Korean J Women Health Nurs.  2013 Jun;19(2):88-98. 10.4069/kjwhn.2013.19.2.88.

Effects of a Case Management Program on Self-efficacy, Depression and Anxiety in Pregnant Women with Gestational Diabetes Mellitus

  • 1Bundang CHA General Hospital, Seongnam, Korea.
  • 2College of Nursing, CHA University, Seongnam, Korea. clara@cha.ac.kr


To examine the effects of a case management program on self-efficacy, depression and anxiety in pregnant women with gestational diabetes mellitus.
Thirty-seven patients who enrolled in a diabetes outpatient clinic were randomly assigned to either an experimental group (n=19) or a control group (n=18). The experimental group received a 2-week intervention composed of a series of one face-to-face interactive interview and five telephone interviews based on the National standards for diabetes self-management education and Bandura's self-efficacy resources of performance accomplishment, vicarious experience, verbal persuasion, and emotional arousal. The effects of the intervention were assessed by completion of a 9-item self-efficacy questionnaire, a 20-item depression questionnaire and a 20-item anxiety questionnaire prior to, and after the intervention. The statistical significances were examined using t-test.
The change in self-efficacy was significantly greater in the experimental group than in the control group. Depression and anxiety changes in the experimental group were significantly greater compared to those in the control group.
The results of study suggest that a case management program improves self-efficacy, and decreases depression and anxiety in pregnant women with gestational diabetes mellitus.


Case management; Self-efficacy; Depression; Anxiety; Gestational diabetes mellitus

MeSH Terms

Ambulatory Care Facilities
Case Management
Diabetes, Gestational
Interviews as Topic
Persuasive Communication
Pregnant Women
Surveys and Questionnaires
Self Care

Cited by  6 articles

The effects of health care programs for gestational diabetes mellitus in South Korea: a systematic review
Seo Jin Park, Jina Lee
Korean J Women Health Nurs. 2020;26(4):274-284.    doi: 10.4069/kjwhn.2020.10.28.

Relationship among Emotional Clarity, Maternal Identity, and Fetal Attachment in Pregnant Women with Gestational Diabetes Mellitus
Su Min Lee, Hye-Ja Park
Korean J Women Health Nurs. 2017;23(2):99-108.    doi: 10.4069/kjwhn.2017.23.2.99.

Effects of a Postnatal Care Program on Self-efficacy, Self-management, and Glycemic Control in Women with Gestational Diabetes Mellitus
Yeong Kyung Jeon, Hyo Jin Kim, Mi Yeon Yang, Da Yeong Jung, Kum Young Yoon, Gie Ok Noh
Korean J Women Health Nurs. 2018;24(4):367-378.    doi: 10.4069/kjwhn.2018.24.4.367.

Psychosocial support interventions for women with gestational diabetes mellitus: a systematic review
Seulgi Jung, Yoojin Kim, Jeongok Park, Miyoung Choi, Sue Kim
Korean J Women Health Nurs. 2021;27(2):75-92.    doi: 10.4069/kjwhn.2021.05.13.

Effects of nonpharmacological interventions on the psychological health of high-risk pregnant women: a systematic review and meta-analysis
Hyeji Yoo, Sukhee Ahn
Korean J Women Health Nurs. 2021;27(3):180-195.    doi: 10.4069/kjwhn.2021.09.17.

Role of Diabetes Educators and Effectiveness of Diabetes Education
HeeSook Kim
J Korean Diabetes. 2013;14(4):194-198.    doi: 10.4093/jkd.2013.14.4.194.


