背景:未能参加预定的预约是医疗保健领域的常见问题。在产科,妊娠期糖尿病(GDM)的诊断和治疗方案需要客户预订,试验准备,管理和后续审查。我们确定了社会人口统计学,影响GDM测试预约依从性的产科和医疗驱动因素以及孕妇进行口服葡萄糖耐量测试(OGTT)的经验。
方法:使用了一种包括横断面调查和探索性定性描述性设计的会聚平行混合方法研究。我们从初级产前诊所招募了817名怀孕前三个月的妇女,加纳的二级和三级卫生设施。在获得他们的人口统计学和健康史之后,我们安排他们在24至28孕周之间进行2小时OGTT,并估计返回测试的几率.在定性阶段,我们打电话给166名参与者,以确定他们没有报告的原因。此外,我们与60名进行OGTT检查的产后妇女进行了深入和集中的小组讨论,以探讨她们的测试经验.
结果:在计划的817名孕妇中,490(59.97%)报告其中54.59,54.33和53.24%完成空腹血糖,1-h和2-hOGTT,分别。产妇年龄在35岁以上(OR:3.56,95%CI:1.49-8.47),中等教育(OR:3.21,95%CI:1.19-8.69),正规部门就业(OR:2.02,95%CI:1.16-3.51)和有同性子女(OR:4.37,95%CI:1.98-9.66)增加了任命依从性的几率,而三级医院的医疗保健(OR:0.46,95%CI:0.22-0.96),农村居民(OR:0.53,95%CI:0.34-0.85)和超重(OR:0.45,95%CI:0.25-0.78)降低了这种可能性.经验被主题化为对测试程序的感受,试验的可接受性,卫生工作者的技能和测试信息。尽管与测试相关的担忧和不适,了解自己疾病状况的愿望是主要动机。移情,放心并获得有关测试程序的充足信息可以缓解焦虑并提高测试依从性。
结论:虽然40%的参与者没有返回,测试总体上是可以接受的。社会文化基础影响了寻求健康的行为,这意味着卫生工作者在测试程序上的互动需要对女性的情况敏感。
BACKGROUND: Failure to attend scheduled appointments is a common problem in healthcare. In obstetrics, diagnostic and treatment protocols for gestational diabetes mellitus (GDM) require client
booking, test preparations, management and follow-up reviews. We identified the socio-demographic, obstetric and medical drivers influencing adherence to appointments for GDM testing and experiences of pregnant women\'s regarding performing oral glucose tolerance test (OGTT).
METHODS: A convergent parallel mixed-methods study comprising a cross-sectional survey and an explorative qualitative descriptive design were used. We recruited 817 women in their first trimester of pregnancy from the antenatal clinics of primary, secondary and tertiary health facilities in Ghana. After obtaining their demographic and health history, we scheduled them for 2-h OGTT between 24 and 28 gestational weeks and estimated the odds of returning for the test. In the qualitative phase, we called 166 participants to ascertain why they failed to report. Also, we had in-depth and focused group discussions with 60 postpartum women who performed the OGTT to explore their experiences with the test.
RESULTS: Out of 817 pregnant women scheduled, 490 (59.97%) reported of which 54.59, 54.33 and 53.24% completed fasting plasma glucose, 1-h and 2-h OGTT, respectively. Maternal age above 35 years (OR: 3.56, 95% CI:1.49-8.47), secondary education (OR: 3.21, 95% CI: 1.19-8.69), formal sector employment (OR: 2.02, 95% CI: 1.16-3.51) and having same-sex children (OR: 4.37, 95% CI: 1.98-9.66) increased odds of appointment adherence whereas healthcare in a tertiary hospital (OR:0.46, 95% CI:0.22-0.96), rural residence (OR: 0.53, 95% CI: 0.34-0.85) and being overweight (OR: 0.45, 95% CI: 0.25-0.78) decreased the likelihood. Experiences were thematized into feelings about test procedure, acceptability of test, skillfulness of the health workers and information on the test. Despite the apprehension and discomforts associated with the test, the desire to know one\'s disease status was the chief motivation. Empathy, reassurance and receiving ample information on the test procedures eased anxiety and improved test compliance.
CONCLUSIONS: Although 40% of participants scheduled did not return, the test was generally acceptable. Socio-cultural underpinnings influenced the health-seeking behaviors, meaning that health worker interactions on test procedures need to be sensitive to the woman\'s situation.