Effect of Educational Package on Self-Care Behavior and Quality of Life in Pregnant Women with Gestational Diabetic: A Randomized Controlled Clinical Trial

Abstract

Abstract: Background: Gestational diabetes is a particular problem during pregnancy which can cause complications for mother and fetus. One reason for the lack of success in the treatment of diabetes is the lack of patient participation in the process of treatment. Self-care education is an important principle in the treatment of diabetes and can enhance the quality of life. This study aimed to determine the effect of educational package on self-care behavior, quality of life, fasting blood glucose level and GTT as primary outcomes and the frequency of preterm labor and caesarian delivery and neonatal anthropometric indices as secondary outcomes which was performed in women with gestational diabetes. Materials and Methods: This randomized controlled clinical trial was performed on 92 pregnant women with gestational diabetes (n = 46 in each group) referred to Tohid hospital diabetes clinic in Sanandaj - Iran. The educational program was designed in four sessions (one hour) per week for intervention group through lecture and question and answer and the participants were received educational booklet at the end of the first session. The control group received only routine prenatal care. Before and four weeks after the intervention, self-care and quality of life questionnaires were completed by participants in both groups and fasting blood glucose and GTT were measured in. The frequency of preterm labor and caesarian delivery and neonatal anthropometric indices were recorded in the checklist according to childbirth file. The chi-square, chi-square for trend, ANCOVA and independent t tests were used for data analysis. Results: There was no significant difference between two groups in terms of socio-demographic characteristics (p>0.05). By adjusting the baseline score, self-care behaviors mean score of the intervention group was significantly higher compared with the control group four weeks after the intervention [adjusted mean difference: 19.5; 95% confidence interval: 14.4 to 24.6; P<0.001]. Also, by adjusting baseline values, there was a statistically significant difference in the average level of blood glucose at one hour after GTT [-21.6; -32.1 TO -11.1; P<0.001] and two hours after GTT [-17.3; -23.0 to -11.6; P<0.001]. level of GTT between the two groups [-17.3; -23.0 to -11.6; P=0.001]. No statistically significant difference was seen in the FBS (P=0.443) and quality of life (P=0.264) four weeks after the intervention. There was no significant difference between two groups in terms of weight, height and head circumference (p>0.05). Also, there was no significant difference between two groups in terms of preterm labor (p= 0.664) but the frequency of caesarian delivery was significantly lower in intervention group than the control group (p<0.001). Conclusion: Self-care education in women with gestational diabetes can improve self-care behavior and is effective on impaired glucose tolerance. Thus, including of these educations in prenatal cares of women with gestational diabetes are recommended.