Objective To construct the decision-making behavior model of blood glucose management among pregnant women with gestational diabetes mellitus（GDM） based on protection motivation theory. Methods A total of 1 261 pregnant women with GDM from 6 hospitals in Shanghai and Jiangsu province were selected by convenient sampling and investigated through the cross-sectional survey. The Self-Developed Blood Glucose Management Decision-Making Behavior Questionnaire，Protection Motivation Questionnaire，Knowledge Questionnaire and General Information Questionnaire were used to collect data. Multi-linear regression analysis was used to identify the influencing factors of decision-making behavior. Structural equation model was used to establish and revise the decision-making behavior model of blood glucose management. Results 1 181 pregnant women with GDM were included in this study. Vulnerability，severity，response efficacy，self-efficacy and response costs were influencing factors of blood glucose management decision-making behavior（P<0.001）. Perceived severity（β=0.204），vulnerability （β=0.196） and self-efficacy（β=0.336） had a direct positive influence on decision-making behavior. Perceived vulnerability had an indirect positive influence on decision-making behavior mediated by self-efficacy（β=0.136）. Response costs（β=-0.186） had a direct negative influence on decision-making behavior. Knowledge had an indirect influence on decision-making behavior mediated by response costs（β=0.016）. All the indicators for fit test were acceptable or optimal，and the path coefficients of model reached significant level（P<0.05）. Conclusion The decision-making behavior of blood glucose management among pregnant women with GDM could be improved through increasing perceived severity，vulnerability and confidence，providing more knowledge and decreasing barriers related to blood glucose management.

Objective To understand the motivation of blood glucose management behavior changes in pregnant women with gestational diabetes mellitus（GDM）,in order to provide suggestions and evidence for promoting good blood glucose management in GDM patients. Methods Purposive sampling method was used to select 28 pregnant women with gestational diabetes mellitus from September to December 2020 in 4 hospitals in Shanghai for semi-structured in-depth interviews. Content analysis was used to analyze and refine the theme. Results The motivation of blood glucose management behavior change of GDM pregnant women includes perceiving the severity of the disease,perceiving the risk of bad blood glucose management behaviors,and perceiving the benefits of healthy blood glucose management behavior. Conclusion Clinical nursing staffs can improve the awareness of GDM pregnant women on the severity of disease and the risk of bad blood glucose management behaviors,and improve the awareness of GDM pregnant women on healthy blood glucose management behaviors,so as to improve their motivation to change their poor blood glucose management behavior and unhealthy lifestyles.

Objective To describe the status of blood glucose management decision-making behavior of pregnant women with gestational diabetes mellitus（GDM）and to explore its influencing factors. Methods A total of 1 127 pregnant women with GDM from 6 hospitals in Shanghai and Jiangsu province were investigated with the blood glucose management protection motivation questionnaire,knowledge questionnaire,decision-making behavior questionnaire and general information questionnaire. Results The score of decision-making behavior in blood glucose management of pregnant women with GDM was 69.30±6.85,which is at a high level. Gestational age,vulnerability,severity,response efficacy,self-efficacy and response costs were influencing factors of blood glucose management decision-making behavior in pregnant women with GDM（P<0.05）. Conclusion Nursing professionals should strengthen GDM pregnant women’s protection motivation of blood glucose management,especially for women who during the third trimester. This study suggested that GDM women’s decision-making behavior of blood glucose management could be improved through increasing patient’s cognition of disease severity and vulnerability,enhancing response efficacy and self-efficacy,and reducing response costs.