CoChat
Sign Up
Cited by 17Gestational Diabetes Research and ManagementDiabetes Management and EducationMaternal and Neonatal Healthcare

Self‐reported barriers in self‐management of women with gestational diabetes: A systematic review of qualitative studies

Open access
Xu, Nuo, Han, Xia, Chen, Sijing, Zhang, Jingjing, Gu, Ping·2023·Nursing Open
DOI 10.1002/nop2.1988PMC PMC10563407
Open this paper in CoChat — free accountOpen PDF

Abstract

Aim: To provide a systematic review of the qualitative literature on self‐reported barriers to self‐management in pregnant women with gestational diabetes mellitus (GDM). Design: Systematic review. Methods: This systematic review followed the Joanna Briggs Institute meta‐aggregation approach and was evaluated using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research. Qualitative studies on the barriers to self‐management among GDM pregnancy survivors conducted until 17 May 2022, were searched. Results: A total of 30 studies were included, of which seven were in Chinese and 23 were in English, and 10 findings resulted in three themes: (a) Knowledge and belief, (b) Skills and abilities and (c) Environment and social support. By summarizing the self‐reported barriers to self‐management in patients with GDM and recommends precise interventions for these barriers, thereby saving health resources and helping to increase their willingness and ability to engage in self‐management.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1002/nop2.1988

