Effectiveness of the Information-Motivation-Behavioral Skills Model-Based Nursing Intervention on Maternal and Neonatal Outcomes in Women with Gestational Diabetes Mellitus: A Randomized Controlled Trial

基于信息-动机-行为技能模型的护理干预对妊娠期糖尿病妇女母婴结局的有效性:一项随机对照试验

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Abstract

OBJECTIVE: This study aimed to evaluate the effectiveness of the information-motivation-behavioral skills (IMB) model-based nursing intervention in improving maternal and neonatal outcomes in patients with gestational diabetes mellitus (GDM). METHODS: A total of 240 pregnant women with GDM were enrolled and randomly assigned to either the IMB group or the traditional health education group between June 2023 and May 2024. The IMB group received a 6-week intervention incorporating information support, motivational enhancement, and behavioral skill development. The control group received standard health education. Outcomes assessed included fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), insulin treatment rates, adverse delivery outcomes, and postpartum glucose metabolism abnormalities. RESULTS: The IMB group showed a significant reduction in FPG from 8.05 mmol/L (145.05 mg/dL) to 4.95 mmol/L (89.19 mg/dL) (p < 0.001) and HbA1c from 6.60% to 4.98% (p < 0.001) postintervention, compared with the control group's reduction to 6.00 mmol/L (108.11 mg/dL) (p < 0.001) and 5.78% (p < 0.001), respectively. The rate of insulin treatment was 2.5% in the IMB group versus 13.3% in the control group (p = 0.003). The IMB group had a lower cesarean section rate (15.0% vs. 40.0%, p < 0.001) and neonatal respiratory distress syndrome incidence (1.67% vs. 10.0%, p = 0.007). Postpartum, the IMB group exhibited a lower total incidence of abnormal glucose metabolism (12.5%) compared to the control group (25.0%, p < 0.001). CONCLUSION: The IMB model-based nursing intervention was more effective in managing blood glucose levels, reducing the need for insulin therapy, and improving both maternal and neonatal outcomes compared to traditional health education. This intervention may offer a promising approach to enhance the care of women with GDM.

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