Efficacy of a King’s Goal Attainment Theory-Based Support Model on Breastfeeding Outcomes in Women with Gestational Diabetes Mellitus: A Quasi-Experimental Study

Yuexia Liu,1 Yin Ying,2 Xianling Zou1 1Integrated Obstetrics District 3, Hangzhou Women’s Hospital (Hangzhou Maternity and Child Health Care Hospital), Hangzhou, Zhejiang, 310000, People’s Republic of China; 2Nursing Department, Hangzhou Women’s Hospital (Hangzhou Maternity and Child Health Care Hospital), Hangzhou, Zhejiang, People’s Republic of ChinaCorrespondence: Xianling Zou, Email [email protected]: To evaluate the effectiveness of a breastfeeding support model based on King’s Goal Attainment Theory in improving breastfeeding outcomes and metabolic health among women with gestational diabetes mellitus (GDM).Methods: A retrospective cohort study was conducted involving 120 women with GDM who delivered at a tertiary hospital between March 2022 and March 2024. Participants were divided into two groups based on the type of care received: the study group (n = 60) received a structured, theory-based breastfeeding support intervention involving goal negotiation, dynamic assessment, and interactive feedback delivered by a multidisciplinary team; the control group (n = 60) received routine breastfeeding support. Primary outcome was continued breastfeeding rate at 6 weeks, 3 months, and 6 months postpartum. Secondary outcomes included breastfeeding self-efficacy (BSES-SF), glycemic control (FPG and HbA1c), and incidence of neonatal hypoglycemia. Statistical analyses included t-tests, χ²-tests, and generalized estimating equations (GEE).Results: The study group showed significantly higher continued breastfeeding rates at all time points: 80.0% vs 58.3% at 6 weeks (p = 0.010), 73.3% vs 46.7% at 3 months (p = 0.003), and 65.0% vs 36.7% at 6 months (p = 0.002). At 6 weeks postpartum, the study group also had higher breastfeeding self-efficacy scores (62.50 ± 5.31 vs 53.11 ± 6.82, p < 0.001) and better glycemic control, with higher proportions achieving target FPG (75.0% vs 51.7%, p = 0.008) and HbA1c (80.0% vs 60.0%, p = 0.017). The incidence of neonatal hypoglycemia was significantly lower in the study group (8.33% vs 21.67%, p = 0.041).Conclusion: The breastfeeding support model based on King’s Goal Attainment Theory was associated with significantly improved breastfeeding rates, self-efficacy, glycemic control, and neonatal outcomes in women with GDM. This theory-driven, multidisciplinary approach shows promise for enhancing perinatal care in this high-risk population.Keywords: goal attainment theory, gestational diabetes mellitus, breastfeeding, self-efficacy, intervention study