Women's experience with receiving advice on diet and Self-Monitoring of blood glucose for gestational diabetes mellitus: a qualitative study

Objective: We aimed to explore how women with gestational diabetes mellitus (GDM) experience advice about diet and self-monitoring of blood glucose received in primary health care (PHC) and secondary health care (SHC) with a focus on how women perceived the care coordination and collaboration between healthcare professionals. Design, setting and subjects: Individual interviews were conducted with 12 pregnant women diagnosed with GDM. Six women had immigrant backgrounds, and six were ethnic Norwegian. Women received GDM care in the area of Oslo, Norway. Interviews were analysed using thematic analysis. Results: Women described feeling shocked when they were diagnosed with GDM and feeling an immediate need for information about the consequences and management of GDM. Most of the women felt that their general practitioner (GP) had too little knowledge about GDM. Women with an immigrant background felt that the PHC midwives provided them with sufficient dietary advice related to GDM. Ethnic Norwegian women appreciated receiving more individually tailored dietary advice in SHC. Self-monitoring of blood glucose influenced women’s daily lives; however, they perceived the training in PHC and SHC as adequate. The women experienced poor collaboration between healthcare professionals in PHC and SHC, which implied that they sometimes had to initiate follow-up steps in their GDM care by themselves. Conclusions: Ideally, women diagnosed with GDM should meet healthcare professionals with sufficient knowledge about GDM as soon as possible after being diagnosed. The collaboration between healthcare professionals involved in the care of women with GDM should be improved to avoid having women feel that they need to coordinate their own care

Women's experience with receiving advice on diet and Self-Monitoring of blood glucose for gestational diabetes mellitus: a qualitative study

Objective: We aimed to explore how women with gestational diabetes mellitus (GDM) experience advice about diet and self-monitoring of blood glucose received in primary health care (PHC) and secondary health care (SHC) with a focus on how women perceived the care coordination and collaboration between healthcare professionals. Design, setting and subjects: Individual interviews were conducted with 12 pregnant women diagnosed with GDM. Six women had immigrant backgrounds, and six were ethnic Norwegian. Women received GDM care in the area of Oslo, Norway. Interviews were analysed using thematic analysis. Results: Women described feeling shocked when they were diagnosed with GDM and feeling an immediate need for information about the consequences and management of GDM. Most of the women felt that their general practitioner (GP) had too little knowledge about GDM. Women with an immigrant background felt that the PHC midwives provided them with sufficient dietary advice related to GDM. Ethnic Norwegian women appreciated receiving more individually tailored dietary advice in SHC. Self-monitoring of blood glucose influenced women’s daily lives; however, they perceived the training in PHC and SHC as adequate. The women experienced poor collaboration between healthcare professionals in PHC and SHC, which implied that they sometimes had to initiate follow-up steps in their GDM care by themselves. Conclusions: Ideally, women diagnosed with GDM should meet healthcare professionals with sufficient knowledge about GDM as soon as possible after being diagnosed. The collaboration between healthcare professionals involved in the care of women with GDM should be improved to avoid having women feel that they need to coordinate their own care

Women's experience with receiving advice on diet and Self-Monitoring of blood glucose for gestational diabetes mellitus: a qualitative study

Objective We aimed to explore how women with gestational diabetes mellitus (GDM) experience advice about diet and self-monitoring of blood glucose received in primary health care (PHC) and secondary health care (SHC) with a focus on how women perceived the care coordination and collaboration between healthcare professionals. Design, setting and subjects Individual interviews were conducted with 12 pregnant women diagnosed with GDM. Six women had immigrant backgrounds, and six were ethnic Norwegian. Women received GDM care in the area of Oslo, Norway. Interviews were analysed using thematic analysis. Results Women described feeling shocked when they were diagnosed with GDM and feeling an immediate need for information about the consequences and management of GDM. Most of the women felt that their general practitioner (GP) had too little knowledge about GDM. Women with an immigrant background felt that the PHC midwives provided them with sufficient dietary advice related to GDM. Ethnic Norwegian women appreciated receiving more individually tailored dietary advice in SHC. Self-monitoring of blood glucose influenced women’s daily lives; however, they perceived the training in PHC and SHC as adequate. The women experienced poor collaboration between healthcare professionals in PHC and SHC, which implied that they sometimes had to initiate follow-up steps in their GDM care by themselves. Conclusions Ideally, women diagnosed with GDM should meet healthcare professionals with sufficient knowledge about GDM as soon as possible after being diagnosed. The collaboration between healthcare professionals involved in the care of women with GDM should be improved to avoid having women feel that they need to coordinate their own care

