4.6 Review

Is self-management a burden? What are the experiences of women self-managing chronic conditions during pregnancy? A systematic review

Journal

BMJ OPEN
Volume 12, Issue 3, Pages -

Publisher

BMJ PUBLISHING GROUP
DOI: 10.1136/bmjopen-2021-051962

Keywords

diabetes in pregnancy; qualitative research; Prenatal diagnosis

Funding

  1. National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care Oxford (NIHR CLAHRC Oxford) now recommissioned as NIHR Applied Research Collaboration Oxford and Thames Valley
  2. Primary Care Research Trust
  3. NIHR Programme Grant [RP-PG-0614-20005]
  4. National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research
  5. Care Oxford at Oxford Health NHS Foundation Trust now recommissioned as NIHR Applied Research Collaboration Oxford and Thames Valley
  6. Primary Care Research Trust [R62050/CN001]
  7. Research Professorship from the National Institute for Health Research [NIHR-RP-R2-12-015]
  8. NIHR Oxford Biomedical Research Centre

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This study found that pregnant women with chronic conditions in pregnancy often self-manage primarily for the health of their baby, while facing barriers such as anxiety, lack of understanding, and inadequate support from families and healthcare professionals. Further research is needed on a range of self-management of chronic conditions in pregnancy.
Objective This systematic review examines the qualitative literature on women's experiences of self-managing chronic conditions in pregnancy. Design Systematic review of qualitative literature. Searches were performed in PubMed and CINAHL from inception to February 2021. Critical interpretive synthesis informed the coding framework and the analysis of the data. The Burden of Treatment theory emerged during the initial analysis as having the most synergy with the included literature, themes were refined to consider key concepts from this theory. Participants Pregnant women who are self-managing a chronic condition. Results A total of 2695 articles were screened and 25 were reviewed in detail. All 16 included studies concerned diabetes self-management in pregnancy. Common themes coalesced around motivations for, and barriers to, self-management. Women self-managed primarily for the health of their baby. Barriers identified were anxiety, lack of understanding and a lack of support from families and healthcare professionals. Conclusions Pregnant women have different motivating factors for self-management than the general population and further research on a range of self-management of chronic conditions in pregnancy is needed. PROSPERO registration number CRD42019136681.

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