用于普遍筛查妊娠糖尿病的口服葡萄糖耐量试验。

Q3 Medicine
Abha Shrestha, Rajani Shakya, Rabina Shrestha, Sulata Karki, Seema Das, Priya Shrestha, Anisha Rai, Saroj Thapa, Abha Shrestha, Biraj Karmacharya
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引用次数: 0

摘要

背景:在许多国家,包括欠发达国家,妊娠糖尿病的发病率增加了近30%,尼泊尔也是如此。尼泊尔以医院为基础的研究报告显示,妊娠糖尿病病例的发病率从 2010 年的 2.48% 上升到 2019 年的 4.47%,这强调了普遍筛查妊娠糖尿病的必要性:作为产前护理电子决策支持系统实施工作的一部分,2019 年 10 月至 12 月期间,在形成性研究中向尼泊尔卡夫雷县和多拉卡县 3 家初级医疗保健机构的 6 名医疗服务提供者(主管、辅助护士、助产士和实验室助理)展示了有关妊娠糖尿病病例的临床小故事。对来自 4 个县(卡夫雷县、多拉卡县、信都里县和信都帕尔卓克县)19 个基层医疗机构的 19 名辅助护士和助产士进行了 4 小时的口服葡萄糖耐量测试培训。对 16 名辅助护士和助产士(8 名接受过培训,8 名来自选定的 4 个家庭护理中心)进行了深入访谈,以了解她们对进行口服葡萄糖耐量测试的看法和经验,并在今后继续开展这项工作。将临床试纸与 PEN 方案进行比较,并对 IDI 进行专题分析:结果:只有 4/6 名保健医生做出了妊娠糖尿病的可能诊断。进行了 217 次口服葡萄糖耐量测试,发现 24 人患有妊娠糖尿病。深入访谈显示,辅助护士和助产士热衷于实施妊娠糖尿病测试,并继续在培训中学到的知识。面临的一些挑战是:由于没有交通工具和家务劳动,客户不愿在医疗机构逗留 2 小时。接受过口服葡萄糖耐量试验培训的辅助护士和助产士在提供咨询和进行口服葡萄糖耐量试验方面似乎比接受过同伴辅导的人员更有信心:尽管存在一些挑战,但在高危家庭中进行口服葡萄糖耐量试验似乎是可行的。市政当局提供的培训和持续的后勤供应似乎很有前景。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Oral Glucose Tolerance Test for Universal screening for Gestational Diabetes Mellitus.

Background: Gestational Diabetes Mellitus increased almost 30% in many countries, including underdeveloped countries and same in Nepal. Hospital-based studies in Nepal reported Gestational Diabetes Mellitus cases, with prevalence 2.48% in 2010 to 4.47% in 2019 emphasising on necessity of universal screening for Gestational Diabetes Mellitus.

Methods: As part of implementation of Electronic Decision support System for Antenatal Care, in formative study clinical vignettes on Gestational Diabetes Mellitus case presented to six healthcare providers ( Incharges, Auxiliary Nurse, Midwives and Lab Assistants) from 3 primary healthcare facilities in Kavre and Dolakha districts, Nepal from October-December 2019. 19 Auxiliary Nurse, Midwives from 19 HCF of 4 districts (Kavre, Dolakha, Sindhuli, and Sindhupalchok, including where clinical vignette were applied trained to perform Oral Glucose Tolerance Test for 4 hours. In-depth Interviews conducted with 16 Auxiliary Nurse, Midwives (8 trained and 8 peer coached from selected 4 HCF to explore their perception and experiences of conducting Oral Glucose Tolerance Test and continuing it for future. Clinical vigenttes compared with PEN protocol and IDIs analyzed thematically.

Results: Only 4/6 HCPs made probable diagnosis of Gestational Diabetes Mellitus. 217 Oral Glucose Tolerance Test performed, 24 found to have Gestational Diabetes Mellitus. In-depth Interviews showed Auxiliary Nurse, Midwives enthusiasts on implementing tests for Gestational Diabetes Mellitus and to continue what has been learnt in training. Some challenges; clients hesitate to stay 2 hours at facilities due to unavailability of transport and household work. Oral Glucose Tolerance Test trained Auxiliary Nurse, Midwives seem more confident in counselling and conducting Oral Glucose Tolerance Test than those peer coached.

Conclusions: Administering Oral Glucose Tolerance Test seemed feasible in HCF settings despite some challenges. Training and continuing logistics supply from municipality level seems promising.

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来源期刊
CiteScore
1.40
自引率
0.00%
发文量
81
审稿时长
15 weeks
期刊介绍: The journal publishes articles related to researches done in the field of biomedical sciences related to all the discipline of the medical sciences, medical education, public health, health care management, including ethical and social issues pertaining to health. The journal gives preference to clinically oriented studies over experimental and animal studies. The Journal would publish peer-reviewed original research papers, case reports, systematic reviews and meta-analysis. Editorial, Guest Editorial, Viewpoint and letter to the editor are solicited by the editorial board. Frequently Asked Questions (FAQ) regarding manuscript submission and processing at JNHRC.
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