Poster Presentation Australasian Diabetes in Pregnancy Society Annual Scientific Meeting 2019

Qualitative investigation into culturally appropriate gestational diabetes mellitus care: providers’ and patients’ perspectives (#80)

Ching Shan Wan 1 , Alison Nankervis 2 , Helena Teede 3 , Rosalie Aroni 4
  1. School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
  2. Departments of Diabetes and Endocrinology, The Royal Melbourne and Royal Women’s Hospitals, Parkville, Victoria, Australia
  3. Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
  4. Medical School, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia

BACKGROUND:

There is a high migration rate of ethnic Chinese to Australia. They are at high risk of gestational diabetes mellitus (GDM) but little is known about their experiences of managing GDM compared to the host population. While patient-centred collaborative models of care are viewed as empowering patients with GDM to optimise GDM self-management, there are no studies comparing the views of ethnic Chinese women and Caucasian Australian born women with GDM with their healthcare providers. Conducting research which can fill this gap in knowledge may help improve patient-centred care.

AIMS:

This qualitative study aimed to examine GDM management from the perspectives of ethnic Chinese immigrants and Australian born Caucasian women with GDM, and their healthcare providers.

METHODS:

In-depth, semi-structured audio-recorded interviews were conducted with 17 healthcare providers, 42 ethnic Chinese and 30 Australian-born Caucasian women with GDM recruited from two large tertiary hospitals in Melbourne. A grounded theory approach was used in sampling, data collection and data analysis. Theoretical saturation had been achieved. NVivo was used in data analysis and management.

RESULTS:

Areas of consensus and dissensus were identified between healthcare providers’ and patients’ perceptions of barriers and enablers of improvement in GDM health care delivery. All groups agreed on the need for more culturally relevant advice and information provision. Health professionals were concerned about the lack of consensus regarding GDM diagnostic criteria and treatment targets across organisations and countries and the effects on clinical practice. A key solution suggested was to reach consensus in treatment targets at the organizational level. Patients and providers agreed on ways to improve care (improvement of public awareness of GDM and multidisciplinary communication, continuous gestational weight gain monitoring and development of courses to advance skills in selecting healthier foods). Patients viewed provision of culturally relevant GDM advice and postpartum education as essential.

CONCLUSIONS:

This study provides evidence to assist in future development of system-, provider-, and patient-focused approaches to optimize GDM care.