Abstract
CONTEXT: Decision-making behavior pertains to the cognitive process where a patient evaluates the advantages and disadvantages of health-related decisions, taking into account their personal preferences, values, and cognitive factors. This behavior is central to the successful implementation of clinical care. Effective decision-making enhances an individual's or organization's response to challenges and opportunities, improves problem-solving capabilities, reduces risks and uncertainties, and facilitates the attainment of desired outcomes. OBJECTIVE: The goal of this study was to investigate the current status of dietary choice decision-making in gestational diabetes mellitus and to analyze its influencing factors, and then to find the determining factors and give targeted nursing interventions in order to improve the dietary decision-making ability of gestational diabetes mellitus patients and further standardize their dietary patterns. METHODS: A cross-sectional research design was employed in this study. Convenience sampling was utilized to survey 539 GDM patients attending the obstetrics outpatient clinic and obstetrics ward of a tertiary hospital in Wuxi City, China, from March 2023 to July 2023. The survey instruments used were the General Information Questionnaire, the Motivation to Protect Pregnant Women with Gestational Diabetes Mellitus Dietary Intake Questionnaire, and the Conflict in Decision-Making Scale. RESULTS: The findings were derived from data collected from 539 GDM cases. The participants' ages ranged from 19 to 52 years, with a mean age of 31.53 ± 4.37 years. The scores for GDM disease perceived susceptibility were 15.200 ± 3.481, disease perceived severity 18.455 ± 4.670, internal reward 13.226 ± 4.275, external reward 8.278 ± 2.923, response efficacy 15.078 ± 3.889, self-efficacy 18.952 ± 4.800, cost of response 14.540 ± 5.227, and decision conflict questionnaire score 70.96 ± 11.78. CONCLUSIONS: The study revealed that GDM patients exhibited a moderate level of decision-making dilemma. Notably, the patients' perceived susceptibility and severity of the disease, along with their response efficacy and self-efficacy, positively influenced their dietary decision-making abilities. Specifically, enhancing patients' awareness of their condition and boosting their self-efficacy significantly improved their decision-making capabilities. Conversely, internal and external rewards, as well as the cost of response, exerted a negative impact on GDM patients' decision-making abilities. Therefore, it is imperative to mitigate potential barriers in GDM patients' dietary intake behaviors, thereby enhancing their decision-making skills related to dietary intake.