantly higher in the intervention group (52 ± 0.15 vs. 33.9 ± 4.1, P = 0.001).
Conclusion: The results of the study showed that the self-management program implementation based on the five-A model in pregnant women with gestational diabetes could lead to an increase in self-efficacy, so it can be suggested to use this program in the treatment plan and pregnancy care protocol for pregnant women.

کلیدواژه‌ها [English]

  • Pregnancy
  • Gestational diabetes
  • Self-management
  • Self-efficacy
  1. McIntyre HD, Catalano P, Zhang C, Desoye G, Mathiesen ER, Damm P. Gestational diabetes mellitus. Nat Rev Dis primers 2019; 5(1): 47.
  2. Alejandro EU, Mamerto TP, Chung G, Villavieja A, Gaus NL, Morgan E, et al. Gestational diabetes mellitus: a harbinger of the vicious cycle of diabetes. Int J Mol Sci 2020; 21(14): 5003.
  3. Nakshine VS, Jogdand SD. A comprehensive review of gestational diabetes mellitus: impacts on maternal health, fetal development, childhood outcomes, and long-term treatment strategies. Cureus 2023; 15(10): e47500.
  4. Sweeting A, Hannah W, Backman H, Catalano P, Feghali M, Herman W, et al. Epidemiology and management of gestational diabetes. Lancet 2024; 404(10448):175-92.
  5. Delpisheh M, Firouzkouhi M, Rahnama M, Badakhsh M, Abdollahimohammad A. Prevalence of gestational diabetes mellitus in iran: a systematic review and meta-analysis study [in Persian]. J Diabetes Nurs 2022; 10(2): 1872-85.
  6. Bolghanabadi N, Kharaghani R, Hosseinkhani A, Fayazi A, Mossayebnezhad R. Prevalence of Gestational Diabetes in Iran: A Systematic Review and Meta-analysis. Preventive Care in Nursing and Midwifery Journal 2023; 13(1): 35-49.
  7. Sadeghi S, Khatibi SR, Mahdizadeh M, Peyman N, Zare Dorniani S. Prevalence of Gestational Diabetes in Iran: A Systematic Review and Meta-analysis. Med J Islam Repub Iran 2023; 37: 83.
  8. Spaight C, Gross J, Horsch A, Puder JJ. Gestational diabetes mellitus. E Endocr Dev 2016; 31: 163-78.
  9. Carolan-Olah MC. Educational and intervention programmes for gestational diabetes mellitus (GDM) management: An integrative review. Collegian 2016; 23(1): 103-14.
  10. Kautzky-Willer A, Harreiter J, Winhofer-Stöckl Y, Bancher-Todesca D, Berger A, Repa A, et al. Gestational diabetes mellitus (Update 2019). Wien Klin Wochenschr 2019; 131(1): 91-102.
  11. Rasmussen L, Poulsen CW, Kampmann U, Smedegaard SB, Ovesen PG, Fuglsang J. Diet and healthy lifestyle in the management of gestational diabetes mellitus. Nutrients 2020; 12(10): 3050.
  12. Valizadeh M, Hosseinpanah F, Ramezani Tehrani F, Abdi H, Mehran L, Hadaegh F, et al. Iranian endocrine society guidelines for screening, diagnosis, and management of gestational diabetes mellitus. Int J Endocrinol Metab 2021; 19(1): e107906.
  13. He R, Lei Q, Hu H, Li H, Tian D, Lai Z. The effect of

