Health Care Providers' Perspectives on Factors Influencing Diabetes Management Among Thai Pregnant Women.

Abstract

Background: Diabetes during pregnancy poses significant risks to maternal and fetal health. This study explores health care providers' perspectives on factors influencing pregnant women with type 2 diabetes management in Thailand.

Methods: A qualitative descriptive study based on the National Institute on Minority Health and Health Disparities (NIMHD) Research Framework. Semi-structured interviews were conducted with 13 physicians and nurses from two public hospitals (urban and rural areas). Directed content analysis was used to analyze the data, with themes and subthemes derived from initial codes based on the NIMHD framework.

Results: Thirteen health care providers participated, including 10 nurses and 3 physicians. Three major themes emerged. Each theme was categorized into NIMHD domains of influence, including biological, behavioral, physical/built environment, and sociocultural environment. Theme 1: Individual-level factors include biological vulnerability and mechanisms in diabetes risk, maternal and neonatal complications, unplanned pregnancy and unawareness of preexisting diabetes, lifestyle behavior factors contributing to diabetes risk, diabetes management during pregnancy, environmental and workplace adjustments for pregnant women, sociodemographic challenges in diabetes management during pregnancy, and culture and beliefs in pregnancy care. Theme 2: Interpersonal-level factors include maternal responsibility for a safe pregnancy, family involvement in pregnancy care, promoting diabetes awareness and healthy lifestyle in schools and workplaces, and the role of social media and digital platforms in maternal health. Theme 3: Community-level factors include the role of community functioning in maternal health, access to healthy and safe food in the community, and cultural shifts toward convenience food options.

Discussion: Emphasizing these factors requires a coordinated approach involving health care providers, families, communities, schools, workplaces, and policymakers. Tailored interventions promoting diabetes screening, healthy lifestyles, and supportive environments for pregnant women, particularly those from disadvantaged backgrounds, are crucial. Future research should focus on developing culturally sensitive, community-based strategies to overcome barriers to care and improve diabetes management during pregnancy.