妊娠期糖尿病患者身体活动影响因素质性研究的Meta整合

doi:10.3761/j.issn.0254-1769.2026.18.016

中华护理杂志 ›› 2026, Vol. 61 ›› Issue (18): 2564-2570.DOI: 10.3761/j.issn.0254-1769.2026.18.016

妊娠期糖尿病患者身体活动影响因素质性研究的Meta整合

张晓彤¹(), 徐奇², 李敏敏³, 刘霞¹^,^*()

¹ 山东第一医科大学附属省立医院护理部济南市 250021
² 山东第一医科大学（山东省医学科学院）护理学院泰安市 271016
³ 山东第一医科大学附属省立医院奥体院区新生儿科济南市 250021

收稿日期:2026-01-04 出版日期:2026-09-20 发布日期:2026-09-23
*通讯作者: *刘霞，E-mail：liuxia2388@163.com
作者简介:张晓彤：女，本科（硕士在读），E-mail：1326874780@qq.com
第一联系人：作者贡献声明
张晓彤：选题设计、文献检索与筛选、资料提取、质量评价、资料分析、论文撰写；徐奇：文献检索与筛选、资料提取、质量评价、资料分析；李敏敏：选题设计、质量评价、研究指导、论文审阅和修改；刘霞：选题设计、研究指导、论文审阅和修改

A Meta-synthesis of influencing factors to physical activity in women with gestational diabetes mellitus

ZHANG Xiaotong¹(), XU Qi², LI Minmin³, LIU Xia¹^,^*()

¹ Department of Nursing， Shandong Provincial Hospital Affiliated to Shandong First Medical University， Jinan 250021， China
² School of Nursing， Shandong First Medical University（Shandong Academy of Medical Sciences）， Taian 271016， China
³ Department of Neonatology， Olympic Campus of Shandong Provincial Hospital Affiliated to Shandong First Medical University， Jinan 250021， China

Received:2026-01-04 Online:2026-09-20 Published:2026-09-23
* Corresponding author: *LIU Xia，E-mail：liuxia2388@163.com

摘要/Abstract

摘要：

目的基于能力、机会、动机-行为模型和理论域框架，整合国内外妊娠期糖尿病患者身体活动影响因素的质性研究，系统梳理促进与阻碍其身体活动的因素，为制订个性化身体活动方案提供参考依据。方法系统检索PubMed、Web of Science、Cochrane Library、CINAHL、PsycINFO、中国知网、万方数据库、维普数据库、中国生物医学文献数据库等中英文数据库中关于妊娠期糖尿病身体活动影响因素的质性研究，检索时限为建库至2026年4月21日，依据质性研究质量评价标准筛选文献，采用汇集性整合方法分析数据。结果共纳入16篇文献，提取28个研究结果。妊娠期糖尿病患者身体活动的促进和障碍因素均涵盖能力、机会、动机三大维度，促进因素包括行为调节、完善的公共资源、社会支持、明确的健康目标及身体活动的正向反馈；障碍因素主要为缺乏身体活动知识与技能，记忆、决策与执行困境，经济与环境约束，传统观念束缚与角色冲突，消极行为意向与情绪，共11个类别，形成2个整合结果。结论妊娠期糖尿病患者身体活动受个体能力、机会及内在动机的影响。未来干预需综合认知、身心状况，围绕医疗服务、社会文化、资源环境，优化身体活动方案设计，提升孕妇自我效能与健康素养，实现全周期动态管理。

关键词: 妊娠期糖尿病, 身体活动, 促进与障碍因素, 质性研究, Meta整合, 循证护理学

Abstract:

