title: Women with gestational diabetes in Vietnam: a qualitative study to determine attitudes and health behaviours.
abstract: BACKGROUND
  Diabetes is increasing in prevalence globally, notably amongst populations from low- and middle- income countries. Gestational Diabetes Mellitus(GDM), a precursor for type 2 diabetes, is increasing in line with this trend. Few studies have considered the personal and social effects of GDM on women living in low and middle-income countries. The aim of this study was determine attitudes and health behaviours of pregnant women with GDM in Vietnam.
  
  
  METHODS
  This was a qualitative study using focus group methodology conducted in Ho Chi Minh City. Pregnant women, aged over 18 years, with GDM were eligible to participate. Women were purposely sampled to obtain a range of gestational ages and severity of disease. They were invited to attend a 1-hour focus group. Questions were semi structured around six themes. Focus groups were recorded, transcribed, translated and cross-referenced. Non-verbal and group interactions were recorded. Thematic analysis was performed using a theoretical framework approach.
  
  
  RESULTS
  From December 2010 to February 2011, four focus groups were conducted involving 34 women. Median age was 31.5 years (range 23 to 44), median BMI 21.8 kg/m(2). Women felt confusion, anxiety and guilt about GDM. Many perceived their baby to be at increased risk of death. Advice to reduce dietary starch was confusing. Women reported being 'hungry' or 'starving' most of the time, unaware of appropriate food substitutions. They were concerned about transmission of GDM through breast milk. Several women planned not to breastfeed. All felt they needed more information. Current sources of information included friends, magazines, a health phone line or the Internet. Women felt small group sessions and information leaflets could benefit them.
  
  
  CONCLUSIONS
  This study highlights the need for culturally appropriate clinical education and health promotion activities for women with GDM in Vietnam.
authors.affiliation: Department of Obstetrics & Gynaecology, Sydney Medical School- Northern, University of Sydney, Royal North Shore Hospital, Sydney, NSW, Australia. jane.hirst@sydney.edu.au
authors.forename: Jane E
authors.initials: JE
authors.lastname: Hirst
authors.forename: Thach Son
authors.initials: TS
authors.lastname: Tran
authors.forename: My An Thi
authors.initials: MA
authors.lastname: Do
authors.forename: Forsyth
authors.initials: F
authors.lastname: Rowena
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Morris
authors.forename: Heather E
authors.initials: HE
authors.lastname: Jeffery
mesh_terms: D000328:Adult; D001294:Attitude to Health; D001786:Blood Glucose / Q000032:analysis; D001942:Breast Feeding; D016640:Diabetes, Gestational / Q000175:diagnosis; D005260:Female; D017144:Focus Groups; D015438:Health Behavior; D006293:Health Promotion; D006801:Humans; D006815:Hunger; D008991:Monitoring, Physiologic; D011247:Pregnancy; D011256:Pregnancy Outcome; D036301:Qualitative Research; D014744:Vietnam
chemical_list: D001786:Blood Glucose