Abstract

Background: Women, who previously have had GDM, is at increased risk of developing T2DM. It is recommended that this group of women participates in screening at their general practitioner, as well as change their lifestyle to prevent T2DM. Only few women participate in screening and lifestyle interventions, due to an experience of a lack of continuity of care as well as a lack of healthcare support in the transition between the secondary and primary sectors. This i caused by lack of continuity between the womens care for GDM and routine obstetric care.

Purpose: The purpose of this study is to contribute with a proposal that can contribute to reinforce the prevention of T2DM through an improvement in the continuity of care of women with previous GDM.

Method: Based on a hermeneutic approach, the hypothesis of the study is answered by a literature study and qualitative interviews. The literature study provides evidence about what is effective to ensure continuity of care, and hereby strengthen the prevention of T2DM. Qualitative interviews are used to collect knowledge about, what health professionals in the women's routine obstetric care careers believe can contribute to the lack of continuity of care how this can be improved.

Results: The qualitative study, supplemented by the literature study reveals, that sharing of information between sectors, a health professional relationship in the transition between sectors, and coordinated and interdisciplinary cross-sectoral collaboration are key elements in continuity of care, which contributes to reinforcing the prevention of T2DM.

Conclusion: A change in the continuity of care to women with former GDM, as part of reinforcing the prevention of T2DM, can be based on the following points: establishment of interdisciplinary cooperation agreements and coordination groups to establish a structure that clarifies goals, responsibilities and treatments. Collaboration between health professionals in the continuity of postpartum care of women involving the healthcare practitioner and the nurse in general practice, in an effort that considers, what the women wishes, what she needs and the opportunities, and here by ensure that the woman have a long-term relationship with the nurse. Improved sharing of information between sectors and health professionals, either through a change in electronic patient records, or through an improvement of the existing system of knowledge sharing between health professionals and sectors.
However, more research in the field should be carried out, to test the proposed changes on a smaller scale, for example in a smaller municipality to see if there is a basis for implementation on a larger scale.