Health information needs of women with gestational diabetes mellitus: a qualitative study

Abstract

Glycemic control in women with gestational diabetes mellitus(GDM) is largely dependent on effective self-management. The adequacy of health information provided plays a critical role in determining self-management success. While existing studies recognise the importance of addressing health information needs, the specific needs of women with GDM in China remain unclear. Sixteen women diagnosed with GDM were recruited using purposive sampling from a tertiary general hospital in Hefei, Anhui Province, China. Face-to-face semi-structured interviews were conducted individually. The verbatim transcripts were analyzed by employing hybrid deductive-inductive qualitative content analysis. Health information needs were extracted for 3 domains and 10 topics. These include health information needs related to existence (disease, treatment, examination, childbirth); relationships (social support); and growth (dietary management, exercise management, blood glucose management, emotional management, and postnatal management). Based on ERG theory, this study identified patient-centered health information needs among women with GDM. The findings call for structured, staged, and accessible information services, with healthcare providers playing a key role in individualized assessment and trust-building. Future research should explore information prioritization and evaluate targeted strategies to improve self-management, clinical outcomes, and long-term health literacy in diverse GDM populations.

Introduction

Gestational diabetes mellitus (GDM), defined as glucose intolerance with onset or first recognition during pregnancy¹, currently affects 14.8% of pregnant women in China². Over the past three decades, the prevalence of GDM has demonstrated a marked upward trajectory across the nation, imposing a growing economic burden on the healthcare system^3,4. This rising prevalence poses significant health risks for both mothers and infants. Women with GDM face an elevated risk of preterm delivery and caesarean section, alongside a 7.7-fold higher risk of developing type 2 diabetes mellitus, a 63% greater likelihood of cardiovascular disease, and increased chances of childbirth complications such as macrosomia, shoulder dystocia, and neonatal hypoglycemia^5–7. Furthermore, children born to mothers with GDM face a twofold to eightfold higher risk of obesity, metabolic syndrome, and type 2 diabetes compared with children born to mothers without GDM⁸.

Women with GDM can manage their blood glucose through a combination of monitoring, individualised nutrition plans, physical activity, and medication to maintain stable levels⁹. This requires comprehensive health knowledge to support effective glycemic control and self-management. However, they encounter systemic barriers including uneven distribution of hospital resources, prolonged consultation wait times, inadequate clinician-patient communication, and insufficiently detailed blood glucose management guidance¹⁰. These limitations compromise both the quality and efficiency of health information access, making it difficult to effectively meet their healthcare information needs. Research indicates that diabetes education for women with GDM is associated with lower HbA1c levels, less weight gain, and reduced need for insulin therapy¹¹. This highlights the importance of providing targeted health information to promote behavioural improvements and improve maternal and infant outcomes. The 2025 WHO Recommendations on Maternal Health (2nd edition) highlight several non-pharmacological options that consider women’s preferences and available resources¹². The WHO Introductory Guidelines for Therapeutic Patient Education, published in 2023, suggest that therapeutic patient education is central to the management of chronic non-communicable diseases such as diabetes, hypertension, and respiratory diseases. The guidance emphasises that people with chronic conditions are at the centre of this process, ensuring that their perspectives are listened to in order to structure services around their needs. Ensure that organisations provide usable and accessible health information and resources using different formats and methods to meet the information needs of the population they serve¹³.

Against this background, it is crucial to understand the health information needs of women with GDM. Meeting these needs can enhance patients’ disease awareness and self-management efficacy, and improve their psychological state and treatment compliance. Medical institutions can tailor health education content by first identifying patients’ specific health information needs. This enables targeted support for pregnant women, preventing GDM development and assisting those with GDM in better managing blood glucose levels. These measures enhance clinical outcomes, improve service quality and patient satisfaction, and reduce healthcare costs and disputes. For society, they can reduce the overall disease burden and promote universal health coverage.

