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

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