Factors Influencing Stress among Women with Gestational Diabetes Mellitus

Main Article Content

Supattra Auntarin
Tatirat Tachasuksri
Wantana Supasrimanont



This predictive research aimed to examine factors influencing stress among women with gestational diabetes mellitus. Participants were 176 pregnant women with gestational diabetes who visited Queen Savang Vadhana Memorial Hospital. They were selected by simple random sampling. Data were collected from May to September 2018. Research instruments consisted of personal data record form, perceived risk of gestational diabetes mellitus questionnaire, self–efficacy questionnaire, social support questionnaire and perceived stress scale. Cronbach’s alpha coefficients of the latter four questionnaires were .89, .88, .92, and .72, respectively. Data were analyzed by descriptive statistics and backward multiple regression.

Results revealed that most participants were multigravida (73.30 %), were in the third trimester of pregnancy (77.84 %), had pre-gestational body mass as overweight and obesity (63.64%), and were diagnosed as GDM A1 (74.43 %). Their mean score of stress was at a moderate level (mean = 17.70, SD = 3.79). Self–efficacy and social support significantly negatively influenced their stress (β = -.35, p < .001; β = -.15, p = .04). Both variables significantly predicted 19.1 % of the variance in stress (R2 = .191, F(2, 173) = 20.46, p < .001).

Research finding indicated that nurses and health care providers would promote women to perceive their self-efficacy and support their families to take care of women. Consequently, women with gestational diabetes mellitus might effectively cope with their illness, and then reduce their stress.


Download data is not yet available.