Previous studies have primarily focused on aspects such as dietary management, self-management, and illness experience among women with GDM, or have synthesised findings to identify their comprehensive care needs^14,15. To date, few studies have comprehensively explored the health information needs specifically of Chinese women with GDM. Given that these needs are highly individualised and context-dependent, quantitative methodologies alone are cannot capture their full spectrum. Conducting a needs assessment within this population, incorporating a deeper understanding of their personal perspectives, lived experiences, and emotions, is crucial. Such an approach enables the identification of deeper, potentially unforeseen needs, elucidates the logic underlying these needs, and clarifies both the specific health information required and the reasons driving these needs. This understanding provides a vital foundation for designing personalised health services. Therefore, this study conducted in-depth interviews with Chinese women with GDM based on ERG theory¹⁶. The aim was to explore their health information needs and provide a reference for subsequent targeted health information services and related interventions.

Methods

Study design

This study employed a qualitative design to investigate the health information needs of women with GDM. To enhance sample diversity and data richness, this study employed maximum variation sampling to intentionally recruit women with GDM who differed substantially across multiple dimensions, including age, occupation, education, gestational age, and family history of diabetes. Data analysis was conducted using a hybrid deductive–inductive approach to qualitative content analysis, whereby preliminary codes were derived both from a pre-established theoretical framework and from emergent patterns within the data. Qualitative research helps to add depth, width, and breadth to the experience of everyday behaviours compared to quantitative research. This report has been prepared in accordance with the Standard for Reporting Qualitative Research(SRQR) guidelines, and the research has been conducted in compliance with all relevant regulations.

Theoretical framework

This study explored the health information needs of women with GDM based on ERG theory¹⁶. ERG theory classifies human needs into three categories. Existence needs include the basic requirements for an individual’s material survival, such as clothing, food, shelter, transportation, income, benefits and allowances; Relationship needs relate to the necessity for interpersonal contact, which can be sought to be fulfilled by interacting with others at work and in life; and Growth needs revolve around an individual’s intrinsic desire for self-improvement and development, which can be achieved by realising one’s personal potentials and abilities. For women with GDM, existence needs are health information needs related to disease, treatment, examination, and childbirth; relationship needs refer to social support; and growth needs refer to self-management. The ERG theory emphasises that multiple needs can coexist in no fixed order, which is more in line with the diversity of these women’s needs in a real-world scenario.

Setting and sample

Ethical approval for this study was obtained from the Biomedical Ethics Committee of Anhui Medical University prior to commencement (Approval No.: 82240198). Between December 24, 2024, and January 14, 2025, a total of 16 patients with GDM were recruited using purposive sampling from a tertiary general hospital in Hefei City, Anhui Province, central China¹⁷.

Inclusion criteria: (1) women diagnosed with GDM during the current pregnancy according to the International Association of Diabetes and Pregnancy Study Groups criteria published in 2010¹⁸; (2) age ≥ 20 years (according to the Civil Code of the People’s Republic of China); (3)women who were cognitively normal and able to communicate effectively; (4) willingness to provide informed consent. Exclusion criteria: women who refused to participate after the investigator’s explanation.

Data collection

We developed a semi-structured interview guide based on the aims of this study, a literature review of relevant research, and ERG theory¹⁹. This guide was reviewed and revised three times by experts in the field of maternal and child care, and then served as the basis for one-to-one semi-structured interviews. Three women participated in individual pilot interviews prior to the formal interviews. The formal interviews were conducted face-to-face in a quiet, unoccupied consultation room in the maternity outpatient clinic. At the beginning of each interview, after obtaining informed consent, we explained the purpose of the study and the principle of confidentiality to the participants.

All sessions were audio-recorded following participants’ informed consent. Each participant received an honorarium of 10 RMB for their time. Interviews were conducted as single sessions, with detailed notes taken by the researcher. All sessions occurred privately without third-party presence. To ensure methodological rigor, data saturation was continuously monitored throughout the data collection and analysis process. Data saturation was defined as the point at which no new concepts, codes, or thematic dimensions emerged from subsequent interviews and the existing thematic structure remained stable. We assessed this after every two interviews by comparing new data against the established analytical framework. Saturation was reached after 14 interviews, as no new codes appeared in the following two interviews and the research team confirmed saturation through group discussion. The entire process was meticulously documented in analytical memos, establishing a transparent audit trail to support the determination of data saturation. Each interview lasted approximately 30 min. The final interview guide can be found in Fig. 1 .

Fig. 1.

