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Coping strategies and uncertainty in the woman with gestational diabetes Riddell, Lenore Anne


The purpose of this descriptive correlational study was to describe the level of uncertainty, the coping strategies, and the relationship between uncertainty and coping strategies for women with gestational diabetes. Snyder's (1979) holistic model of childbearing and Mishel's (1984, 1988) theory of uncertainty served as the theoretical framework for the study. A convenience sample of 46 subjects who were experiencing gestational diabetes for the first time completed the Uncertainty Stress Scale (High-Risk Pregnancy Version), the Jaloweic Coping Scale (1987), and a patient information sheet. The questionnaires to the subjects were mailed. For the majority of subjects this was their first pregnancy. The average gestational age of the subjects was 31.2 weeks. The average maternal age was 31.6 years. The majority had a family history of diabetes. Overall, the women with gestational diabetes perceived moderately low levels of uncertainty however, perceived uncertainty varied from quite low to quite high. The women also indicated that gestational diabetes was considered to be fairly serious. The nature of the uncertainty appeared to be generated primarily by concerns over the baby's health and the meaning of the diabetes for the women's pregnancy. Women who were in the 20 to 29 weeks pregnancy group perceived the most uncertainty. Women with gestational diabetes used various coping strategies to manage their uncertainty and the stress it generated. There was a tendency to use optimistic and confrontive coping strategies the most with problem-focused coping strategies being the most frequently used in dealing with the stress of gestational diabetes. Findings indicated that the patients with higher levels of uncertainty tended to use emotion-focused coping strategies such as evasive, fatalistic and self-reliant. Findings also indicated that although positive feelings may be associated with the uncertainty, positive feelings were rather low. Based on the findings of this study, implications were suggested for new directions for the provision of effective nursing care for women with gestational diabetes. It also recommended that further research is needed to identify and explore relationships between uncertainty and coping strategies, particularly as it relates over time.

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