The effect of mental health-based self-care model counseling on anxiety and depression in women with gestational diabetes: a randomized clinical trial.

BACKGROUND

Anxiety and depression caused by gestational diabetes can lead to adverse outcomes for both the mother and the baby. Mental health self-care counseling focusing on awareness, recognition, and coping strategies can play a protective role. This study aimed to determine the effect of a mental health-based self-care counseling model on anxiety and depression in women with Gestational Diabetes Mellitus (GDM).

METHODS

This randomized clinical trial was conducted from June 2023 to May 2024 on 84 pregnant women with gestational diabetes at Amir al-Momenin Hospital in Semnan. After block randomization, the women were divided into a self-care mental health counseling group (42 participants) and a control group (42 participants). The intervention group received six individual weekly sessions (30-45 min each) of computer-linked self-care mental health counseling. Data were collected before, immediately after, one month after the intervention, and six weeks after delivery using the questionnaires including demographic and reproductive, Hospital Anxiety and Depression Scale (HADS), health behavior during Pregnancy, mental health self-care, and gestational diabetes self-efficacy.

RESULTS

The study results showed that the mean (standard deviation) anxiety scores in the intervention and control groups were 6.85 (2.11) and 7.31 (2.26) before the intervention, 4.02 (1.78) and 7.49 (1.73) at the end of the intervention, 3.88 (1.56) and 7.13 (1.36) one month after the intervention, and 2.07 (1.14) and 4.14 (1.16) six weeks after delivery (p < 0.001, η² = 0.56), respectively. For depression scores, the two groups had means of 6.03 (2.15) and 6.10 (1.71) before the intervention, 4.07 (1.20) and 5.82 (1.88) at the end of the intervention, 3.62 (1.12) and 5.82 (1.35) one month after the intervention, and 5.15 (1.25) and 8.62 (1.62) six weeks after delivery (p < 0.001, η² = 0.60). Compared to the control group, intervention group showed a significant reduction in mean anxiety and depression scores at all three follow-ups after the intervention. Additionally, the mean scores for health-promoting behaviors, mental health self-care, and self-efficacy increased significantly more in the intervention group. Based on linear regression analysis, mental health self-care was the strongest predictor of reduced anxiety and depression (β = -0.393, p < 0.001).

CONCLUSION

Mental health-based self-care counseling is effective in reducing anxiety and depression, as well as promoting health behaviors, self-efficacy, and mental health self-care in women with gestational diabetes. Therefore, it is recommended as a valuable strategy for managing the complications of gestational diabetes.

TRIAL REGISTRATION: IRCT20230130057274N1. Date of registration: 2024-08-06.