1. American Diabetes Association. Standards of medical care in diabetes-2010. Diabetes Care. 2010; 33:Suppl 1. S11–S61. http://dx.doi.org/10.2337/dc10-S011.
2. Bandura A. Self-efficacy: Toward a unifying theory of behavioral change. Psychol Rev. 1977; 84:191–215.
3. Beck AT, Beamesderfer A. Assessment of depression: The depression inventory. Mod Probl Pharmacopsychiatry. 1974; 7:151–169.
4. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: Psychometric properties. J Consult Clin Psychol. 1988; 56:893–897.
5. Bowen A, Muhajarine N. Antenatal depression. Can Nurse. 2006; 102:26–30.
6. Campayo A, Gómez-Biel CH, Lobo A. Diabetes and depression. Curr Psychiatry Rep. 2011; 13:26–30. http://dx.doi.org/10.1007/s11920-010-0165-z.
7. Choi ES, Oh JA, Hur MH, Lee IS, Choi SY. The knowledge and learning needs about gestational diabetes in pregnant women. J Korean Acad Womens Health Nurs. 2000; 6:96–108.
8. Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale: Lawrence Erlbaum Associates;1988.
9. Coleman K, Austin BT, Brach C, Wagner EH. Evidence on the chronic care model in the new millennium. Health Aff (Millwood). 2009; 28:75–85. http://dx.doi.org/10.1377/hlthaff.28.1.75.
10. Crowther CA, Hiller JE, Moss JR, McPhee AJ, Jeffries WS, Robinson JS. Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. N Engl J Med. 2005; 352:2477–2486.
11. Daniells S, Grenyer BF, Davis WS, Coleman KJ, Burgess JA, Moses RG. Gestational diabetes mellitus: Is a diagnosis associated with an increase in maternal anxiety and stress in the short and intermediate term? Diabetes Care. 2003; 26:385–389.
12. Gabbay RA, Lendel I, Saleem TM, Shaeffer G, Adelman AM, Mauger DT, et al. Nurse case management improves blood pressure, emotional distress and diabetes complication screening. Diabetes Res Clin Pract. 2006; 71:28–35.
13. Gu MO. A study of the relationship among self-efficacy, self regulation, situational barriers and self care behavior in patients with diabetes mellitus. J Nurs Acad Soc. 1994; 24:635–651.
14. Hahn HM, Yum TH, Shin YW, Kim KH, Yoon DJ, Chung KJ. A standardization study of Beck Depression Inventory in Korea. J Korean Neuropsychiatr Assoc. 1986; 25:487–500.
15. Held RF, DePue J, Rosen R, Bereolos N, Nu'usolia O, Tuitele J, et al. Patient and health care provider views of depressive symptoms and diabetes in American Samoa. Cultur Divers Ethnic Minor Psychol. 2010; 16:461–467. http://dx.doi.org/10.1037/a0020089.
16. Hjelm K, Berntorp K, Frid A, Aberg A, Apelqvist J. Beliefs about health and illness in women managed for gestational diabetes in two organizations. Midwifery. 2008; 24:168–182.
17. Homko CJ, Sivan E, Reece EA. The impact of self-monitoring of blood glucose on self-efficacy and pregnancy outcomes in women with diet-controlled gestational diabetes. Diabetes Educ. 2002; 28:435–443.
18. Ilioudi S, Lazakidou A, Tsironi M. Information and communication technologies for better patient self-management and self-efficacy. Int J Electron Healthc. 2010; 5:327–339.
19. Jang HC, Cho YM, Park KS, Kim SY, Lee HK, Kim MY, et al. Pregnancy outcome in Korean women with gestational diabetes mellitus diagnosed by the Carpenter-Coustan criteria. J Korean Diabetes Assoc. 2004; 28:122–130.
20. Koh D, Miller YD, Marshall AL, Brown WJ, McIntyre D. Health-enhancing physical activity behaviour and related factors in postpartum women with recent gestational diabetes mellitus. J Sci Med Sport. 2010; 13:42–45. http://dx.doi.org/10.1016/j.jsams.2008.10.003.
21. Korean Diabetes Association. Clinical practice recommendation 2005. Clin Diabetes. 2005; 6(3-4):206–209.
22. Kozhimannil KB, Pereira MA, Harlow BL. Association between diabetes and perinatal depression among low-income mothers. JAMA. 2009; 301:842–847. http://dx.doi.org/10.1001/jama.2009.201.
23. Kwik M, Seeho SK, Smith C, McElduff A, Morris JM. Outcomes of pregnancies affected by impaired glucose tolerance. Diabetes Res Clin Pract. 2007; 77:263–268.
24. Lustman PJ, Clouse RE. Depression in diabetic patients: The relationship between mood and glycemic control. J Diabetes Complications. 2005; 19:113–122.
25. Mensing C, Boucher J, Cypress M, Weinger K, Mulcahy K, Barta P, et al. National standards for diabetes self-management education. Diabetes Care. 2006; 29:Suppl 1. S78–S85.
26. Rumbold AR, Crowther CA. Women's experiences of being screened for gestational diabetes mellitus. Aust N Z J Obstet Gynaecol. 2002; 42:131–137.
27. Spirito A, Williams C, Ruggiero L, Bond A, McGarvey ST, Coustan D. Psychological impact of the diagnosis of gestational diabetes. Obstet Gynecol. 1989; 73:562–566.
28. Stuckey HL, Dellasega C, Graber NJ, Mauger DT, Lendel I, Gabbay RA. Diabetes nurse case management and motivational interviewing for change (DYNAMIC): Study design and baseline characteristics in the chronic care model for type 2 diabetes. Contemp Clin Trials. 2009; 30:366–374. http://dx.doi.org/10.1016/j.cct.2009.03.002.
29. Yook SP, Kim ZS. A clinical study on the Korean version of Beck anxiety inventory: Comparative study of patient and non-patient. Korean J Clin Psychol. 1997; 16:185–197.
30. Zehle K, Smith BJ, Chey T, McLean M, Bauman AE, Cheung NW. Psychosocial factors related to diet among women with recent gestational diabetes: Opportunities for intervention. Diabetes Educ. 2008; 34:807–814. http://dx.doi.org/10.1177/0145721708323641.
Full Text Links
export Copy
  • Twitter
  • Facebook
Similar articles
Copyright © 2023 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr