Complying, Resisting and Collaborating: Family Power Dynamics in Dietary Management Among Chinese Women With Gestational Diabetes

AIM: To explore how Chinese women with gestational diabetes mellitus understand and navigate dietary management within family power dynamics and the factors influencing these management practices. DESIGN: Interpretative Phenomenological Analysis. METHODS: Fifteen women with gestational diabetes were purposively recruited from two tertiary hospitals in Jiangsu Province, China. Semi-structured interviews and participant-provided artefacts were collected between April and July 2025. Data were analysed using Interpretative Phenomenological Analysis, supplemented by metaphorical methods. RESULTS: Five themes were identified, which included four interactional states of dietary management within family power dynamics: (1) Passive Compliance (Sailing with the current); (2) Strategic Compliance (Sailing over hidden undercurrents); (3) Mild Resistance (Rowing against the tide); (4) Collaborative Negotiation (Charting the course together). The fifth theme, Determinants (The riverbed shaping the flow), described factors influencing shifts across these states, including individual willingness, management capability and family power structures. CONCLUSIONS: Dietary management in gestational diabetes mellitus is not merely an individual health behaviour but a dynamic process shaped by shifting family power dynamics. This perspective helps to explain differences in management and offers a novel framework for family-centered, culturally adaptable interventions in collectivist settings. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: People's choices, including their personal experiences, perceived risks and individual values, were shaped by family power dynamics. Recognizing these factors is essential in improving patient-centered care and shared decision-making. Nurse-led patient education should identify women's current interactional states in dietary management and tailor support accordingly. IMPACT: There is limited evidence exploring the experiences of women with gestational diabetes managing their diet within family power dynamics. This enriched understanding supports improvement of the care pathway and service delivery for these women and their families. REPORTING METHOD: COREQ. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.