Objective Based on the Capability，Opportunity，Motivation-Behavior（COM-B） model and the Theore-tical Domains Framework（TDF），this study integrated qualitative studies on factors influencing physical activity among women with gestational diabetes mellitus（GDM） at home and abroad，systematically sorted out the facilitators and barriers to their physical activity，and provided evidence for developing personalized physical activity protocols and improving patient adherence. Methods Chinese and English databases including PubMed，Web of Science，Cochrane Library，CINAHL，PsycINFO，CNKI，WanFang Data，VIP Database，and China Biomedical Literature Database were systematically searched for qualitative studies concerning factors affecting physical activity in GDM patients，with the search period spanning from database establishment to April 21，2026. Literatures were screened according to the quality appraisal criteria for qualitative research，and data were analyzed using the integrative synthesis method. Results A total of 16 studies were included and 28 findings were extracted. Facilitators and barriers to physical activity in GDM covered 3 dimensions of capability，opportunity and motivation. Facilitators involved behav-ioral regulation，adequate public resources，social support，clear health goals，and positive feedback of physical activi-ty. Barriers fell into 11 categories，including lack of relevant knowledge and skills，difficulties in memory，decision-making and implementation，economic and environmental constraints，traditional concepts and role conflicts，as well as negative intention and emotion，which were synthesized into 2 integrated results. Conclusion Physical activity in GDM patients is affected by individual capability，external opportunity and internal motivation. Future interventions should integrate cognitive and physical-mental status，optimize the design of physical activity programs in terms of medical services，social culture and resource environment，enhance pregnant women’s self-efficacy and health literacy，and realize the whole cycle dynamic management of GDM.

Key words: Gestational Diabetes Mellitus, Physical Activity, Facilitators and Barriers, Qualitative Research, Meta-Synthesis, Evidence-Based Nursing

张晓彤, 徐奇, 李敏敏, 刘霞. 妊娠期糖尿病患者身体活动影响因素质性研究的Meta整合[J]. 中华护理杂志, 2026, 61(18): 2564-2570.

ZHANG Xiaotong, XU Qi, LI Minmin, LIU Xia. A Meta-synthesis of influencing factors to physical activity in women with gestational diabetes mellitus[J]. Chinese Journal of Nursing, 2026, 61(18): 2564-2570.

