Abstract
Objectives
For women with pre-existing and gestational diabetes, pregnancy involves specialized
and intensive medical care to optimize maternal and infant outcomes. Medical management
for patients with diabetes in pregnancy typically occurs via frequent face-to-face
outpatient appointments. COVID-19–induced barriers to face-to-face care have identified
the need for high-quality, patient-centred virtual health-care modalities, such as
mobile health (mHealth) technologies. Our aim in this review was to identify the patient-reported
benefits and limitations of mHealth technologies among women with diabetes in pregnancy.
We also aimed to determine how the women’s experiences aligned with the best practice
standards for patient-centred communication.
Methods
The framework presented by Arksey and O’Malley for conducting scoping reviews, with
refinements by Levac et al, was used to guide this review. Relevant studies were identified
through comprehensive database searches of MEDLINE, Embase, Emcare and PsycINFO. Thomas
and Harden's methods for the thematic synthesis of qualitative research in systematic
reviews guided the synthesis of patient-reported benefits and limitations of mHealth
technology.
Results
Overall, 19 studies describing the use of 16 unique mHealth technologies among 742
women were included in the final review. Patient-reported benefits of mHealth included
convenience, support of psychosocial well-being and facilitation of diabetes self-management.
Patient-reported limitations included lack of important technological features, perceived
burdensome aspects of mHealth and lack of trust in virtual health care.
Conclusions
Women with diabetes report some benefits from mHealth use during pregnancy. Codesigning
future technologies with end users may help address the perceived limitations and
effectiveness of mHealth technologies.
Résumé
Objectifs
Durant la grossesse des femmes qui ont un diabète préexistant et gestationnel, des
soins spécialisés et intensifs sont nécessaires à l’optimisation des issues chez la
mère et le nourrisson. La prise en charge médicale des patientes diabétiques durant
la grossesse s’effectue généralement par des consultations externes fréquentes en
personne. Les obstacles aux soins en personne occasionnés par la COVID-19 ont fait
ressortir la nécessité de modalités en matière de soins virtuels de haute qualité
axés sur le patient tels que les technologies mobiles de la santé (santé mobile).
L’objectif de notre présente revue était de cerner les avantages et les limites en
matière de technologies mobiles de la santé chez les femmes diabétiques durant la
grossesse. Nous avions aussi comme objectif de déterminer comment les expériences
des femmes s’harmonisent aux normes de pratiques exemplaires en matière de communication
axée sur le patient.
Méthodes
Pour réaliser cette revue, nous avons suivi le cadre proposé par Arksey et O’Malley
sur les études de la portée, et affiné par Levac et coll. Nous avons trouvé des études
pertinentes grâce à des recherches exhaustives dans les bases de données de MEDLINE,
Embase, EmCare et PsycINFO. Les méthodes de synthèse thématique en recherche qualitative
selon Thomas et Harden dans les revues systématiques ont permis d’orienter la synthèse
des avantages et des limites de la santé mobile signalés par les patientes.
Résultats
Au total, nous avons inclus à la revue finale 19 études qui décrivaient l’utilisation
de 16 technologies mobiles uniques de la santé par 742 femmes. Les patientes ont signalé
les avantages de la santé mobile suivants : la commodité, le soutien en matière de
bien-être psychosocial et la facilitation de la prise en charge autonome. Les patientes
ont aussi signalé les limites suivantes : le manque de caractéristiques technologiques
importantes, les aspects contraignants perçus de la santé mobile et le manque de confiance
dans les soins de santé virtuels.
Conclusions
Les femmes diabétiques signalent certains avantages de l’utilisation de la santé mobile
durant la grossesse. La conception participative qui favorise la participation d’utilisatrices
finales à la création des futures technologies peut permettre d’aborder les limites
perçues et l’efficacité des technologies mobiles de la santé.
Keywords
Mots clés
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Article info
Publication history
Published online: August 11, 2022
Accepted:
August 2,
2022
Received in revised form:
June 28,
2022
Received:
March 17,
2022
Identification
Copyright
© 2022 Canadian Diabetes Association.