Article Details



Bijl, J.V., Poelgeest-Eeltink, A.V. & Shortridge-Baggett, L. (1999). The psychometric properties of the diabetes management self-efficacy scale for patients with type 2 diabetes mellitus. Journal Advance Nursing, 30(2), 352-359.
Cashion, K. (2012). Endocrine and metabolic disorders in pregnancy. In D. L. Lowdermilk, S. E. Perry, M. Cashion, & K. Alden (Eds.), Maternity and women’s health care (10th ed., pp. 688-707). St. Louis: Elsevier Mosby.
Cho, N. H., Shaw, J. E., Karuranga, S., Huang, Y., da Rocha Fernandes, J. D., Ohlrogge, A.W., & Malanda, B. (2018). IDF diabetes atlas: Global estimates for the prevalence of diabetes for 2017 and 2045. Diabetes Research and Clinical Practice, 138, 271-281.
Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24(4), 385-396.
Faramarzi, M., & Pasha, H. (2015). The role of social support in prediction of stress during pregnancy. Journal of Babol University of Medical Sciences, 17(11), 52-60.
Guariguata, L., Linnenkamp, U., Beagley, J., Whiting, D. R., & Cho, N. H. (2014). Global estimates of the prevalence of hyperglycaemia in pregnancy. Diabetes Research and Clinical Practice, 103(2), 176-185.
Gupton, A., Heaman, M., & Cheung, L. W. K. (2001). Complicated and uncomplicated pregnancies: Women's perception of risk. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 30(2), 192-201.
Hayase, M., Shimada, M., & Seki, H. (2014). Sleep quality and stress in women with pregnancy-induced hypertension and gestational diabetes mellitus. Women and Birth, 27(3), 190-195.
Horsch, A., Kang, J. S., Vial, Y., Ehlert, U., Borghini, A., Marques-Vidal, P., Jacobs, I., & Puder, J. J. (2016). Stress exposure and psychological stress responses are related to glucose concentrations during pregnancy. British Journal of Health Psychology, 21(3), 712-729.
Hui, A. L., Sevenhuysen, G., Harvey, D., & Salamon, E. (2014). Stress and anxiety in women with gestational diabetes during dietary management. Diabetes Educator, 40(5), 668-677.
Iamsumang, W. (2009). The development of the Thai Version of the Diabetes Management Self-Efficacy Scale (T-DMSES) for older adults with type 2 diabetes. Dissertations, Doctoral in Philosophy, University of New York at Buffalo.
Iranzad, I., Bani, S., Hasanpour, S., Mohammadalizadeh, S., & Mirghafourvand, M. (2014). Perceived social support and stress among pregnant women at health centers of Iran-Tabriz. Journal of Caring Sciences, 3(4), 287-295.
Jerusalem, M., & Schwarzer, R. (1992). Self-efficacy as a resource appraisal process. In R. Schwarzer (Ed.), Self-efficacy: Thought of action (pp. 195-210). Washington: Hemisphere.
Jittrapirom, A., Chareonsanti, J., & Sriarporn, P. (2014). Pregnancy risk perception, uncertainty, and stress among gestational diabetic women. Nursing Journal, 41(1), 50-61. [In Thai]
Kanbara, S., Taniguchi, H., Sakaue, M., Wang, D. H., Takaki, J., Yajima, Y., Naruse, F., Kojima, S., Sauriasari, R., & Ogino, K. (2008). Social support, self-efficacy and psychological stress responses among outpatients with diabetes in Yogyakarta, Indonesia. Diabetes Research and Clinical Practice, 80(1), 56-62.
Kanthiya, K., Luangdansakul, W., Wacharasint, P., Prommas, S., & Smanchat, B. (2013). Prevalence of gestational diabetes mellitus and pregnancy outcomes in women with risk factors diagnosed by IADPSG Criteria at Bhumibol Adulyadej Hospital. Thai Journal of Obstetrics and Gynaecology, 21(1), 141-149.
Kopec, J. A., Ogonowski, J., Rahman, M. M., & Miazgowski, T. (2015). Patient-reported outcomes in women with gestational diabetes: A longitudinal study. International Journal of Behavioral Medicine, 22(2), 206-213.
Langer, N. & Langer, O. (1994). Emotional adjustment to diagnosis and intensified treatment of gestational diabetes. Obstetrics and Gynecology, 84(3), 329–334.
Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer Publishing.
Nierop, A., Wirtz, P. H., Bratsikas, A., Zimmermann, R., & Ehlert, U. (2008). Stress-buffering effects of psychosocial resources on physiological and psychological stress response in pregnant women. Biological Psychology, 78(1), 261–268.
Phongpate, K. (2016). Factors predicting stress among gestational diabetes women. Master’s thesis, Midwifery, Faculty of Nursing, Chiangmai University. [In Thai]
Phrommasen, P, Chareonsanti, J., & Sriarporn, P. (2019). Hardiness, social support, and stress among gestational diabetic women. Nursing Journal, 46(3), 169-180. [In Thai]
Queen Savang Vadhana Memorial Hospital. (2017). Annual Report 2016. Chonburi: Queen Savang Vadhana Memorial Hospital.
Radarith, C., Tachasuksri, T., & Siriarunrat, S. (2019). Factors influencing self management among women with gestational diabetes mellitus. The Journal of Faculty of Nursing Burapha University, 27(1), 50-59. [In Thai]
Suntorn, R., & Panichkul, P. (2015). Prevalence of gestational diabetes mellitus detected by
international association of the diabetes and pregnancy study groups (IADPSG)
criteria in Phramongkutklao Hospital. Thai Journal of Obstetrics and Gynaecology,
23(3), 144-150.
Tabachnick, B. G., & Fidell, L. S. (2014). Using multivariate statistics (6th ed.). Harlow: Pearson.
Tachasuksri, T., Siriarunrat, S., Suppasri, P., Suppaseemanont, W., Boonnate, N., & Kwannate, C. (2017). Causal model for quality of life among pregnant women. The Southern College Network Journal of Nursing and Public Health, 4(1), 28-48. [In Thai]
Wongpakaran, N., & Wongpakaran, T. (2010). The Thai version of the PSS-10: An investigation of its psychometric properties. Biopsychosocial Medicine, 4(1), 1-6.