    health education combined with personalized psychological nursing intervention on pregnancy outcome of pregnant women with gestational diabetes mellitus. Biomed Res Int 2022; 2022: 3157986.
  14. Kim YS, Kim HS, Kim YL. Effects of a web-based self-management program on the behavior and blood glucose levels of women with gestational diabetes mellitus. Telemedicine and e-Health 2019; 25(5): 407-14.
  15. Mohebbi B, Tol A, Sadeghi R, Mohtarami SF, Shamshiri A. Self-management intervention program based on the Health Belief Model (HBM) among women with gestational diabetes mellitus: a quazi-experimental study. Arch Iran Med 2019; 22(4): 168-73.
  16. van Smoorenburg AN, Hertroijs DF, Dekkers T, Elissen AM, Melles M. Patients’ perspective on self-management: type 2 diabetes in daily life. BMC Health Serv Res 2019; 19: 605.
  17. Hedayati A, Pouresmail A, Gholampour Y, Dehghan A. The relation between sleep disorders and Hemoglobin A1c levels in patients with type II diabetes mellitus [in Persian]. Med J Mashhad Univ Med Sci 2016; 59(3): 179-87.
  18. Taheri Z, Khorsandi M, Ghafari M, Amiri M. Empowerment-based interventions in patients with diabetes: a review study [in Persian]. J Rafsanjan Univ Med Sci 2016; 15(5): 453-68.
  19. Karavasileiadou S, Almegewly W, Alanazi A, Alyami H, Chatzimichailidou S. Self-management and self-efficacy of women with gestational diabetes mellitus: a systematic review. Glob Health Action 2022; 15(1): 2087298.
  20. Kordi M, Heravan M. Prediction of self-efficacy and self-care behaviors among diabetic women based on their attitude towards gestational diabetes. Journal of Midwifery & Reproductive Health 2020; 8(4): 2486-93.
  21. Mohebi Amin A, Rabiei M. Study of the relationship between self-efficacy beliefs and creative teaching in Mashhad nursing and midwifery faculty [in Persian]. Res Med Educ 2019; 11(1): 10-9.
  22. Xu N, Han X, Chen S, Zhang J, Gu P. Self-reported barriers in self-management of women with gestational diabetes: A systematic review of qualitative studies. Nursing Open 2023; 10(11): 7130-43.
  23. Keivan S, Shariati A, Miladinia M, Haghighizadeh MH. Role of self-management program based on 5A nursing model in quality of life among patients undergoing hemodialysis: a Randomized Clinical Trial. BMC Nephrol 2023; 24(1): 58.
  24. Shojaee D, Shahboulaghi FM, Fallahi-Khoshknab M, Vahedi M, Bakhtiari A, Zabolypour S. Effect of a 5A Model-based Self-management Program on Self-management Ability and Dyspnea Severity in the Elderly with Chronic Heart Failure: A Randomized Clinical Trial [in Persian]. Iranian Journal of Ageing 2024; 18(4): 488-501.
  25. Rokni S, Rezaei Z, Noghabi AD, Sajjadi M, Mohammadpour A. Evaluation of the effects of diabetes self-management education based on 5A model on the quality of life and blood glucose of women with gestational diabetes mellitus: an experimental study in eastern Iran. J Prev Med Hyg 2022; 63(3): E442-E7.
  26. Sadeghigolafshani M, Rejeh N, Heravi-Karimooi M, Tadrisi SD, Yosefi Abdolmaleki E. The effect of model-based self-management program 5a on quality of life of elderly patients with diabetes [in Persian]. Iran J Nurs Res 2019; 14(5): 37-44.
  27. Lorig K, Ritter PL, Laurent DD, Plant K, Green M, Jernigan VB, et al. Online diabetes self-management program: a randomized study. Diabetes Care 2010; 33(6): 1275-81.
  28. Bastani F, Zarrabi R. Correlations of self-efficacy among women with gestational diabetes [in Persian]. Journal of Hayat 2011; 16(3): 56-65.
  29. Glasgow RE, Funnell MM, Bonomi AE, Davis C, Beckham V, Wagner EH. Self-management aspects of the improving chronic illness care breakthrough series: implementation with diabetes and heart failure teams. Ann Behav Med 2002; 24(2): 80-7.
  30. Morovati Sharifabad MA, Rouhani Tonekaboni N. Perceived self-efficacy in self-care behaviors among diabetic patients referring to Yazd Diabetes Research Center [in Persian]. JBUMS 2009; 15(4): 91-9.