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

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