图/表 2

参考文献 34

[1]	复旦大学循证护理中心, 邢年路, 周英凤, 等. 妊娠期糖尿病非药物管理患者指南[J]. 中华护理杂志, 2024, 59(6):662-668. DOI
	Fudan University Centre for Evidence-Based Nursing, Xing NL, Zhou YF, et al. The development of a patient guideline on non-pharmacological management of gestational diabetes melli-tus[J]. Chin J Nurs, 2024, 59(6):662-668. DOI
[2]	Wang H, Li NH, Chivese T, et al. IDF diabetes atlas:estimation of global and regional gestational diabetes mellitus prevalence for 2021 by international association of diabetes in pregnancy study group’s criteria[J]. Diabetes Res Clin Pract, 2022, 183:109050. DOI URL
[3]	Ye WR, Luo C, Huang J, et al. Gestational diabetes mellitus and adverse pregnancy outcomes:systematic review and meta-analysis[J]. BMJ, 2022:e067946.
[4]	Caspersen CJ, Powell KE, Christenson GM. Physical activity,exercise,and physical fitness:definitions and distinctions for health-related research[J]. Public Health Rep, 1985, 100(2):126-131. PMID
[5]	Piotrowska K, Zgutka K, Tkacz M, et al. Physical activity as a modern intervention in the fight against obesity-related inflam-mation in type 2 diabetes mellitus and gestational diabetes[J]. Antioxidants, 2023, 12(8):1488. DOI URL
[6]	Laredo-Aguilera JA, Gallardo-Bravo M, Rabanales-Sotos JA, et al. Physical activity programs during pregnancy are effective for the control of gestational diabetes mellitus[J]. Int J Environ Res Public Health, 2020, 17(17):6151. DOI URL
[7]	Syed H, Slayman T, DuChene Thoma K. ACOG committee opi-nion No. 804:physical activity and exercise during pregnancy and the postpartum period[J]. Obstet Gynecol, 2021, 137(2):375-376.
[8]	AlBlooshi S, Hijazi R, Kennedy L, et al. UAE women’s know-ledge and attitudes towards physical activity during pregnancy[J]. Int J Environ Res Public Health, 2023, 20(17):6669. DOI URL
[9]	Wang Y, Zhu W, Pu Y, et al. Barriers and enablers in the implementation of physical activity improvement for pregnant women with gestational diabetes mellitus:a mixed-methods study[J]. J Adv Nurs, 2025, 81(11):7868-7881. DOI URL
[10]	Michie S, van Stralen MM, West R. The behaviour change wheel:a new method for characterising and designing behaviour change interventions[J]. Implement Sci, 2011, 6:42. DOI PMID
[11]	Cane J, O’Connor D, Michie S. Validation of the theoretical domains framework for use in behaviour change and imple-mentation research[J]. Implement Sci, 2012, 7(1):37. DOI URL
[12]	Lockwood C, Porritt K, Munn Z, et al. JBI manual for eviden-ce synthesis[EB/OL].(2024-03-26)[2025-03-11]. https://syn-thesismanual.jbi.global.
[13]	Harrison AL, Taylor NF, Frawley HC, et al. Women with ges-tational diabetes mellitus want clear and practical messages from credible sources about physical activity during pregna-ncy:a qualitative study[J]. J Physiother, 2019, 65(1):37-42. DOI PMID
[14]	Ioannou E, Humphreys H, Homer C, et al. Barriers and system improvements for physical activity promotion after gestational diabetes:a qualitative exploration of the views of healthcare professionals[J]. Diabet Med, 2024, 41(12):e15426. DOI URL
[15]	Smyth S, Mulligan K, Rutter E, et al. Attitudes of women with gestational diabetes toward diet and exercise:a qualitative study[J]. J Matern Fetal Neonatal Med, 2023, 36(1):2155045. DOI URL
[16]	Wan CS, Teede H, Nankervis A, et al. Ethnic differences in phy-sical activity participation when managing gestational dia-betes mellitus:a mixed-methods study comparing ethnic Chinese migrants and Australian women[J]. Ethn Health, 2024, 29(6):665-684. DOI URL
[17]	Muhwava LS, Murphy K, Zarowsky C, et al. Experiences of life-style change among women with gestational diabetes mellitus(GDM):a behavioural diagnosis using the COM-B model in a low-income setting[J]. PLoS One, 2019, 14(11):e0225431. DOI URL
[18]	Wah YYE, McGill M, Wong J, et al. Self-management of gesta-tional diabetes among Chinese migrants:a qualitative study[J]. Women Birth, 2019, 32(1):e17-e23. DOI URL
[19]	Su MC, Chang MY, Sun JC. Self-management experience of first-time diagnosed gestational diabetes mellitus:a focus group interview[J]. Nurs Open, 2023, 10(3):1744-1754. DOI URL