Cites

3 of 3 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 47

  1. Billany, R. E., Thopte, A., Adenwalla, S. F., March, D. S., Burton, J. O., & Graham‐Brown, M. P. M. (2023). Associations of health literacy with self‐management behaviours and health outcomes in chronic kidney disease: A systematic review. Journal of Nephrology, 36, 1267– 1281. 10.1007/s40620-022-01537-0 36645651 PMC10333418 · DOI
  2. Carolan, M., Gill, G. K., & Steele, C. (2012). Women's experiences of factors that facilitate or inhibit gestational diabetes self‐management. BMC Pregnancy and Childbirth, 12, 99. 10.1186/1471-2393-12-99 22988897 PMC3561108 · DOI · Paper page
  3. Carolan‐Olah, M., Duarte‐Gardea, M., Lechuga, J., & Salinas‐Lopez, S. (2017). The experience of gestational diabetes mellitus (GDM) among Hispanic women in a U.S. border region. Sexual & Reproductive Healthcare, 12, 16– 23. 10.1016/j.srhc.2016.11.003 28477926 · DOI
  4. Dayyani, I., Terkildsen Maindal, H., Rowlands, G., & Lou, S. (2019). A qualitative study about the experiences of ethnic minority pregnant women with gestational diabetes. Scandinavian Journal of Caring Sciences, 33(3), 621– 631. 10.1111/scs.12655 30653703 · DOI
  5. de Sequeira, S., Halperin, I., & Lipscombe, L. L. (2019). Culturally tailored resources for south Asian immigrant women with gestational diabetes: Do they work and What's missing? A qualitative study. Canadian Journal of Diabetes, 43(8), 573– 579. 10.1016/j.jcjd.2019.09.007 31787243 · DOI
  6. Edwards, K. J., Bradwell, H. L., Jones, R. B., Andrade, J., & Shawe, J. A. (2021). How do women with a history of gestational diabetes mellitus use mHealth during and after pregnancy? Qualitative exploration of women's views and experiences. Midwifery, 98, 102995. 10.1016/j.midw.2021.102995 33784541 · DOI
  7. Ferranti, E. P., Narayan, K. M., Reilly, C. M., Foster, J., McCullough, M., Ziegler, T. R., Guo, Y., & Dunbar, S. B. (2014). Dietary self‐efficacy predicts AHEI diet quality in women with previous gestational diabetes. The Diabetes Educator, 40(5), 688– 699. 10.1177/0145721714539735 24942530 PMC4260266 · DOI
  8. Figueroa Gray, M., Hsu, C., Kiel, L., & Dublin, S. (2017). "It's a very big burden on me": Women's experiences using insulin for gestational diabetes. Maternal and Child Health Journal, 21(8), 1678– 1685. 10.1007/s10995-017-2261-8 28092062 · DOI
  9. Ge, L., Wikby, K., & Rask, M. (2016). 'Is gestational diabetes a severe illness?' exploring beliefs and self‐care behaviour among women with gestational diabetes living in a rural area of the south east of China. The Australian Journal of Rural Health, 24(6), 378– 384. 10.1111/ajr.12292 27087496 · DOI
  10. Guo, J., Long, Q., Li, J., Wang, X., Li, Y., Jiang, S., Sun, M., Wiley, J., & Chen, J.‐L. (2020). Barriers and facilitators of self‐monitoring of blood glucose engagement among women with gestational diabetes mellitus in China: A mixed‐methods study. Midwifery, 90, 102797. 32755742
  11. Harrison, A. L., Taylor, N. F., Frawley, H. C., & Shields, N. (2019). Women with gestational diabetes mellitus want clear and practical messages from credible sources about physical activity during pregnancy: A qualitative study. Journal of Physiotherapy, 65(1), 37– 42. 10.1016/j.jphys.2018.11.007 30573442 · DOI · Paper page
  12. Hewage, S., Audimulam, J., Sullivan, E., Chi, C., Yew, T. W., & Yoong, J. (2020). Barriers to gestational diabetes management and preferred interventions for women with gestational diabetes in Singapore: Mixed methods study. JMIR Formative Research, 4(6), – e14486. 10.2196/14486 32602845 PMC7367517 · DOI
  13. Hjelm, K., Bard, K., & Apelqvist, J. (2018). A qualitative study of developing beliefs about health, illness and healthcare in migrant African women with gestational diabetes living in Sweden. BMC Womens Health, 18(1), 34. 10.1186/s12905-018-0518-z 29402265 PMC5800284 · DOI
  14. Hui, A. L., Sevenhuysen, G., Harvey, D., & Salamon, E. (2014). Food choice decision‐making by women with gestational diabetes. Canadian Journal of Diabetes, 38(1), 26– 31. 10.1016/j.jcjd.2013.08.263 24485210 · DOI
  15. Javalkar, K., Williamson, N., Vaidya, S., Vaidya, A., & Ferris, M. (2016). The association between educational resource utilization and knowledge/self‐management among patients with type 2 diabetes in Pune, India. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 10(4), 186– 189. 10.1016/j.dsx.2016.06.002 27339796 · DOI
  16. Jiang, J., Gu, X., Cheng, C. D., Li, H. X., Sun, X. L., Duan, R. Y., Zhu, Y., Sun, L., Chen, F. K., Bao, Z. Y., Zhang, Y., & Shen, J. H. (2020). The hospital‐community‐family‐based telemedicine (HCFT‐AF) program for integrative Management of Patients with Atrial Fibrillation: Pilot feasibility study. JMIR mHealth and uHealth, 8(10), e22137. 10.2196/22137 33084588 PMC7641782 · DOI