Interview outline for women with GDM.Interview outline for women with GDM.

Data analysis

Data analysis was conducted following the method proposed by Elo et al.²⁰. All audio recordings were transcribed verbatim by three researchers within 24 h after each interview, and accuracy was verified through repeated listening. A hybrid deductive-inductive qualitative content analysis approach was employed, assisted by Nvivo 20 software. The analytical procedure comprised three key steps: (1) identifying the analysis units and immersing deeply in the data to achieve a comprehensive understanding of participants’ narratives; (2) constructing a classification matrix based on ERG theory; (3) having the first author conduct line-by-line open coding independently after repeated review of the transcripts, followed by iterative comparison, grouping, and refinement of codes. Specifically, after the first author completed the initial coding, the two co-authors, a doctoral researcher in maternal health and a senior professor in GDM management, jointly reviewed the coded transcripts in team meetings, cross-checking them against the original interview data. Discrepancies were discussed and resolved through group consensus, with the senior professor making the final decision when needed. This process was repeated until full agreement on coding rules was achieved. Data analysis was concurrent with data collection. An audit trail documented all coding decisions and revisions.

Rigour and reflection

Interviews were conducted by a trained female interviewer, specifically a Master‘s student in maternal and child health with formal interview training, competency in qualitative methods, and prior interviewing experience. She had no clinical experience in GDM or prior relationship with participants, though her academic background could bias expectations; to address this, she kept a reflexive journal and discussed preconceptions weekly with the research team. To ensure methodological rigour, we addressed Lincoln and Guba’s (1985)²¹ four criteria—credibility, dependability, confirmability, and transferability—in line with the SRQR. Credibility was enhanced by prolonged engagement with interview data, peer debriefing, and regular consultation with a senior professor in maternal and child health management. Dependability was ensured through a detailed audit trail of the research process. Confirmability was achieved by iterative team review of coding schemes and thematic structures, with reflexivity documented as above. Transferability was supported by thick descriptions of the study context, participants, and analytical procedures, facilitating potential application of the findings to similar populations.

Results

We initially recruited 18 women with GDM from the obstetrics outpatient clinic. Two eligible participants withdrew due to personal arrangements, leaving a final sample of 16 participants, which achieved data saturation with no new key information emerging from further interviews.The participants were aged 26 to 40 years, with a median age of 31 years. Each interview lasted around 30 min on average.(See Table 1.)

Table 1.

Socio-demographic characteristics of participants(n = 16).

Number	Age (years)	careers	education level	parity	Gestational age	Family history of diabetes	Drug use
P1	40	professional manager	Junior college	0	32 + 2	NO	NO
P2	36	counsellor	Master’s degree	1	27 + 5	NO	NO
P3	28	workless	high school	0	25 + 2	NO	NO
P4	26	workless	Junior college	0	26	NO	NO
P5	26	clerical staff	Bachelor’s degree	0	31 + 5	NO	NO
P6	31	staff member	Bachelor’s degree	0	37 + 4	NO	NO
P7	36	staff member	Master’s degree	0	24	NO	NO
P8	28	staff member	Bachelor’s degree	0	24 + 3	YES	YES
P9	26	clerical staff	Junior college	0	26 + 5	YES	NO
P10	33	staff member	Junior college	1	34 + 3	YES	NO
P11	35	Sales person	Bachelor’s degree	1	35 + 2	YES	NO
P12	30	Audit	Bachelor’s degree	0	25 + 2	YES	NO
P13	29	Foreign trade	Bachelor’s degree	0	29 + 1	YES	YES
P14	34	engineer	Bachelor’s degree	0	26 + 6	YES	NO
P15	31	clerical staff	Bachelor’s degree	0	26	NO	YES
P16	35	clerical staff	Junior college	1	37 + 4	NO	NO

Note: Drug use: Insulin or other blood sugar-controlling medicines.

After a detailed review of the transcripts, three categories comprising a total of 10 health information need themes applicable to ERG theory were identified using a deductive approach.(See Fig. 2.)

Fig. 2.

Health information needs of GDM patients based on ERG theory.

