TABLE 3.
Provider-Identified Patient Facilitators to Diabetes Care and Self-Management During Pregnancy
| Theme | Subtheme | Exemplary Quotation |
|---|---|---|
| Environment & Access | No facilitators identified | |
| Institutional | Cohesive multidisciplinary care | “My clinic is a great clinic for diabetes care because it’s great for our moms because they not only see the [maternal-fetal medicine specialist], they see [the APN] and/or the endocrinologist. [T]he providers . . . can step out of the room and chat with each other about the patient’s care, and it’s right there. So, our patients . . . don’t have to wait, ya know? Because they have the answer. . . .” |
| Interpersonal | Positive framing of diabetes diagnosis | “That’s where [the APN] comes in, which is a big attribute to our department, I must say, because she can alleviate a lot of fears . . . because there’s a lot of fear with it. Will I end up on insulin? . . . What’s going to happen to my baby? Is my baby gonna be too big to deliver? [T]hose are all things that create a fear for the patient, and if we can alleviate those fears by them having contact, quick contact that’s easy for the provider [and] easy for the patient, I think it’ll be a really positive outlook for pregnancy for them.” |
| Celebrating achievable milestones | “Our patients are really motivated by the ultrasounds and by the [non-stress tests]. When a patient is a type 2 diabetic on insulin or gestational diabetic on insulin, we do more fetal testing, so I find my experience that the patients who earlier in the pregnancy I was sort of every week reminding them to do certain mundane tasks and tests . . . were really excited to get the test done. That I think is very motivating; the baby becomes real; the pregnancy becomes more real. They’re looking at the fetal growth at 32 and 36 weeks . . . [and] patients, I think, are very motivated for that. | |
| Knowledge | Patient-centered teaching | “It’s a team approach. . . .[If the endocrinologist] steps out and says, ‘You know what? I really think [the APN] should see this patient,’ [the APN] puts her on her schedule, she sees them, and they’re counseled. So, they get an extensive education piece with [the APN]. It’s really, really good. And [it's] available for moms who have [the] low-income clinic, too.” |
Individual characteristics presented in Table 4.