  17. Jiang, W., Huang, X., Li, S., Guo, Y., & Yang, M. (2020). A qualitative study on the causes of health promotion behaviors in pregnant women with gestational diabetes. Journal of Nursing Science, 35(12), 20– 22. 10.3870/j.issn.1001-4152.2020.12.020 · DOI
  18. Jirojwong, S., Brownhill, S., Dahlen, H. G., Johnson, M., & Schmied, V. (2017). Going up, going down: The experience, control and management of gestational diabetes mellitus among southeast Asian migrant women living in urban Australia. Health Promotion Journal of Australia, 28(2), 123– 131. 10.1071/HE15130 27745571 · DOI
  19. Johns, E. C., Denison, F. C., Norman, J. E., & Reynolds, R. M. (2018). Gestational diabetes mellitus: Mechanisms, treatment, and complications. Trends in Endocrinology and Metabolism, 29(11), 743– 754. 10.1016/j.tem.2018.09.004 30297319 · DOI · Paper page
  20. Khooshehchin, T. E., Keshavarz, Z., Afrakhteh, M., Shakibazadeh, E., & Faghihzadeh, S. (2016). Perceived needs in women with gestational diabetes: A qualitative study. Electronic Physician, 8(12), 3412– 3420. 10.19082/3412 28163857 PMC5279975 · DOI
  21. Koetsenruijter, J., van Eikelenboom, N., van Lieshout, J., Vassilev, I., Lionis, C., Todorova, E., Portillo, M. C., Foss, C., Serrano Gil, M., Roukova, P., Angelaki, A., Mujika, A., Knutsen, I. R., Rogers, A., & Wensing, M. (2016). Social support and self‐management capabilities in diabetes patients: An international observational study. Patient Education and Counseling, 99(4), 638– 643. 10.1016/j.pec.2015.10.029 26549171 · DOI · Paper page
  22. Kytö, M., Koivusalo, S., Ruonala, A., Strömberg, L., Tuomonen, H., Heinonen, S., & Jacucci, G. (2022). Behavior change app for self‐management of gestational diabetes: Design and evaluation of desirable features. JMIR Human Factors, 9(4), e36987. 10.2196/36987 36222806 PMC9607927 · DOI
  23. Lambrinou, E., Hansen, T. B., & Beulens, J. W. (2019). Lifestyle factors, self‐management and patient empowerment in diabetes care. European Journal of Preventive Cardiology, 26(2_suppl), 55– 63. 10.1177/2047487319885455 31766913 · DOI · Paper page
  24. Lee‐Parritz, A. (2011). Contemporary management of gestational diabetes. Current Opinion in Endocrinology, Diabetes and Obesity, 18(6), 395– 400. 10.1097/MED.0b013e32834cd3c4 21986513 · DOI
  25. Liu, Y. B., Liu, L., Li, Y. F., & Chen, Y. L. (2015). Relationship between health literacy, health‐related behaviors and health status: A survey of elderly Chinese. International Journal of Environmental Research and Public Health, 12(8), 9714– 9725. 10.3390/ijerph120809714 26295246 PMC4555308 · DOI
  26. Mensah, G. P., van Rooyen, D. R. M., & Ten Ham‐Baloyi, W. (2019). Nursing management of gestational diabetes mellitus in Ghana: Perspectives of nurse‐midwives and women. Midwifery, 71, 19– 26. 10.1016/j.midw.2019.01.002 30640135 · DOI
  27. Mitra, K., Afsaneh, K., MehrAli, R., Zahra, M., Mohammad, S., & MohammadHassan, E. (2018). Self‐care education needs in gestational diabetes tailored to the Iranian culture: A qualitative content analysis. Iranian Journal of Nursing and Midwifery Research, 23(3), 222. 29861762 PMC5954645
  28. Mohebbi, B., Tol, A., Sadeghi, R., Mohtarami, S. F., & Shamshiri, A. (2019). Self‐management intervention program based on the health belief model (HBM) among women with gestational diabetes mellitus: A Quazi‐experimental study. Archives of Iranian Medicine, 22(4), 168– 173. 31126174
  29. Neufeld, H. T. (2011). Food perceptions and concerns of aboriginal women coping with gestational diabetes in Winnipeg, Manitoba. Journal of Nutrition Education and Behavior, 43(6), 482– 491. 10.1016/j.jneb.2011.05.017 22078771 · DOI
  30. Rokni, S., Rezaei, Z., Noghabi, A. D., Sajjadi, M., & Mohammadpour, A. (2022). 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. Journal of Preventive Medicine and Hygiene, 63(3), E442– E447. 10.15167/2421-4248/jpmh2022.63.3.2611 36415299 PMC9648546 · DOI
  31. Ruth, M., Julie, B., Judith, M.‐C., & Crowther, C. A. (2018). Enablers and barriers for women with gestational diabetes mellitus to achieve optimal glycaemic control—A qualitative study using the theoretical domains framework. BMC Pregnancy and Childbirth, 18(1), 1– 22. 29642898 PMC5896082
  32. Ryan, P. (2009). Integrated theory of health behavior change: Background and intervention development. Clinical Nurse Specialist, 23(3), 161– 170; quiz 171‐2. 10.1097/NUR.0b013e3181a42373 19395894 PMC2778019 · DOI
  33. Saha, S. (2019). Compliance and barriers to self‐monitoring of blood glucose in patients with gestational diabetes mellitus: A systematic review. International Journal of Health Sciences, 13(3), 44– 52. PMC6512150 31123440
  34. Shi, Z., Ji, C., & Tao, C. (2021). A qualitative study of maternal information‐behavioral motivational experiences in gestational diabetes. Chinese Journal of Practical Nursing, 37(5), 348– 352. 10.3760/cma.j.cn211501-20200915-03899 · DOI