Existence needs

Basic disease knowledge-related needs

The demand for health information related to diseases is the main health information demand of women with GDM. In this study, it refers to the knowledge and information related to diseases that an individual actively wants to understand or obtain. For example, they want to know what causes the occurrence of the disease, what the high-risk factors are, what the diagnostic criteria are, the harm to the health of mothers and infants, and what the prognosis is like.

P11: “Mainly, I want to know what causes me to have gestational diabetes now.”

P7: “Let me ask, does high blood sugar mean gestational diabetes?”

P12: “I’m worried that if I don’t control it well in the past two weeks, will there be any serious impact?”

P16: “But gestational diabetes doesn’t always go away after delivery, right? Doesn’t that mean some women will develop type 2 diabetes directly?”

Disease treatment-related needs

When it came to information related to treatment, most women wanted to know specifically how to control blood glucose, normal values of blood glucose, and information related to medication use.

P15: “I wanted to ask the doctor how to control the blood sugar if it is high.”

P13: “I only learned about this one week before undergoing the glucose tolerance test. The blood glucose levels for pregnant women are different from those of non-pregnant people.”

P14: “If my blood sugar is abnormally high, should I take medicine and so on?”

Disease screening-related needs

Following the WHO recommendations for staged monitoring of antenatal care, regular fortnightly check-ups need to be implemented after 28 weeks of gestation and adjusted to weekly high-frequency monitoring after 36 weeks. Based on this standardized maternity cycle, pregnant women clearly have a need for health information. This need is particularly pronounced among those with GDM. Due to the dynamic nature of blood glucose monitoring, GDM women require significantly more information on individualized blood glucose testing protocols than the general pregnant population. In addition, they mainly want to know what their pregnancy check-ups include.

P4: “Well, what tests do I have to do at the back? I’m not sure roughly which week because the internet tells me differently.”

P16: “Didn’t she say we should have a follow-up examination 42 days after delivery? What kinds of tests are usually performed postpartum?”

Childbirth-related needs

Generally, women with GDM are diagnosed in the third trimester of pregnancy. As they approach delivery, they tend to want to know some information about childbirth, including the mode of delivery and the relevant preparations before delivery.

P3: “If you have GDM, does that mean the risk of natural childbirth is very high? It hurts so much.”

P5: “I’d like to know. Since I’ve always been in the hospital for checkups, can I reserve a bed when I’m giving birth?”

P14: “The baby is too big. Will she ask you to have a caesarean section?”

Relationship needs

Social support-related needs

Pregnant women are in a special period of pregnancy, and women with GDM need more social support than ordinary pregnant and postpartum women due to fluctuations in blood sugar. At this time, the main sources of social support are medical staff, friends, colleagues, and family members. They provide patients with information and psychological support to varying degrees, which can alleviate the patients’ negative emotions.

P1: “Search online. Then one of our colleagues has GDM, and she also gave me some advice (laughing).”

P5: “No, my grandma just told me that it would be better for you to walk more. And when it comes to giving birth, she said it would be smooth if possible because it would be better for your health.”

In addition, we learned in the interview that some pregnant women will feel physically and mentally tired due to the need to continue working during pregnancy. Based on this situation, they prefer to consult and obtain information online, or the hospital will distribute some paper leaflets to guide blood glucose management. This will be more convenient and not limited by time and space.

P1: “Although offline communication is smooth, you may not have enough time or space for us. Online, I can get answers anytime I encounter problems. A combination of both would be better.”

P7: “But I think it is not as convenient as online or handing out leaflets.”

Growth needs

Dietary management-related needs

The majority of participants emphasised the need for diet-related health information. When managing GDM, these needs were expressed through requests for guidance on food selection and meal composition, recommendations for portion sizes and eating frequency, specific dietary plans to support effective self-management during GDM management.

P12: “I feel it specifically to what I eat for each meal, approximately how many grammes I consume, and perhaps to this extent.”

P5: “It’s like how to eat staple foods and how to plan those fruits reasonably. ”

P9: “It would be best to be specific about what to eat every day. It would be best to have a recipe for me to follow.”

