Reasons for women's non-participation in follow-up screening after gestational diabetes

Women Birth. 2015 Dec;28(4):e157-63. doi: 10.1016/j.wombi.2015.04.006. Epub 2015 May 18.

Abstract

Background: Due to the increased risk of type 2 diabetes, follow-up screening after birth is recommended to women with previous gestational diabetes. Low participation in such screening has been shown to delay detection of diabetes with potentially serious consequences for the women's future health. The women's experiences of treatment and care during their pregnancies may affect participation.

Aim: This study aimed at understanding the women's experiences with treatment and care during pregnancy and to understand how these experiences influence participation in follow-up screening.

Methods: A qualitative study was undertaken drawing on a phenomenological methodology. Seven women treated for gestational diabetes at a university hospital in the North Denmark Region participated in interviews.

Findings: The women experienced lack of continuity in care between hospital departments and health sectors. We identified the following causes for low participation in follow-up screening: poor coordination, little elaboration of information, a lack of clear coordination of responsibility for follow-up screening among health care professionals and absence of focus and inclusion of their individual needs and preferences.

Conclusion: The women wished to be reminded of screening to increase their sense of safety. The women's experiences seem to reflect a lack of patient-centeredness during the pregnancy, which may be remedied by increasing the focus on the women's need for improved continuity in treatment and care. Participation in follow-up screening after gestational diabetes may be increased by sending reminders to the women. Raised awareness of the women's individual needs and preferences for treatment and care offers potential for improvement.

Keywords: Decision-making; Gestational diabetes; Patient compliance; Patient-centred care; Reminder systems.

MeSH terms

  • Adult
  • Decision Making
  • Diabetes Mellitus, Type 2 / diagnosis
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / prevention & control*
  • Diabetes, Gestational / diagnosis*
  • Female
  • Follow-Up Studies
  • Humans
  • Interviews as Topic
  • Mass Screening / methods*
  • Parturition
  • Patient Compliance*
  • Patient-Centered Care*
  • Postpartum Period
  • Pregnancy
  • Qualitative Research
  • Reminder Systems
  • Social Support
  • Surveys and Questionnaires
  • Young Adult