关键词: 妊娠期糖尿病, 血糖管理, 促进因素, 阻碍因素, 质性研究, Meta 整合

Abstract: Background　In recent years, the incidence of gestational diabetes mellitus has increased, posing a serious threat to maternal and infant health. Standardized glycemic management can effectively improve adverse maternal and infant outcomes. While current qualitative studies have explored patients' blood glucose management behaviors and experiences in depth, the findings are relatively fragmented.Therefore, a meta-synthesis is urgently needed to comprehensively understand the facilitating and hindering factors for patients' blood glucose management. Objective　To systematically synthesize qualitative studies on factors promoting and hindering blood glucose management in patients with gestational diabetes, providing evidence-based guidance for optimizing management strategies. Methods　We searched PubMed, Web of Science, Embase, CINAHL, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, VIP Database, and China Biomedical Literature Database for qualitative studies on factors promoting and hindering blood glucose management in patients with gestational diabetes. The search period spanned from database inception to June 30, 2025.Two researchers independently assessed study quality using the Joanna Briggs Institute(JBI) Australian Centre for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research.Literature screening was conducted using NoteExpress software, and results were synthesized using a meta-synthesis approach.Results　A total of 20 studies were included, yielding 44 research findings categorized into 10 themes and synthesized into 2 integrated results: Facilitating factors included maternal-infant health responsibility, proactive self-regulation, diverse social support, and medical support and interventions.Barriers factors included endogenous cognitive impairments and exogenous stigma pressures, emotional burdens and difficulties in psychological adaptation, multiple practical challenges in managing blood glucose during pregnancy, an imperfect healthcare system, obstacles in implementing blood glucose monitoring, and socioeconomic and cultural environmental challenges. Conclusion　Blood glucose management in women with gestational diabetes mellitus is influenced by multiple factors, including individual cognition, the healthcare system, and social support. Healthcare providers should enhance patients' blood glucose management by fostering patients' intrinsic motivation for self-management, strengthening cognitive and emotional interventions, and integrating diverse support resources.

Key words: Gestational diabetes mellitus, Blood glucose management, Promoting factors, Hindering factors, Qualitative research, Meta-synthesis