Influencing factors to self‐management among women with hypertensive disorders of pregnancy: A qualitative systematic review using the COM‐B model

Abstract Background Hypertensive disorders are a leading cause of mortality and morbidity during pregnancy. For people with hypertensive disorders of pregnancy (HDP), self‐management is a necessity. There is limited evidence on the influencing factors of self‐management in women with HDP. Objectives To synthesize qualitative evidence on the influencing factors among women with HDP and explore how self‐management can be optimized in this population based on the capability, opportunity, motivation and behavior (COM‐B) model. Search Strategy A systematic search of eight electronic databases was conducted until December 31, 2024. Selection Criteria Qualitative and mixed‐methods studies on the influencing factors of self‐management in women with HDP. Data Collection and Analysis The methodological quality of the included studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for qualitative studies and the Mixed Methods Appraisal Tool (MMAT) checklist for mixed‐methods studies. Two independent reviewers screened, appraised, and extracted the data. Data analysis was carried out using the meta‐aggregation method and mapped onto the COM‐B model. Main Results A total of 17 studies were included in the systematic review. Three themes with 10 subthemes were identified: capability of women with HDP (lack of disease‐related knowledge, limited medication health literacy, deficits in blood pressure self‐monitoring competence); opportunities in the self‐management process (support from family and peers, guidance from healthcare professionals, external objective constraints, insufficient availability of professional support resources); motivation in the self‐management process (responsibility for fetal health, gaining a sense of mastery, perceived benefits in disease management). Conclusions This qualitative systematic review identified a wide range of interacting factors that influence self‐management in women with HDP and provided evidence for the design of the relevant interventions. Further research is recommended to carry out interventions from the aspects of information support, social support, digital technology support and positive psychological support to meet the information needs of pregnant women, enhance their confidence and ability in coping with the disease.