Feber under fødsel og antibiotikabehandling – en kvalitetssikringsstudie

Bakgrunn: Feber under fødsel defineres som kroppstemperatur ≥38 °C og forekommer ved omtrent 7 prosent av fødsler til termin. Tilstanden gir økt risiko for maternell og neonatal sykelighet og dødelighet. Korrekt bruk av antibiotika kan redusere forekomsten av alvorlige utfall for mor og barn. Hensikt: Kartlegge forekomst av feber under fødsel og bruk av antibiotika med denne indikasjonen ved Fødeavdelingen Ullevål på Oslo universitetssykehus samt vurdere om bruken av antibiotika var i henhold til klinikkens prosedyre. Metode: Gjennomgang av journaler til pasienter med fødsel til termin som var innlagt på fødeavdelingen i perioden 1.–30. april 2018. Resultat: Feber under fødsel (intrapartum feber) var registrert hos 67 av 552 pasienter (12 prosent). 99 pasienter (18 prosent) mottok behandling med feberreduserende medikamenter og/eller antibiotika grunnet feber. Av disse fikk 53 penicillin (54 prosent) grunnet mistanke om infeksjon. Kriteriene etter gjeldende prosedyre for profylaktisk antibiotikabehandling ble oppfylt hos 38 av de 53 pasientene som fikk penicillin (72 prosent). Penicillin i kombinasjon med gentamycin ble gitt til 21 av 99 pasienter (21 prosent) med indikasjon klinisk chorioamnionitt (betennelse i føtale membraner). Av disse 21 pasientene var det 15 (71 prosent) som oppfylte kriteriene for behandling. Konklusjon: Vi fant en høyere forekomst av intrapartum feber enn beskrevet i litteraturen. Journalgjennomgangen viste at bruken av antibiotika var i henhold til prosedyren på flere områder, men at det var utfordringer knyttet til overbehandling

Feber under fødsel og antibiotikabehandling – en kvalitetssikringsstudie

Bakgrunn: Feber under fødsel defineres som kroppstemperatur ≥38 °C og forekommer ved omtrent 7 prosent av fødsler til termin. Tilstanden gir økt risiko for maternell og neonatal sykelighet og dødelighet. Korrekt bruk av antibiotika kan redusere forekomsten av alvorlige utfall for mor og barn. Hensikt: Kartlegge forekomst av feber under fødsel og bruk av antibiotika med denne indikasjonen ved Fødeavdelingen Ullevål på Oslo universitetssykehus samt vurdere om bruken av antibiotika var i henhold til klinikkens prosedyre. Metode: Gjennomgang av journaler til pasienter med fødsel til termin som var innlagt på fødeavdelingen i perioden 1.–30. april 2018. Resultat: Feber under fødsel (intrapartum feber) var registrert hos 67 av 552 pasienter (12 prosent). 99 pasienter (18 prosent) mottok behandling med feberreduserende medikamenter og/eller antibiotika grunnet feber. Av disse fikk 53 penicillin (54 prosent) grunnet mistanke om infeksjon. Kriteriene etter gjeldende prosedyre for profylaktisk antibiotikabehandling ble oppfylt hos 38 av de 53 pasientene som fikk penicillin (72 prosent). Penicillin i kombinasjon med gentamycin ble gitt til 21 av 99 pasienter (21 prosent) med indikasjon klinisk chorioamnionitt (betennelse i føtale membraner). Av disse 21 pasientene var det 15 (71 prosent) som oppfylte kriteriene for behandling. Konklusjon: Vi fant en høyere forekomst av intrapartum feber enn beskrevet i litteraturen. Journalgjennomgangen viste at bruken av antibiotika var i henhold til prosedyren på flere områder, men at det var utfordringer knyttet til overbehandling