Abstract:

Objective To explore the developmental trajectory of family support and glucose management decision-making behaviours of gestational diabetes mellitus patients and the mutual predictive relationship between them，in order to provide a basis for improving the glucose management decision-making behaviours of gestational diabetes mellitus patients. Methods From April to September 2022，216 patients with gestational diabetes mellitus in a tertiary hospital in Jiangsu Province were selected by convenience sampling method，and follow-up surveys were conducted during the diagnosis period，the expectant period，and the postpartum follow-up period，and data were analysed using latent variable growth model and cross-lagged model. Results 211 patients completed the follow-up survey. The latent variable growth model showed that family support（S=-0.222，P<0.001） and glucose management decision-making behaviours（S=-4.520，P<0.001） in patients with gestational diabetes mellitus showed a decreasing trend from the diagnostic period to the postnatal follow-up period，and that the initial level of family support positively predicted the initial level of glucose management decision-making behaviours（β=0.380，P=0.018） and developmental speed（β=0.747，P<0.001），and the developmental speed of family support can positively predict the developmental speed of blood glucose management decision-making behaviour（β=0.601，P<0.001）. The cross-lagged model showed that the family support of the previous period among the 3 periods can positively predict the blood glucose management decision-making behaviour in the next period（β=0.751，P=0.027），（β=0.590，P=0.049） and vice versa. Conclusion This study confirms that family support and glucose management decision-making behaviours of gestational diabetes mellitus patients gradually weakened from the diagnosis period to the postpartum follow-up period，revealing that family support is an important protective factor in the development of glucose management decision-making behaviours. Healthcare professionals should guide family members to participate in the management of glucose at an early stage，continue to pay attention to the developmental trajectory in different periods and develop personalized intervention strategies to assist patients in making the best decisions.

Key words: Gestational Diabetes Mellitus, Family Support, Blood Glucose Management, Decision-Making Behaviour, Latent Variable Growth Model, Cross-Lagged Model, Nursing Care

摘要：

目的 探讨妊娠期糖尿病（gestational diabetes mellitus，GDM）患者家庭支持与血糖管理决策行为的发展轨迹及两者之间的预测关系，为改善GDM患者血糖管理决策行为提供理论依据。方法 2022年4月—9月，采用便利抽样法，选取在江苏省某三级甲等医院产科门诊就诊并规律产检的216例GDM患者作为调查对象，分别于确诊期、待产期及产后随访期对其家庭支持及血糖管理决策行为进行追踪调查，使用潜变量增长模型及交叉滞后模型进行数据分析。结果 最终211例GDM患者完成追踪调查。潜变量增长模型显示，GDM患者自确诊期至产后随访期的家庭支持（S=-0.222，P<0.001）与血糖管理决策行为（S=-4.520，P<0.001）均呈下降趋势；家庭支持的初始水平能够正向预测血糖管理决策行为的初始水平（β=0.380，P=0.018）及发展速度（β=0.747，P<0.001），家庭支持的发展速度能够正向预测血糖管理决策行为的发展速度（β=0.601，P<0.001）。交叉滞后模型显示，3个时期中上一时期的家庭支持可以正向预测下一时期的血糖管理决策行为（β=0.751，P=0.027）、（β=0.590，P=0.049），反之则不能。结论 该研究证实GDM患者自确诊期至产后随访期家庭支持及血糖管理决策行为逐渐减弱，家庭支持是血糖管理决策行为发展过程中的重要保护因素，医护工作者应尽早引导家属共同参与血糖管理，持续关注两者不同时期的发展轨迹并制订个性化的干预策略，辅助患者做出最佳决策。

关键词: 妊娠期糖尿病, 家庭支持, 血糖管理, 决策行为, 潜变量增长模型, 交叉滞后模型, 护理