Exercise management-related needs

Women with GDM have less demand for information on exercise. They generally believe that it is not convenient for them to engage in more activities during pregnancy. Therefore, most women choose walking as a form of exercise. Moreover, due to the need for work, they are often in a sedentary state. Some women are reluctant to exercise during pregnancy due to complications or a low-lying placenta. Consequently, their primary health information needs regarding exercise focus on appropriate methods, including the duration, frequency, and intensity of activity, as well as relevant contraindications and precautions.

P9: “Yeah, and then how long do you exercise every day, and then what kind of exercises do you do and all that stuff?”

P3: “Sometimes exercise, like if you walk for a long time, your body gets a bit tired; does that time have an effect?”

Glycemic management-related needs

Women with GDM primarily require health information on blood glucose monitoring. This includes understanding the frequency of blood glucose testing during hospital visits, whether testing is required at every antenatal appointment, and guidance on home monitoring—specifically the timing and frequency of self-testing.

P10: “I want to ask, if blood sugar is abnormal, do I need to recheck it every time I have a prenatal checkup?”

P4: “Do I need to continue monitoring my blood sugar after I get home? Then I have no idea approximately when I check my fasting stomach in the morning, when I check after that meal, or how many times I check in a day.”

Emotional management-related needs

Many pregnant women must balance physical discomfort with work pressures, which may lead to negative emotions. These emotions primarily arise from concerns about GDM’s impact on the baby, workplace stress, and the emotional effects of dietary management. Some women express that bad moods can affect blood sugar control and require a psychological assessment after giving birth. Therefore, it is also crucial for women with GDM to pay attention to emotional assessment, guidance, and timely intervention.

P11: “When I’m in a bad mood, my blood sugar can soar to over ten.”

P4: “I’m a little scared. I feel like it might be bad for the baby or something. I’m a bit worried and anxious.”

P13: “It’s just that I don’t control my blood sugar in daily life. After I did control it, I was actually in a bad mood. Later, I found out that was the case.”

P11: “I think postpartum psychological assessment is also very necessary. ”

P5: “Yes, they say that after giving birth, psychologically, pregnant women may have postpartum depression or something like that.” If it could be guided, I think that would be quite good.”

Postnatal management-related needs

Postpartum management is a key link to ensure the health of mothers and infants. Women with GDM pay more attention to postpartum blood sugar management and information on lifestyle changes because they have the risk of secondary metabolic diseases. Besides, they also need to know the relevant information about postpartum recovery.

P1: “I just want to pay attention. For instance, after giving birth, do I need to keep my blood sugar under control?”

P10: “I would like to know if it is necessary to continue controlling blood sugar for a period of time after giving birth, or how to adjust the diet after giving birth, and so on.”

P11: “Yes, postpartum recovery covers all parts of the body. After giving birth, everything definitely needs to be comprehensively evaluated.”

Pregnant women have always been very concerned about their babies’ health, and postpartum breastfeeding is also a matter of concern for them.

P16: “I think the new mother should just talk about how to ensure an adequate supply of breast milk in case there is no breast milk.”

Discussion

This study conducted an in-depth qualitative exploration of health information needs among Chinese women with GDM based on ERG theory, identifying prominent unmet information needs and highlighting the necessity of tailored health information services. While prior research^22–24 has generally described GDM women’s information needs through empirical qualitative summary without adopting established theoretical frameworks, our study systematically categorized these needs across existence, relatedness, and growth dimensions. The findings reveal that GDM women’s health information needs are multi-level and dynamic: growth-related needs can emerge in parallel with existence and relational needs, without following a fixed sequence. Moreover, different need levels interact—unmet growth needs may intensify the focus on survival or relational needs (i.e., frustration-regression), whereas partial satisfaction of a given need level tends to stabilize information demand at that level. These findings suggest that health information services should move beyond a linear framework toward a multi-dimensional, dynamically adaptive support system.

