title: Diabetes nurse educators' experiences of providing care for women, with gestational diabetes mellitus, from disadvantaged backgrounds.
abstract: OBJECTIVE
  To explore diabetes nurse educators' experiences of providing care for women, with gestational diabetes mellitus, from disadvantaged backgrounds and to gather information which would assist with the development of an educational programme that would support both women and diabetes educators.
  
  
  BACKGROUND
  Rates of gestational diabetes mellitus have increased dramatically in recent years. This is concerning as gestational diabetes mellitus is linked to poorer pregnancy outcomes including hypertension, stillbirth, and nursery admission. Poorest outcomes occur among disadvantaged women. gestational diabetes mellitus is also associated with maternal type 2 diabetes and with child obesity and type 2 diabetes among offspring. Effective self-management of gestational diabetes mellitus reduces these risks. Diabetes nurse educators provide most education and support for gestational diabetes mellitus self-management.
  
  
  METHODS
  An interpretative phenomenological analysis approach, as espoused by Smith and Osborn (Qualitative Psychology: A Practical Guide to Research Methods, 2008, Sage, London, 51), provided the framework for this study.
  
  
  METHODS
  The views of six diabetes educators were explored through in-depth interviewing. Interviews were transcribed verbatim and analysed according to steps outlined by Smith and Osborn (Qualitative Psychology: A Practical Guide to Research Methods, 2008, Sage, London, 51).
  
  
  RESULTS
  Three themes emerged from the data: (1) working in a suboptimal environment, (2) working to address the difficulties and (3) looking to the future. Throughout, the diabetes nurse educators sought opportunities to connect with women in their care and to make the educational content understandable and meaningful.
  
  
  CONCLUSIONS
  Low literacy among disadvantaged women has a significant impact on their understanding of gestational diabetes mellitus information. In turn, catering for women with low literacy contributes to increased workloads for diabetes nurse educators, making them vulnerable to burnout.
  
  
  CONCLUSIONS
  There is a need for targeted educational programmes for women with low literacy. Resources should be literacy appropriate, with photographs and simple text, and include culturally appropriate foods and information. This approach should lead to an improvement in the women's uptake of gestational diabetes mellitus information and may lead to a lessening of the workload burden for diabetes nurse educators.
authors: School of Nursing and Midwifery, Victoria University, St Albans, Vic., Australia.
authors: Mary
authors: M
authors: Carolan
mesh_terms: D000328:Adult; D016640:Diabetes, Gestational / Q000451:nursing*; D004739:England; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D024802:Nurse's Role; D011247:Pregnancy; D011295:Prenatal Care; D013222:State Medicine; D035862:Vulnerable Populations; D014932:Women's Health Services
keywords: barriers; disadvantaged; gestational diabetes; self-management