HOW EFFECTIVE THE STRUCTURED TRAINING IN THE DECISION OF SCREENING OF GESTATIONAL DIABETES? ABSTRACT

Introduction and Aim: It is aimed to evaluate the effectiveness of training of pregnant women on decision of having an oral glucose challenge test (GCT) which recommended by physician for screening of gestational diabetes mellitus (GDM). Materials and Methods: This randomised controlled intervention study conducted at the antenatal outpatient clinics of an education and research hospital between January-July 2019. Permission was obtained from the ethics committee, hospital and each pregnant woman. Pregnant women who were not yet been diagnosed as GDM, not diagnosed as diabetes mellitus before invited to study and recommended GCT according to national and international guidelines in the second trimester of pregnancy. Two hundred and five volunteer pregnant women who met the inclusion criteria were randomized to two groups as control (n=101) and intervention (n=104). The control group, directly recommended to do GCT as routine, daily life. The intervention group trained by a physician with a structured-spesific audio-visual guidebook which was created by research team. Nearly 15-20 minutes trainings were held in a separate room in the same hospital. The outcome indicator was whether the pregnant did take the test or not, with and without attending the training; it was confirmed with medical records or patients’ declaration on call. Statistical analysis was done with package programme. Results: Six of 205 patients couldn't be reached for final results, so the study completed with 199 patients. It was determined that, 52 (53,6%) pregnant women in the control group and 30 (29,4 %) in the intervention group did not had GCT. Forty-five (46,4%) pregnant women in control group and 72 (%70,6) pregnants in intervention group did had GCT. There was statistically significant difference between the control and intervention groups in terms of having GCT (p = 0.001); the relative effectiveness (RE) was 1,52 (1,24-2,18) (%95 CI). For the pregnants who declared that she was hesitant about the test beginning of the study, the effectiveness of intervention was statistically significant (p=0,007); RE was 1,95 (1,14-3,32) (%95 CI). Discussion and Recommendations: Refusing the GCT is increasing recently in Turkey depending on the misconceptions like possible harmful effects on the baby and the mother of this test. Failure to detect GDM may result in increased health risks in mother and baby. The training which is simple, easily implemented with an Audio-Visual Aid/Pictured Guide Book have a positive effect on patients' decisions. Such training can be generalized in the other health facilities in a national level. The test suggested may be performed with visible materials. In Turkey, because the test is named as ‘glucose loading test’ in public, health professionals should use the term ‘screening’ instead of ‘loading’ for alleviating patients’ hesitation. All of the authors declare that they have no conflict of interest. Keywords: Antenatal care, effectiveness of structured training, gestational diabetes mellitus, glucose challenge test, screening.