Authors
- . Masoumeh Kordi
- . Mahsima Banaei Heravan
- . Negar Asgharipour 1
- . Farideh Akhlaghi 2
- . Seyed Reza Mazloum 3
1 Department of Psychiatry, School of Medicine
2 Department of Obstetrics and Gynecology, School of Medicine
3 Department of Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
Abstract
INTRODUCTION: Gestational diabetes is the most common metabolic disorder in pregnancy, and
lack of self‑care is the most important reason for mortality in diabetic patients. Since the glycemic
control is associated with physiological and psychological mechanisms, variables such as health
locus of control can play a role in health behaviors of diabetic patients. Therefore, this study was
aimed to predict self‑care behaviors among women with gestational diabetes based on maternal
health locus of control (MHLC) and fetal health locus of control (FHLC).
METHODS: This study is a descriptive, predictive correlational study that it is conducted on
over 400 women with gestational diabetes attending the health centers and clinic of hospitals
affiliated to Mashhad University of Medical Sciences in 2015. Data were collected using individual
questionnaire, self‑care derived from the summary of diabetes self‑care activities, MHLC, and FHLC
scale. The data were analyzed using Spearman’s correlation coefficient test, linear regressions
model, and multiple regression in SPSS software version 16. P < 0.05 was considered statistically
significant.
RESULTS: Results of Spearman’s correlation coefficient test showed a significant direct linear
relationship between self‑care and internal MHLC (P = 0.027) and internal dimensions (P < 0.0001)
and powerful others (P = 0.012) of FHLC. According to linear regressions model, internal
MHLC (P = 0.027), internal dimensions (P < 0.0001), and powerful others (P = 0.012) of FHLC are
considered as predictor variables of self‑care.
CONCLUSION: Midwives should perform interventions to increase internal locus of control and
encourage more responsibility among women with gestational diabetes to achieve better self‑care.
Keywords
Diabetes. In: Ansari SH, editor. Text Book of Obstetrics. 24th ed.
New York: McGraw Hill; 2014. p. 322‑3.
2. Leng J, Shao P, Zhang C, Tian H, Zhang F, Zhang S, et al.
Prevalence of gestational diabetes mellitus and its risk factors in
Chinese pregnant women: A prospective population‑based study
in Tianjin, China. PLoS One 2015;10:e0121029.
3. Hedayati H, Khazaee T, Mogharrab M, Sharifzadeh G. The
prevalence of gestational diabetes and overt diabetes in pregnant
women in the city of Birjand. Mod Care J2012;8:238‑44.
4. Zarrabi R, Rahmatnezhad L, Bastani F. Investigating health
locus of control among women with gestational diabetes and its
relationship with demographic variables. J Urmia Nurs Midwifery
Fac 2013;11:72‑82.
5. Azarmi M, Abolfathi AA, Ahmadi Jouybari T, Ataei M, Lotfi B,
Aqaei A. Comparison of serum and urinary cortisol levels in
women with gestational diabetes and healthy pregnant women.
Iran J Obstet Gynecol Infertil 2015;17:16‑25.
6. Nikoogoftar M. The role of attachment and health locus of
control on self‑care in diabetic patients. Iran J Diabetes Lipid
2013;12:309‑16.
7. Baquedano IR, dos Santos MA, Martins TA, Zanetti ML. Self‑care
of patients with diabetes mellitus cared for at an emergency
service in Mexico. Rev Lat Am Enfermagem 2010;18:1195‑202.
8. Hosseinzadeh M. The Effect of Multiple Teaching Methods
to Preventive Behavior of Postpartum Type 2 Diabetes in
Gestational Diabetic Women Attendance to Mashhad Health
Centers. (Dissertion) Iran: Mashhad University of Medical
Sciences; 2015.
9. Tol A, Sharifi Rad G, Eslami AA, Alhani F, Mohajeri Tehrani MR,
Shojaeezadeh D. Factors influencing self‑management behavior
in type‑2 diabetes patients: A strategy proposed to be adopted
when planning theory/model based interventions. J School Pub
Health Inst Pub Health Res (SJSPH)2012;9:21‑32.
10. Harizopoulou VC, Kritikos A, Papanikolaou Z, Saranti E,
Vavilis D, Klonos E, et al. Maternal physical activity before and
during early pregnancy as a risk factor for gestational diabetes
mellitus. Acta Diabetol 2010;47 Suppl 1:83‑9.
11. Davenport MH, Mottola MF, McManus R, Gratton R. A walking
intervention improves capillary glucose control in women with
gestational diabetes mellitus: A pilot study. Appl Physiol Nutr
Metab 2008;33:511‑7.
12. Parizad N, Hemmati Maslakpak M, Khalkhali HR. Promoting
self‑care in patients with type 2 diabetes: Tele‑education. Hakim
Res J 2013;16:220‑7.
