Title: Recommendations for improvement for an outpatient hospital intervention aimed at women with gestational diabetes.
Purpose: The purpose of this project is to improve the current intervention at an outpatient hospital for women with gestational diabetes mellitus (GDM) during pregnancy, with the specific aim of enhancing action competences and thereby enhancing quality of life among the women.
Methods: The project theory of science is embedded in critical realism and the develop-ment of the intervention is inspired by the MRC-model and assisted by the INDEX-Guidance with the intention of determining possible recommendations for improvement for the out-patient hospital. The results are based on semi structured interviews of six pregnant wom-en diagnosed with GDM, completed with inspiration from realistic interviews and hereby identifying barriers and facilitators for increasing action competences and quality of life. The outpatient hospital has assisted with recruitment of the participants. There is further-more carried out a systematic literature search in four databases, PubMed, Embase, Cinahl and PsycNet, with the intention of examining barriers and facilitators that according to the research literature can enhance action competences among women with GDM. The sys-tematic literature search resulted in identification of six relevant articles. The articles and the interviews are both analysed with inspiration from Braun and Clarkes thematic analysis. The results of the analysis is furthermore used to refine the program theory of the project.
Results: The analysis found five mechanisms, that may benefit the outpatient hospital, in-cluding ‘individual involvement’, ‘support’, ‘shock over the diagnosis’, ‘planning and struc-ture’ and ‘involvement, vision, critical sense, insight, experience of actions’. 1. The advice to activate the mechanism ‘individual involvement’, is to use recommendations from Vibis for involvement (Danish center for user involvement). 2. It is furthermore recommended to use the Fundamental of Care Framework and thereby, being able to form a relationship, in a short time, which can lead to ‘support’ for the woman and reduce the ‘shock over the diag-nosis’. Additionally, it is recommended to involve the partner in the consultations, because the partner is a big support for the woman. 3. It is recommended that the health care per-sonnel compose an action plan and a coping plan, where behaviour is specified and where possible barriers is taken into account, to help the woman with ‘planning and structure’. 4. Finally, it is recommended that focusing on action, participation and knowledge and thereby incorporating elements of the target groups own actions and experiences in the counselling and furthermore updating the present pamphlet with knowledge, comprising behavioural change and finally using the SMART-model. The projects analysis indicates that the sugges-tions of change can lead to enhanced action competences and enhanced quality of life for the women.
Conclusion: The project thereby contributes with 4 recommendations of improvement, that can lead to women enhancing their action competences and hereby their quality of life, which concomitant can reduce the occurrence of unanticipated consequences.