Gestasyonel Diyabetli Kadınlara Diyabet Yönetimine İlişkin Hemşire Tarafından Verilen Web Tabanlı Danışmanlık Hizmetinin Etkinliğinin Değerlendirilmesi

Abstract

Çetinkaya Şimşek Ş. Evaluation of the Efficiency of the Web-based Nursing Counseling Service Provided to Gestational Diabetic Women Hacettepe University, Health Sciences Institute, Gynecology and Obstetrics Nursing Program, Doctorate Thesis, Ankara, 2018. The study was conducted as a randomized control intervention study to determine the efficiency of the Web-Based Nursing Counseling Services provided to women with Gestational Diabetes Mellitus (GDM) between 15.12.2016 and 09.03.2018 in the High-risk Pregnancy Policlinic of the Department of Gynecology and Obstetrics at Hacettepe University, Adult Hospital. The sampling of the study consisted of a total of 45 people 23 of whom were in the intervention group and 22 of whom were in the control group. The women who were included in the intervention group were provided with the web-based nursing counseling services for 14 weeks as of the 24th week of their pregnancy; and the women in control group was received standart care. The data of the study were collected by using the Introductory Characteristics Form for the Pregnant Women, the Information on Gestational Diabetes Mellitus Test, Physical Activity Diary, Nutrition Diary, Perinatal Period Mother and Newborn Follow-up Form, and Satisfaction Form. The data collection tools were applied to the women who were included in the Study after the web-based training with face-to-face interviews during routine pregnancy follow-ups after the web-based training and on the postpartum first day. The numbers, percentages, mean and standard deviation values were used in the analysis of the descriptive data. In the Independent Groups, the t-test was used to determine the difference between the groups. The relation between the two independent categorical variables was analyzed by using the Chi-Square Test. The variables between the dependent groups were compared by employing the Mc-Nemar and Friedman Tests. When the women in the intervention group were compared with the control group after the Web-Based Training, it was determined that their gestational diabetes information scores (p=0.001), physical activity status (p=0.001), complying with the diet provided by the dietitian (p=0.011) were statistically higher. When the perinatal results were evaluated in the women who were included in the İntervention group, it was determined during the pregnancy that, the hypoglycemia (p=0.035), hyperglycemia (p=0.026), vaginal fungi infection (p=0.034), hydramnios (p=0.047), the fear of GDM damaging herself and the baby (p=0.040) and giving birth to macrosomic baby rates (p=0.022) were found statistically higher when compared with the control group. It was determined that there were no differences between the groups in terms of fasting (p=0.772), 1st hour fullness (p=0.586), 2nd hour fullness (p=0.158) blood glucose levels. It was also determined that the Web-Based Counseling Services increased the satisfaction of women because these trainings contributed to increase the level of information, encouraged them to increase the level of physical activity, facilitated their adaptation to the diets, motivated them and saved time. As a result of the research, it was determined that the web-based counseling service provided by the nurse was effective in improving diabetes management and self-care competence in women. For this reason, it is suggested that the web based counseling system provided by the nurse should be integrated into the health care system. Keywords: Web-based counseling; nursing; gestational diabetes; mobile phone; telephone-based application