Determinants of Diabetes Self-Management in Women with Gestational Diabetes with PRCEED Model Approach

Gestational diabetes mellitus (GDM) affects a significant number of individuals worldwide. Self-management is an effective method to control gestational diabetes and the various factors that affect it. This study was conducted to study determinants of diabetes self-management in women with gestational diabetes using the PRCEED model approach. This cross sectional study was conducted on 329 women with gestational diabetes in Qom, during 2018. The convenience sampling method and the multi-sectional questionnaire were used to evaluate knowledge, attitude, self-efficacy, social support, pregnancy distress and enabling factors among the subjects. Data analysis was performed in SPSS v. 21 and Lisrel v. 8.5, using t. test, ANOVA, Correlation and Path analysis. A positive relationship was observed between self-management and predisposing factors such as knowledge (r=0.848, P<0.01), attitude (r=0.132, P<0.05) and self-efficacy (r=0.79, P<0.01); furthermore there was a positive and direct association between self-management and the enabling factors (r=0.353, P<0.01). Regarding the reinforcing factors, social support had a positive and direct relationship with self-management (r=0.173, P<0.01), whereas there was a significant inverse relationship between pregnancy distress and self-management (r=-0.587, P<0.01). Self-efficacy was the strongest predictor for self-management (β=0.87), followed by social support (β=0.80). Study results emphasized the importance of the effects of predisposing, reinforcing and enabling factors on self-management, which could be used as the framework to develop appropriate interventions for women with gestational diabetes.