13. Noroozi A, Tahmasebi R, Rekabpour SJ. Effective social
support resources in self‑ management of diabetic patients in
Bushehr (2011‑12). Iran South Med J 2013;16:250‑9.
14. Rotter JB. Generalized expectancies for internal versus external
control of reinforcement. Psychol monogr. 1966;80:1‑28.
15. Gabry H. Understanding the Relationship Between Health
Behavior During Pregnancy and Health Locus of Control
among Arab and Non‑Arab Women to Reduce High Risk
Pregnancy. (Dissertation) Egypt: University of Alexandria; 1995.
16. Gregg EW, Kriska AM, Narayan KM, Knowler WC. Relationship
of locus of control to physical activity among people with and
without diabetes. Diabetes Care 1996;19:1118‑21.
17. Ciechanowski PS, Hirsch IB, Katon WJ. Interpersonal predictors
of HbA (1c) in patients with type 1 diabetes. Diabetes Care
2002;25:731‑6.
18. Clements LB, York RO, Rohrer GE. The interaction of prenatal
alcoholism and alcoholism as a predictor of drinking‑ related
locus of control. Alcohol Treat Q 1995;12:97‑110.
19. Koski‑Jännes A. Drinking‑related locus of control as a predictor
of drinking after treatment. Addict Behav 1994;19:491‑5.
20. Spirito A, Ruggiero L, McGarvey ST, Coustan DR, Graff Low K.
Maternal and fetal health locus of control during pregnancy:
A comparison of women with diabetes and nondiabetic women.
J Reprod Infant Psychol 1990;8:195‑205.
21. Eswi A, Khalil A. Prenatal attachment and fetal health locus of
control among low risk and high risk pregnant women. World
Appl Sci J 2012;18:462‑71.
22. Özcan S, Duyan V. Fetal health locus of control in a sample of
pregnant Turkish women. Turk J Med Sci 2015;45:714‑22.
23. Hashemi T, Aliloo MM, Poursharifi H, Bayrami M,
Nemati‑Sogolitappeh F. The role of personality characteristics
and coping strategies in self‑care of patients with type 2 diabetes.
J Clin Psychol 2012;5:89‑99.
24. Toobert DJ, Hampson SE, Glasgow RE. The summary of diabetes
self‑care activities measure: Results from 7 studies and a revised
scale. Diabetes Care 2000;23:943‑50.
25. Wallston KA, Stein MJ, Smith CA. Form C of the MHLC scales:
A condition‑specific measure of locus of control. J Pers Assess
1994;63:534‑53.
26. Labs SM, Wurtele SK. Fetal health locus of control scale:
Development and validation. J Consult Clin Psychol 1986;54:814‑9.
27. Nikoogoftar M, Eshaghi F. Prediction of self‑care behaviors of
patients with diabetes based on attachment styles and health locus
of control: Moderating role of gender. J Health Psychol 2013;1:84‑96.
28. Thomas EM, Kamalanabhan TJ, Vasanthi M. Locus of control
among diabetic and non‑diabetic patients: A comparative study.
J Soc Sci 2004;8:221‑6.
29. Shariatmadar A. Locus of control. J Consult 2010;5:28‑31.
30. Momeni Javid F, Simbar M, Dolatian M, Alavi Majd H.
Comparison of pregnancy self‑care, perceived social support and
perceived stress of women with gestational diabetes and healthy
pregnant women. Iran J Endocr Metab 2014;16:156‑64.
31. Hamadzadeh S, Ezatti ZH, Abedsaeidi ZH, Nasiri N. Coping
styles and self‑care behaviors among diabetic patients. Iran J Nurs
2013;25:24‑33.
32. Baldwin K. The Effect of the Centering Prenatal Care Model on the
Knowledge, Social Support, Health Locus of Control, Satisfaction,
and Sense of Practicpation of Pregnant Women. (Dissertation)
USA: University of Columbia; 2003.
33. Hassanzadeh R, Toliati SM, Hosseini SH, Davari F. The
relationship between health locus of control and health behavior.
Iran J Psychiatry Clin Psychol 2006;12:277‑81.
34. Habboushe DF. Coping Style and Locus of Control: Predicting
Daily Adherence to Self‑Monitoring of Blood Glucose in Women
with Gestational Diabetes Mellitus.(Dissertation) USA: University
of MCP Hahnemann; 2000.
35. Rao M. An Exploration of the Predictability of Drinking
Behavior of Pregnant Women using Selected Dimensions of
the Health Belief Model and the Fetal Health Locus of Control
Scale. (Dissertation) USA: University of Toledo; 1996.
36. Pedersen O, Beck‑Nielsen H, Heding L. Increased insulin
receptors after exercise in patients with insulin‑dependent
diabetes mellitus. N Engl J Med 1980;302:886‑92.
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