The effect birth outcome and diabetes management of planned behavior theory based education model in women with gestational diabetes

This study, which aims to determine the effect of Theory of Planned Behavior (TPB)-based education model on diabetes management and birth outcomes in women with gestational diabetes, consist of two stages. In the first stage, the Turkish validity and reliability study of the "The Diabetes Intention, Attitude And Behavior Questionnaire (DIAB-Q)", which is a TPB-based measurement tool, was conducted on 133 pregnant women with gestational diabetes (GDM) between February and April 2020. The data were analyzed first psycholinguistically and then psychometrically. In the analyzes, it was determined that the item-total score correlation values of the questionnaire were between .354 and .713, the Cronbach alpha (α) reliability coefficient was .88, the test-retest correlation coefficient values (r) were high on item basis and showed consistency over a short period of time and the questionnaire was validated as a five sub-dimensional construct. In the second stage, TPB-based education intervention in pregnant women with GDM was performed in a randomized controlled manner on 66 pregnant women (intervention: 33, control: 33) between May and November 2021. Data were collected face-to-face, online and over the phone with the help of the Personal Data Collection Form, DIAB-Q, Metabolic Control Variables (MCV) Form, Maternal and Baby Birth Outcomes Form. While a structured training program was applied with PDT-based "Motivational Interview" to the intervention group; control group received standard care. The data were analyzed with descriptive and significance tests. The significance level is p<0.05. A significant difference was found between the intervention and control groups in terms of mean scores of the DIAB-Q attitude, subjective norm and intention sub-dimensions (p<0.05). A significant difference was found in the measurement values of postprandial blood glucose, HbA1c and Body Mass Index, which are among the MCV parameters (p<0.05). A statistically significant difference was found in terms of the mother's postpartum diabetes control and the first feeding times of the babies (p<0.05). In conclusion, This study showed that the DIAB-Q is a valid and reliable measurement tool for pregnant women with GDM, and the educational intervention based on TPB contributes to diabetes management by affecting attitudes, subjective norms, and intentions in pregnant women with GDM. Keywords: Gestational diabetes, diabetes management, theory of planned behavior, motivational interviewing, nursing, reliability and validity.