Experiences and perceived determinants of healthcare-related time toxicity among women with gestational diabetes mellitus: a qualitative study

Background Gestational diabetes mellitus (GDM) requires women to attend follow-up visits and complete repeated self-management tasks during pregnancy. These tasks include blood glucose monitoring, meal planning, physical activity, health education and medication when needed. They may create a time-related burden in daily life. However, little is known about women’s experiences of healthcare-related time toxicity during GDM management. This study aimed to explore women’s experiences of healthcare-related time toxicity and the perceived factors shaping these experiences. Methods A qualitative descriptive study was conducted in the obstetric outpatient clinics of a tertiary teaching hospital in Henan Province, central China. Women with GDM were recruited using purposive sampling. Individual semi-structured interviews were conducted with 13 participants. The interviews were audio-recorded, transcribed verbatim and analysed using qualitative content analysis. Results Four themes and 13 subthemes were generated from the interview data: (1) GDM added a new timetable to pregnancy; (2) hospital follow-up made time costs visible; (3) work and family roles compressed time for GDM management; and (4) women needed support that reduced time and decision burden. Conclusion Healthcare-related time toxicity in GDM was experienced as both visible hospital time and hidden daily self-management work. Women’s time burden was not produced by GDM tasks alone. The organisation of services, family caregiving, work schedule, and outpatient processes also play a role. There is a need for the nurse, midwife, and/or diabetes educator to be specific and user-friendly in their support, such as providing clear examples of diet, review of blood glucose levels online in a timely fashion, and improved coordination of prenatal, nutrition and blood glucose-related appointments. These changes may decrease unnecessary traveling, waiting, and redundant decision-making, and assist women to incorporate the management of GDM into their daily lives more successfully.