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已发表论文
基于国王目标达成理论的支持模式对妊娠期糖尿病女性母乳喂养结局的影响：一项准实验研究
Received 28 July 2025
Accepted for publication 26 September 2025
Published 8 November 2025 Volume 2025:17 Pages 4323—4330
DOI https://doi.org/10.2147/IJWH.S556749
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Matteo Frigerio
Yuexia Liu,1 Yin Ying,2 Xianling Zou1
1Integrated Obstetrics District 3, Hangzhou Women’s Hospital (Hangzhou Maternity and Child Health Care Hospital), Hangzhou, Zhejiang, 310000, People’s Republic of China; 2Nursing Department, Hangzhou Women’s Hospital (Hangzhou Maternity and Child Health Care Hospital), Hangzhou, Zhejiang, People’s Republic of China
Correspondence: Xianling Zou, Email zp0191@yeah.net
Objective: To evaluate the effectiveness of a breastfeeding support model based on King’s Goal Attainment Theory in improving breastfeeding outcomes and metabolic health among women with gestational diabetes mellitus (GDM).
Methods: A retrospective cohort study was conducted involving 120 women with GDM who delivered at a tertiary hospital between March 2022 and March 2024. Participants were divided into two groups based on the type of care received: the study group (n = 60) received a structured, theory-based breastfeeding support intervention involving goal negotiation, dynamic assessment, and interactive feedback delivered by a multidisciplinary team; the control group (n = 60) received routine breastfeeding support. Primary outcome was continued breastfeeding rate at 6 weeks, 3 months, and 6 months postpartum. Secondary outcomes included breastfeeding self-efficacy (BSES-SF), glycemic control (FPG and HbA1c), and incidence of neonatal hypoglycemia. Statistical analyses included t-tests, χ²-tests, and generalized estimating equations (GEE).
Results: The study group showed significantly higher continued breastfeeding rates at all time points: 80.0% vs 58.3% at 6 weeks (p = 0.010), 73.3% vs 46.7% at 3 months (p = 0.003), and 65.0% vs 36.7% at 6 months (p = 0.002). At 6 weeks postpartum, the study group also had higher breastfeeding self-efficacy scores (62.50 ± 5.31 vs 53.11 ± 6.82, p < 0.001) and better glycemic control, with higher proportions achieving target FPG (75.0% vs 51.7%, p = 0.008) and HbA1c (80.0% vs 60.0%, p = 0.017). The incidence of neonatal hypoglycemia was significantly lower in the study group (8.33% vs 21.67%, p = 0.041).
Conclusion: The breastfeeding support model based on King’s Goal Attainment Theory was associated with significantly improved breastfeeding rates, self-efficacy, glycemic control, and neonatal outcomes in women with GDM. This theory-driven, multidisciplinary approach shows promise for enhancing perinatal care in this high-risk population.
Keywords: goal attainment theory, gestational diabetes mellitus, breastfeeding, self-efficacy, intervention study
1Integrated Obstetrics District 3, Hangzhou Women’s Hospital (Hangzhou Maternity and Child Health Care Hospital), Hangzhou, Zhejiang, 310000, People’s Republic of China; 2Nursing Department, Hangzhou Women’s Hospital (Hangzhou Maternity and Child Health Care Hospital), Hangzhou, Zhejiang, People’s Republic of China
Correspondence: Xianling Zou, Email zp0191@yeah.net
Objective: To evaluate the effectiveness of a breastfeeding support model based on King’s Goal Attainment Theory in improving breastfeeding outcomes and metabolic health among women with gestational diabetes mellitus (GDM).
Methods: A retrospective cohort study was conducted involving 120 women with GDM who delivered at a tertiary hospital between March 2022 and March 2024. Participants were divided into two groups based on the type of care received: the study group (n = 60) received a structured, theory-based breastfeeding support intervention involving goal negotiation, dynamic assessment, and interactive feedback delivered by a multidisciplinary team; the control group (n = 60) received routine breastfeeding support. Primary outcome was continued breastfeeding rate at 6 weeks, 3 months, and 6 months postpartum. Secondary outcomes included breastfeeding self-efficacy (BSES-SF), glycemic control (FPG and HbA1c), and incidence of neonatal hypoglycemia. Statistical analyses included t-tests, χ²-tests, and generalized estimating equations (GEE).
Results: The study group showed significantly higher continued breastfeeding rates at all time points: 80.0% vs 58.3% at 6 weeks (p = 0.010), 73.3% vs 46.7% at 3 months (p = 0.003), and 65.0% vs 36.7% at 6 months (p = 0.002). At 6 weeks postpartum, the study group also had higher breastfeeding self-efficacy scores (62.50 ± 5.31 vs 53.11 ± 6.82, p < 0.001) and better glycemic control, with higher proportions achieving target FPG (75.0% vs 51.7%, p = 0.008) and HbA1c (80.0% vs 60.0%, p = 0.017). The incidence of neonatal hypoglycemia was significantly lower in the study group (8.33% vs 21.67%, p = 0.041).
Conclusion: The breastfeeding support model based on King’s Goal Attainment Theory was associated with significantly improved breastfeeding rates, self-efficacy, glycemic control, and neonatal outcomes in women with GDM. This theory-driven, multidisciplinary approach shows promise for enhancing perinatal care in this high-risk population.
Keywords: goal attainment theory, gestational diabetes mellitus, breastfeeding, self-efficacy, intervention study