Electronic Thesis and Dissertation Repository

Degree

Doctor of Philosophy

Program

Nursing

Supervisor

Dr Marilyn Evans

2nd Supervisor

Dr Sandra Regan

3rd Supervisor

Dr Erin Keeley

Abstract

Abstract

Gestational Diabetes Mellitus (GDM) is defined as glucose intolerance with onset or first diagnosis during pregnancy, and affects 3.7%-18% of Canadian women (Canadian Diabetes Association, 2013). Social support can help women with a history of GDM be successful in achieving optimal health postpartum. The purpose of this constructivist grounded theory (GT) study (Charmaz, 2011) was twofold: (1) To explore the social support processes of women with a history of GDM as they navigate through the healthcare system postpartum, to restore and maintain their health, and (2) To critically examine facilitating factors and barriers to engaging in health behaviours within the context of the individual, interpersonal, organizational, community, and political environments in which the women live. A total of 29 postpartum women with history of GDM participated in this study. In line with constructivist GT methodology data from semi-structured interviews and documents were simultaneously collected and analyzed using the constant comparative method. N-Vivo qualitative software was used to assist with data analysis. Time, social support, individual characteristics, extrinsic variables and barriers & facilitators to engaging in healthy behaviours were the main concepts identified. A model was developed titled It’s About Time! GDM: A Transformative Postpartum Process. Three themes were identified: Dealing with a GDM Diagnosis, Adjusting to Life without Diabetes While Maintaining or Restoring Health and, Reconciling a New Normal. The results from this study were used to guide interventions on the provision of social support to postpartum women targeting various levels of influence to support health promotion and type-2 diabetes prevention.

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