[20]	Rath K, Smitha MV. Gestational diabetes mellitus management among primigravida women:a qualitative study[J]. Cureus, 2025, 17(7):e88710.
[21]	Ismail IZ, Benton M, Sobri HM, et al. Barriers and facilitators to diabetes prevention support for women in Malaysia with gestational diabetes mellitus:a qualitative study[J]. PEC Innov, 2025, 7:100438. DOI URL
[22]	Collier SA, Mulholland C, Williams J, et al. A qualitative study of perceived barriers to management of diabetes among women with a history of diabetes during pregnancy[J]. J Women’s Health, 2011, 20(9):1333-1339. DOI URL
[23]	Issakainen M, Schwab U, Lamminpää R. Qualitative study on public health nurses’ experience and assessment of nutritional and physical activity counseling of women with gestational diabetes[J]. Eur J Midwifery, 2020, 4:127123.
[24]	Jia CL, Wang LJ, Li LH, et al. Using COM-B model in iden-tifying factors influencing exercise adherence in pregnant women with gestational diabetes mellitus in China:a qualita-tive study[J]. Front Public Health, 2026, 13:1736624. DOI URL
[25]	吴映瑛, 徐萌艳. 妊娠期糖尿病患者运动疗法依从性影响因素的质性研究[J]. 护理与康复, 2018, 17(11):7-11.
	Wu YY, Xu MY. Qualitative research on influencing factors of compliance on exercise therapy for patients with gestatio-nal diabetes mellitus[J]. Nurs Rehabil J, 2018, 17(11):7-11.
[26]	肖润希, 周英凤. 妊娠期糖尿病患者孕期参与体力活动促进及障碍因素的质性研究[J]. 中华护理杂志, 2025, 60(14):1683-1689. DOI
	Xiao RX, Zhou YF. Facilitators and barriers of physical activity participation among women with gestational diabetes mellitus during pregnancy:a qualitative study[J]. Chin J Nurs, 2025, 60(14):1683-1689.
[27]	党文珊, 张慧君, 王艺讳, 等. 基于计划行为理论的妊娠期糖尿病患者自我管理行为意向的质性研究[J]. 广州医药, 2024, 55(10):1215-1219. DOI
	Dang WS, Zhang HJ, Wang YH, et al. A qualitative study of self-management behavior intention in patients with gestatio-nal diabetes mellitus based on the theory of planned beha-vior[J]. Guangzhou Med J, 2024, 55(10):1215-1219.
[28]	艾建赛, 王立新, 鲁美苏, 等. 妊娠糖尿病病人身体运动管理现状及其影响因素的研究进展[J]. 全科护理, 2023, 21(27):3807-3810.
	Ai JS, Wang LX, Lu MS, et al. Research progress on the current situation of physical exercise management and its influencing factors in patients with gestational diabetes mellitus[J]. Chin Gen Pract Nurs, 2023, 21(27):3807-3810.
[29]	张欣, 尹卫, 刘巧艳, 等. 妊娠期糖尿病患者血糖管理决策体验的纵向质性研究[J]. 护理学报, 2023, 30(12):22-26. DOI
	Zhang X, Yin W, Liu QY, et al. A longitudinal qualitative study on the decision-making experience of blood glucose management in patients with gestational diabetes mellitus[J]. J Nurs(China), 2023, 30(12):22-26.
[30]	陈彤, 赵倩倩. 妊娠期糖尿病孕妇健康信息搜寻行为的质性研究[J]. 中国计划生育和妇产科, 2025, 17(4):80-83,88.
	Chen T, Zhao QQ. Qualitative study of the health information-seeking behavior of pregnant women with gestational diabetes mellitus[J]. Chin J Fam Plan Gynecotokology, 2025, 17(4):80-83,88.
[31]	冯薇, 解红文, 丁腊春, 等. 应用多学科诊疗模式提高妊娠期糖尿病孕妇自我管理能力的实践[J]. 中国护理管理, 2019, 19(3):428-432.
	Feng W, Xie HW, Ding LC, et al. The effect of MDT mode on improving the self-management ability of pregnant women with gestational diabetes mellitus[J]. Chin Nurs Manag, 2019, 19(3):428-432.
[32]	章孟星, 周英凤, 钟婕, 等. 妊娠期糖尿病临床护理实践指南的整合研究[J]. 中华护理杂志, 2019, 54(1):104-113.
	Zhang MX, Zhou YF, Zhong J, et al. The adaptation of clinical nursing practice guideline for gestational diabetes mellitus[J]. Chin J Nurs, 2019, 54(1):104-113.
[33]	孙可盈, 贺方园, 张柔, 等. 数字健康技术在妊娠期糖尿病患者营养管理中的应用进展[J]. 中华护理杂志, 2025, 60(14):1694-1699. DOI
	Sun KY, He FY, Zhang R, et al. Application progress of digi-tal health technology in nutrition management of gestational diabetes mellitus patients[J]. Chin J Nurs, 2025, 60(14):1694-1699.
[34]	张贤贤, 张利霞, 贾智慧, 等. 妊娠期糖尿病孕妇妊娠相关焦虑的潜在类别分析[J]. 中华护理杂志, 2020, 55(10):1503-1508. DOI
	Zhang XX, Zhang LX, Jia ZH, et al. Analysis of potential categories of pregnancy-related anxiety in patients with gestational diabetes mellitus[J]. Chin J Nurs, 2020, 55(10):1503-1508. DOI

妊娠期糖尿病患者身体活动影响因素质性研究的Meta整合

A Meta-synthesis of influencing factors to physical activity in women with gestational diabetes mellitus

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