Our findings show that women with GDM require comprehensive clinical knowledge, including diagnostic criteria, etiology, and maternal–infant outcomes, whereas information on medication is less sought. This may stem from an underestimation of GDM severity, often perceived merely as elevated blood glucose manageable by diet. Furthermore, some women confused GDM with pre-existing diabetes, which contributed to their incomplete understanding. Regarding insulin, some women expressed no desire for pharmacological intervention, actively avoiding related information and resisting its use due to concerns about drug dependence and fetal safety. These women preferred dietary and lifestyle adjustments even when medication was advised. Regarding relationship needs, women with GDM primarily seek health information associated with social support. This support includes emotional, psychological, and instrumental assistance from social networks. Currently, access to condition-specific information from healthcare professionals remains a key need. However, both community health centres and large hospitals face limitations: the former often lack structured education on prevention and individualised guidance, while the latter are constrained by high patient volume and short consultations, resulting in insufficient information obtained by patients. Consequently, many turn to social media, yet face challenges in verifying content accuracy.

In terms of growth needs, women with GDM primarily sought dietary information. Dietary management is central to GDM self-care, and understanding patients’ information needs in this area helps tailor nursing plans²⁵. Most participants wanted specific dietary guidance, including meal allocation, food lists, quantified intake standards, and strategies for special scenarios. However, they often held a cognitive bias: they overly focused on short-term blood glucose fluctuations while overlooking the long-term maternal and infant benefits of diet management. Regarding exercise, most women paid little attention beyond walking and had limited knowledge of other forms (e.g., swimming, stationary cycling, Pilates, jogging, tai chi²⁶. Possible reasons included exercise contraindications, lack of pre-pregnancy exercise habits, a belief in resting during pregnancy, and time/energy constraints due to busy schedules. Nevertheless, some women expressed concerns about exercise management, particularly the timing, frequency, appropriate types, and feasibility of exercise. On emotional management, a few participants stated they needed no psychological support, yet interview observations revealed that some experienced psychological distress related to work pressure and family relationships. Therefore, targeted screening and timely psychological support should be provided during and after pregnancy²⁷. Postpartum management involves blood glucose control, breastfeeding, and rehabilitation. Currently, care focuses mainly on the prenatal period, while postpartum continuity of care, health information support, and rigorous follow-up remain insufficient.

This study conducted subgroup analyses based on the educational level, age, and gestational age of the participants, revealing significant heterogeneity in health information needs among GDM women with different clinical characteristics. Regarding educational background, individuals with education below a bachelor’s degree tended to prefer obtaining intuitive and actionable guidance on diet and blood glucose management from sources like online health platforms. In contrast, those with higher education demonstrated a stronger demand for in-depth professional knowledge, including disease mechanisms, long-term maternal and neonatal risks, and medication safety. In terms of age, advanced maternal age (≥ 35 years) was associated with a greater focus on the long-term postpartum health implications of GDM, such as the risk of progression to type 2 diabetes. Younger patients concentrated more on the specific and detailed management of the condition during the current pregnancy. When stratified by gestational age, patients at a lower gestational age (≤ 28 weeks) primarily needed information concerning immediate lifestyle modifications. Conversely, the needs of those at a later gestational age (> 28 weeks) extended significantly towards perinatal issues, including postpartum blood glucose control and neonatal health. In summary, educational level, age, and gestational age are all key factors shaping the health information needs of GDM patients. Consequently, clinical health management should move beyond a homogeneous approach and implement targeted, stratified interventions. For patients with lower education levels, information should be simplified, direct, and practical. For older patients, education should emphasize long-term prognosis and follow-up, while for younger patients, it should detail daily pregnancy management. Simultaneously, the focus of education should be dynamically adjusted around the 28-week gestational age mark: emphasizing immediate lifestyle intervention earlier in pregnancy and gradually shifting towards perinatal and postpartum management later. Through such individualized strategies, the specific needs of different patient subgroups can be more accurately met, thereby enhancing the quality of health management and improving maternal and neonatal outcomes.

In summary, this study reveals the multi-level and heterogeneous health information needs of patients with GDM in terms of survival, relationship, and growth, highlighting structural gaps in the current maternal care system regarding the provision of continuous and personalized information support. Specifically, outpatient clinics in large hospitals face high patient loads and time constraints, while primary care services at the community level remain uneven in capacity and are inadequately coordinated with hospitals. This has resulted in a lack of sustained and individualized support for patients, leading to a systematic mismatch between health information supply and patients’ dynamic needs.Research indicates that effective information support can optimize patients’ treatment plans, coping strategies, and quality of life^28,29. Therefore, we propose a tiered “hospital-community-digital” collaborative support system. At the community level, standardized training for primary healthcare workers can enable differentiated and accessible health education. A digital health platform could be utilized to deliver precise, tailored information and management assistance based on gestational week, clinical characteristics, and behavioral data. Furthermore, improving referral coordination and information-sharing procedures between hospitals and communities would help establish a closed-loop management system covering the entire period from pregnancy to postpartum. Such a model would not only address the diverse needs identified in this study but also advance the practice of preventive, patient-centered hierarchical healthcare.

