Exploring the social experiences, stigma and discrimination, faced by women with gestational diabetes: A collaborative qualitative study and item-pool development

IF 3.4 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Diabetic Medicine Pub Date : 2025-05-23 DOI:10.1111/dme.70073

E. Holmes-Truscott, E. Litterbach, C. Arampatzi, C. Calyx, J. E. Cherry, V. Gilbert-Morresi, A. Williams, M. Fuller-Tyszkiewicz, H. Teede, J. Speight

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Abstract

Aim

To explore experiences of stigma related to gestational diabetes (GDM) among Australian women and collaboratively develop a comprehensive item pool to assess experienced and internalised GDM-specific stigma.

Methods

A GDM Lived Experience Advisory Group (G-LEAG; n = 4) informed all aspects of a two-phase qualitative research process. Phase 1 included semi-structured online interviews with 20 women with current or recent GDM. Reflexive thematic analysis identified drivers and facilitators, markers, manifestations, impacts and protective mechanisms of GDM stigma. Findings informed the development of an item pool, debriefed and refined with a subset of 10 participants in Phase 2 interviews.

Results

All participants perceived, experienced, anticipated and/or internalised GDM-specific stigma. They perceived GDM-specific stigma to be driven by stereotypes and blame, and facilitated by societal norms regarding motherhood and pregnancy, media messaging, as well as inflexible and inconsistent healthcare policies. They reported social, emotional and self care impacts, as well as perceived loss of autonomy in clinical care. They proposed potential protective mechanisms, including social and healthcare support, self-belief and self-compassion, and community awareness. In cognitive debriefing interviews, women reported that the draft items comprehensively covered their experiences of GDM-specific stigma and offered suggestions for refinement, resulting in a 74-item pool.

Conclusions

Findings provide rich insights into the experiences and impacts of stigma among women with GDM in Australia and resulted in a co-designed GDM-specific stigma item pool. The item pool is ready for psychometric assessment and item reduction, which will enable future quantification of the occurrence, impacts and mechanisms of GDM-specific stigma.

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探讨妊娠期糖尿病妇女面临的社会经验、污名和歧视：一项合作定性研究和项目池开发。

目的：探讨澳大利亚妇女与妊娠糖尿病（GDM）相关的耻辱感经历，并合作开发一个全面的项目库来评估经历和内化GDM特异性耻辱感。方法：GDM生活经验咨询小组（g - legg）；N = 4)告知两阶段定性研究过程的所有方面。第一阶段包括对20名目前或最近患有GDM的女性进行半结构化的在线访谈。反身性专题分析确定了GDM病耻感的驱动因素和促进因素、标记、表现、影响和保护机制。调查结果为项目库的发展提供了信息，并在第二阶段的访谈中与10名参与者进行了汇报和改进。结果：所有参与者感知、体验、预期和/或内化了gdm特有的耻辱。他们认为，gdm特有的污名是由刻板印象和指责驱动的，并受到有关母亲和怀孕的社会规范、媒体信息以及不灵活和不一致的医疗保健政策的推动。他们报告了社会、情感和自我保健的影响，以及临床护理中自主性的丧失。他们提出了潜在的保护机制，包括社会和保健支持、自信和自我同情以及社区意识。在认知汇报访谈中，妇女报告说，草案项目全面涵盖了她们对gdm特有耻辱的经历，并提出了改进建议，最终形成了74个项目库。结论：研究结果为了解澳大利亚GDM妇女的病耻感经历和影响提供了丰富的见解，并形成了一个GDM特异性病耻感项目库。项目库已准备好进行心理测量评估和项目缩减，这将使未来量化gdm特异性病耻感的发生、影响和机制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetic Medicine 医学-内分泌学与代谢

CiteScore

7.20

自引率

5.70%

发文量

229

审稿时长

3-6 weeks

期刊介绍： Diabetic Medicine, the official journal of Diabetes UK, is published monthly simultaneously, in print and online editions. The journal publishes a range of key information on all clinical aspects of diabetes mellitus, ranging from human genetic studies through clinical physiology and trials to diabetes epidemiology. We do not publish original animal or cell culture studies unless they are part of a study of clinical diabetes involving humans. Categories of publication include research articles, reviews, editorials, commentaries, and correspondence. All material is peer-reviewed. We aim to disseminate knowledge about diabetes research with the goal of improving the management of people with diabetes. The journal therefore seeks to provide a forum for the exchange of ideas between clinicians and researchers worldwide. Topics covered are of importance to all healthcare professionals working with people with diabetes, whether in primary care or specialist services. Surplus generated from the sale of Diabetic Medicine is used by Diabetes UK to know diabetes better and fight diabetes more effectively on behalf of all people affected by and at risk of diabetes as well as their families and carers.”