The experiences of prepregnancy care for women with type 2 diabetes mellitus: a meta-synthesis
Authors Forde R, Patelarou EE, Forbes A
Received 28 June 2016
Accepted for publication 13 September 2016
Published 8 December 2016 Volume 2016:8 Pages 691—703
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Lucy Goodman
Peer reviewer comments 2
Editor who approved publication: Professor Elie Al-Chaer
Rita Forde, Evridiki E Patelarou, Angus Forbes
Department of Adult Nursing, Florence Nightingale Faculty of Nursing and Midwifery, King’s College London, London, UK
Background: Diabetes is one of the most common medical conditions affecting pregnancy and is associated with a number of adverse fetal, infant, and maternal outcomes. These adverse outcomes can be avoided or minimized with appropriate prepregnancy care (PPC). However, the uptake of PPC is limited in women with type 2 diabetes mellitus (T2DM). The reasons for poor uptake are multifactorial, reflecting both women’s understanding of pregnancy risks, and limitations in care delivery.
Methods: A systematic literature review with meta-synthesis was undertaken to identify qualitative studies exploring experiences of PPC for women with T2DM incorporating the views of women with T2DM and health care professionals (HCPs). Identified studies included were synthesized in a meta-ethnography to develop an understanding of the elements contributing to the uptake of PPC among women with T2DM.
Results: The systematic review identified seven studies yielding data from 28 women with T2DM and 83 HCPs. The following six third-order constructs were identified from the synthesis: understanding PPC, emotive catalysts, beliefs about reproduction among women with T2DM, relationships and social factors, HCP behaviors and perspectives, and health care system factors. These constructs were used to develop a multifactorial model expressing the interactive issues that shape the reproductive health-seeking behaviors of women with T2DM to identify potential areas for intervention.
Conclusion: The uptake of PPC among women with T2DM seems to be informed by their personal orientation to their reproductive needs, their interactions with HCPs, and system-level influences. Future interventions to enhance PPC uptake need to address these underlying issues.
Keywords: systematic literature, pre-conception counseling, women’s health, contraception, meta-ethnography, patient education, lived-experience
This work is published by Dove Medical Press Limited, and licensed under a Creative Commons Attribution License. The full terms of the License are available at http://creativecommons.org/licenses/by/4.0/. The license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Download Article [PDF] View Full Text [HTML][Machine readable]