Advantages and Limitations

This study conducted in-depth interviews with women with GDM based on the ERG theory. As the first qualitative study to systematically explore the health information needs of women with GDM in China, it comprehensively revealed the multi-dimensional characteristics of their health information needs. However, the following research limitations need to be pointed out:

(1)The health information needs of women with GDM demonstrate dynamic changes across pregnancy, forming a continuous spectrum encompassing dietary management, complication prevention and control, and postpartum self-care. Although the present study identified explicit needs via qualitative interviews, it failed to fully explore implicit needs that participants might have been reluctant to articulate. To overcome this limitation, future studies are recommended to employ a mixed-methods design and a longitudinal qualitative approach. A mixed-methods design integrating qualitative interviews with quantitative surveys can reduce the psychological burden on participants and facilitate the identification of hard-to-articulate implicit needs, thus enabling a comprehensive understanding of both explicit and implicit health information needs. Meanwhile, a longitudinal qualitative design with extended follow-up can capture the dynamic evolution of participants’ needs at different gestational stages, helping researchers identify critical turning points and understand how temporal and environmental factors shape the emergence and transformation of needs, thereby clarifying patterns of need development and providing more targeted health information support.

(2)Furthermore, although maximum variation sampling was employed to ensure heterogeneity in participant characteristics, the single-center study design may limit the generalizability and transferability of the findings. Participants exhibited a certain degree of homogeneity in social background, lifestyle, dietary habits, and accessible healthcare resources. In particular, all women were recruited from a single tertiary hospital, and rural women as well as those from low-resource areas were not included, which further restricts the applicability of the results. Therefore, caution should be exercised when generalizing these findings to women with GDM in other geographic areas, different healthcare settings, or broader sociocultural contexts. Future studies are recommended to adopt a multicenter design involving participants from urban and rural areas, different levels of healthcare institutions, and diverse socioeconomic and cultural backgrounds. Such studies could validate and refine the research framework, explore how contextual factors shape health information needs across different populations, and improve the generalizability and transferability of evidence supporting person-centered care for women with GDM.

Conclusion

This study explored the health information needs of women with GDM based on ERG theory. Our findings reveal areas of patient-centred and highly needed health information and suggest specific directions for improving information provision. The findings highlight the need for structured and staged health information provision services, as well as convenient, reliable, and responsive information access channels. Healthcare providers and healthcare organisations play a central role in assessing individual needs, providing customised information, and building trust in communication. Considering the differences in cultural backgrounds, medical service conditions and individual characteristics, future studies can carry out similar investigations among diverse groups of women with GDM, further enrich the classification system of their health information needs, and conduct in-depth research on targeted health information supply strategies. Future research should further explore the prioritisation of information needs identified in this study and assess the applicability and effectiveness of targeted information intervention strategies in improving self-management skills, clinical outcomes, and long-term health literacy in patients with GDM.

Author contributions

Jiani Yang: Conceptualization, Data curation, Formal analysis, Writing- original draft.Shanshan Jiang: Visualization, Methodology，Data curation.Weiling Yan: Data curation, Formal analysis.Qingqing Wang: Visualization, Data curation. Ting Yu Mu: Writing- Reviewing and Editing.Fengying Zhang: Resources. Yuhong Li: Writing- Reviewing and Editing, Supervision.

Funding

This study was supported by Joint Training Demonstration Base for Postgraduate Students in Nursing (Maternal and Infant Care Nursing) [grant no. 2024lhpysfjd022], 2025 Qingmiao Training Program for Graduate Students, School of Nursing, Anhui Medical University [grant no. Hlqm12025043].

Data availability

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

Declarations

Competing interests

The authors declare no competing interests.