The impact of spiritual care on gestational diabetes self-management: a randomized controlled trial

BACKGROUND: Gestational diabetes mellitus (GDM) is a common metabolic disorder in pregnancy requiring effective self-management. Spiritual care has been proposed as a supportive approach for chronic disease management. OBJECTIVE: To determine the effect of spiritual care on self-management of gestational diabetes. METHODS: This randomized controlled trial included 60 pregnant women with GDM (24-28 weeks gestation) attending two health centers in Kashan, Iran (2024). The intervention group received eight 80 min spiritual care sessions, while the control group received routine prenatal diabetes education. Diabetes self-management was assessed before, immediately after, and four weeks post intervention using a validated questionnaire. Data were analyzed using repeated measures adjusting for baseline differences. RESULTS: Before the intervention, the mean self-management score was higher in the intervention group (32.90 ± 9.50) than in the control group (24.56 ± 8.90). After adjusting for baseline differences, the intervention group demonstrated significantly higher self-management scores immediately after the intervention (mean difference ≈ 10.3 points) and at four week follow-up (mean difference ≈ 9.8 points) compared with the control group (P < 0.001). The time effect (P = 0.660) and time × group interaction (P = 0.831) were non-significant, indicating that although scores improved, the pattern of change over time did not differ significantly between groups. CONCLUSION: Spiritual care was associated with significantly higher diabetes self-management scores compared with usual care, even after adjusting for baseline differences. However, no significant time-dependent trends were observed, suggesting that the pattern of change between postintervention assessments did not reach a significant level. Future studies could be conducted over longer periods and with larger samples, and could also evaluate the integration of spiritual care with lifestyle and behavioral interventions. TRIAL REGISTRATION: Approved by Iranian Registry of Clinical Trials (ID: IRCT20240509061721N1, 11-06-2024). https://irct.behdasht.gov.ir/trial/76736. 11/06/2024.