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Original Article
Effects of an Integrated Self-Management Program on Self-Management, Glycemic Control, and Maternal Identity in Women with Gestational Diabetes Mellitus
HeeSook Kim, Sue Kim
Journal of Korean Academy of Nursing 2013;43(1):69-80.
DOI: https://doi.org/10.4040/jkan.2013.43.1.69
Published online: February 28, 2013

1Department of Nursing, Dongnam Health College, Suwon, Korea.

2College of Nursing · Nursing Policy Research Institute, Yonsei University, Seoul, Korea.

Address reprint requests to: Kim, HeeSook. Department of Nursing, Dongnam Health College, 50 Cheoncheon-ro 74-gil, Jangan-gu, Suwon-si, Gyeonggi-do 440-714, Korea. Tel: +82-31-249-6657, Fax: +82-31-249-6480, khs0204@dongnam.ac.kr, kimhs02041@hotmail.com
• Received: April 11, 2012   • Accepted: October 10, 2012

© 2013 Korean Society of Nursing Science

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  • Purpose
    The purpose of the study was to investigate the effects of an integrated self-management program on self-management, glycemic control, and maternal identity in women with gestational diabetes mellitus (GDM).
  • Methods
    A non-equivalent control group non-synchronized quasi-experimental design was used. A total of 55 women with GDM were recruited from Cheil General Hospital, Seoul, Korea and were assigned to an experimental (n=28) or control group (n=27). The participants were 24-30 weeks pregnant women who had been diagnosed with GDM as of July 30, 2010. The program was conducted as a 1 hour small group meeting 3 out of 5 times and by telephone-counseling 2 out of 5 times. The integrated self-management program was verified by an expert panel.
  • Results
    Although there was no significant reduction in HbA1c (U= -1.17, p=.238), there were statistically significant increases in self-management (U= -3.80, p<.001) and maternal identity (U= -4.48, p<.001), and decreased 2-h postprandial glucose levels (U= -2.43, p<.015) in the experimental group compared to the control group.
  • Conclusion
    These findings suggest that an integrated self-management program for women with GDM improves self-management, maternal identity, and glycemic control. Further studies are needed to identify the effects of an integrated self-management program on pregnancy and neonatal outcomes.
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Figure 1
Theoretical framework of study.
jkan-43-69-g001.jpg
Table 1
Research Design
jkan-43-69-i001.jpg

C1, E1 (Pretest)=Self-management, Glycemic control (PP2, HbA1c), Maternal identity, general characteristics; C2, E2 (3rd week)=Glycemic control (PP2); C3, E3 (Posttest)=Self-management, Glycemic control (PP2), Maternal identity; C4, E4 (Post-2nd week)=Glycemic control (HbA1c); X=Integrated self-management program (total 5 times).

Table 2
Contents of the Integrated Self-Management Program
jkan-43-69-i002.jpg

GDM=Gestational diabetes mellitus; SMBG=Self monitoring of blood glucose.

Table 3
Homogeneity Test of Characteristics for the Experimental and Control Groups (N=55)
jkan-43-69-i003.jpg

Exp.=Experimental group; Cont.=Control group; GDM=Gestational diabetes mellitus; BMI=Body mass index.

*Fisher's exact test; 2009 Institute of Medicine (IOM) criteria; Normal range.

Table 4
Homogeneity Test of Dependent Variables for the Experimental and Control Groups (N=55)
jkan-43-69-i004.jpg

Exp.=Experimental group; Cont.=Control group; PP2=2-hour postprandial glucose; HbA1c=Hemoglobin A1c.

*Normal range.

Table 5
Differences in Dependent Variables between the Experimental and Control Groups (N=55)
jkan-43-69-i005.jpg

Exp.=Experimental group; Cont.=Control group; SMBG=Self-monitoring of blood glucose; PP2=2-hour postprandial glucose; HbA1c=Hemoglobin A1c.

Figure & Data

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        Effects of an Integrated Self-Management Program on Self-Management, Glycemic Control, and Maternal Identity in Women with Gestational Diabetes Mellitus
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      Effects of an Integrated Self-Management Program on Self-Management, Glycemic Control, and Maternal Identity in Women with Gestational Diabetes Mellitus
      Image
      Figure 1 Theoretical framework of study.
      Effects of an Integrated Self-Management Program on Self-Management, Glycemic Control, and Maternal Identity in Women with Gestational Diabetes Mellitus

      Research Design

      C1, E1 (Pretest)=Self-management, Glycemic control (PP2, HbA1c), Maternal identity, general characteristics; C2, E2 (3rd week)=Glycemic control (PP2); C3, E3 (Posttest)=Self-management, Glycemic control (PP2), Maternal identity; C4, E4 (Post-2nd week)=Glycemic control (HbA1c); X=Integrated self-management program (total 5 times).

      Contents of the Integrated Self-Management Program

      GDM=Gestational diabetes mellitus; SMBG=Self monitoring of blood glucose.

      Homogeneity Test of Characteristics for the Experimental and Control Groups (N=55)

      Exp.=Experimental group; Cont.=Control group; GDM=Gestational diabetes mellitus; BMI=Body mass index.

      *Fisher's exact test; 2009 Institute of Medicine (IOM) criteria; Normal range.

      Homogeneity Test of Dependent Variables for the Experimental and Control Groups (N=55)

      Exp.=Experimental group; Cont.=Control group; PP2=2-hour postprandial glucose; HbA1c=Hemoglobin A1c.

      *Normal range.

      Differences in Dependent Variables between the Experimental and Control Groups (N=55)

      Exp.=Experimental group; Cont.=Control group; SMBG=Self-monitoring of blood glucose; PP2=2-hour postprandial glucose; HbA1c=Hemoglobin A1c.

      Table 1 Research Design

      C1, E1 (Pretest)=Self-management, Glycemic control (PP2, HbA1c), Maternal identity, general characteristics; C2, E2 (3rd week)=Glycemic control (PP2); C3, E3 (Posttest)=Self-management, Glycemic control (PP2), Maternal identity; C4, E4 (Post-2nd week)=Glycemic control (HbA1c); X=Integrated self-management program (total 5 times).

      Table 2 Contents of the Integrated Self-Management Program

      GDM=Gestational diabetes mellitus; SMBG=Self monitoring of blood glucose.

      Table 3 Homogeneity Test of Characteristics for the Experimental and Control Groups (N=55)

      Exp.=Experimental group; Cont.=Control group; GDM=Gestational diabetes mellitus; BMI=Body mass index.

      *Fisher's exact test; 2009 Institute of Medicine (IOM) criteria; Normal range.

      Table 4 Homogeneity Test of Dependent Variables for the Experimental and Control Groups (N=55)

      Exp.=Experimental group; Cont.=Control group; PP2=2-hour postprandial glucose; HbA1c=Hemoglobin A1c.

      *Normal range.

      Table 5 Differences in Dependent Variables between the Experimental and Control Groups (N=55)

      Exp.=Experimental group; Cont.=Control group; SMBG=Self-monitoring of blood glucose; PP2=2-hour postprandial glucose; HbA1c=Hemoglobin A1c.


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