  35. Siad, F. M., Fang, X. Y., Santana, M. J., Butalia, S., Hebert, M. A., & Rabi, D. M. (2018). Understanding the experiences of east African immigrant women with gestational diabetes mellitus. Canadian Journal of Diabetes, 42(6), 632– 638. 10.1016/j.jcjd.2018.01.013 29914780 · DOI
  36. Song, H., Gao, M., & Liu, W. (2016). A qualitative study of authentic perinatal experiences in patients with gestational diabetes mellitus. Chinese General Practice Nursing, 14(24), 2564– 2566.
  37. Tewari, A., Praveen, D., Madhira, P., Josyula, L. K., Joshi, R., Kokku, S. B., Garg, V., Rawal, I., Chopra, K., Chakma, N., Ahmed, S., Pathmeswaran, A., Godamunne, P., Lata, A. S., Sahay, R., Patel, T., Gupta, Y., Tandon, N., Naheed, A., … Kapoor, D. (2020). Feasibility of a lifestyle intervention program for prevention of diabetes among women with prior gestational diabetes mellitus (LIVING study) in South Asia: A formative research study. Frontiers in Global Women's Health, 1, 587607. 10.3389/fgwh.2020.587607 PMC8594035 34816163 · DOI
  38. Tseng, H. M., Liao, S. F., Wen, Y. P., & Chuang, Y. J. (2017). Stages of change concept of the transtheoretical model for healthy eating links health literacy and diabetes knowledge to glycemic control in people with type 2 diabetes. Primary Care Diabetes, 11(1), 29– 36. 10.1016/j.pcd.2016.08.005 27595215 · DOI
  39. van de Velde, D., de Zutter, F., Satink, T., Costa, U., Janquart, S., Senn, D., & de Vriendt, P. (2019). Delineating the concept of self‐management in chronic conditions: A concept analysis. BMJ Open, 9(7), e027775. 10.1136/bmjopen-2018-027775 PMC6661649 31315862 · DOI · Paper page
  40. Wah, Y. Y. E., McGill, M., Wong, J., Ross, G. P., Harding, A. J., & Krass, I. (2019). Self‐management of gestational diabetes among Chinese migrants: A qualitative study. Women and Birth, 32(1), e17– e23. 10.1016/j.wombi.2018.03.001 29693546 · DOI
  41. Wang, N., & Ding, Y. (2014). A qualitative study of the disease self‐management experience of pregnant women with gestational diabetes. Journal of Nursing Science, 29(14), 16– 19.
  42. Wu, Y., Liu, L., Zheng, W., Zheng, C., Xu, M., Chen, X., Li, W., Xie, L., Zhang, P., Zhu, X., Zhan, C., & Zhou, C. (2021). Effect of prolonged expressive writing on health outcomes in breast cancer patients receiving chemotherapy: A multicenter randomized controlled trial. Support Care Cancer, 29(2), 1091– 1101. 10.1007/s00520-020-05590-y 32601853 · DOI
  43. Xia, Z., Yu, S., Zhang, H., Hu, K., & Qin, Q. (2020). A qualitative study of the real‐life experience of pregnant women with gestational diabetes mellitus after diagnosis. Nursing of Integrated Traditional Chinese and Western Medicine, 6(10), 86– 92. 10.11997/nitcwm.202010018 · DOI
  44. Yee, L. M., McGuire, J. M., Taylor, S. M., Niznik, C. M., & Simon, M. A. (2015). “I was tired of all the sticking and poking”: Identifying barriers to diabetes self‐care among low‐income pregnant women. Journal of Health Care for the Poor & Underserved, 26(3), 926– 940. 10.1353/hpu.2015.0073 26320923 · DOI
  45. Youngwanichsetha, S., & Phumdoung, S. (2017). Lived experience of blood glucose self‐monitoring among pregnant women with gestational diabetes mellitus: A phenomenological research. Journal of Clinical Nursing, 26(19–20), 2915– 2921. 10.1111/jocn.13571 27603420 · DOI
  46. Youssef Wazqar, D., & Evans, M. K. (2012). Socio‐cultural aspects of self‐management in gestational diabetes. Journal of Diabetes Nursing, 16(2), 62– 67.
  47. Zhou, Y. F., Huang, N., Li, L., Fang, Y., Xing, N. L., Zhu, J. L., Zhao, M. H., & Wang, L. (2022). A qualitative study of decision dilemmas in the management of glucose in pregnant women with gestational diabetes. Nursing Journal of Chinese People's Liberation Army, 39(1), 9– 12.

Cited by

Sorted by citations

Authors
Xu, N., Han, X., Chen, S., Zhang, J., & Gu, P.
Affiliations
  • Nanjing Medical University (CN)
  • Nanjing Maternity and Child Health Care Hospital (CN)
Corresponding author
  • Zhang, Jingjing
  • Gu, Ping
ORCID
Venue
Nursing Open
Publisher
Wiley
Published
2023-09-12
Volume
10
Issue
11
Pages
7130-7143
ISSN
2054-1058 (ISSN-L)
DOI
10.1002/nop2.1988
PMC
PMC10563407
OpenAlex
W4386695800
Cited by
17
References
3
Citations by year
2026: 7 · 2025: 6 · 2023: 4
FWCI
1.04
Type
journal article
Language
en
Open access
Licence
Locations
  • Nursing Open (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Priority Academic Program Development of Jiangsu Higher Education Institutions (No.87)
Topics
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
  • Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
Keywords
gestational diabetes mellitus, self-management, barriers to self-management, pregnant women, knowledge and belief, skills and abilities, social support, environment
MeSH terms
Self-Management, Adult, Female, Humans, Pregnancy, Social Support, Diabetes, Gestational, Qualitative Research, Self Report

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review