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Chen TT, Su WC, Liu MI. Patient-centered care in diabetes care-concepts, relationships and practice. World J Diabetes 2024; 15:1417-1429. [DOI: 10.4239/wjd.v15.i7.1417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 04/11/2024] [Accepted: 05/13/2024] [Indexed: 07/08/2024] Open
Abstract
We still do not have comprehensive knowledge of which framework of patient-centered care (PCC) is appropriate for diabetes care, which elements of PCC are evidence-based, and the mechanism by which PCC elements are associated with outcomes through mediators. In this review, we elaborate on these issues. We found that for diabetes care, PCC elements such as autonomy support (patient individuality), cooperation and collaboration (system-level approach), com-munication and education (behavior change techniques), emotional support (biopsychosocial approach), and family/other involvement and support are critically important. All of these factors are directly associated with different patient outcomes and indirectly associated with outcomes through patient activation. We present the practical implications of these PCC elements.
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Affiliation(s)
- Tsung-Tai Chen
- Department of Public Health, College of Medicine, Fu Jen Catholic University, New Taipei 24205, Taiwan
| | - Wei-Chih Su
- Department of Gastroenterology, Taipei Tzu-Chi Hospital, New Taipei 23142, Taiwan
| | - Mei-I Liu
- Department of Pediatric Endocrinology, Mackay Children's Hospital, Taipei 10449, Taiwan
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2
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Köse S, Geçkil E, Sabetsarvestani R, Bolat S. Examining the interplay of self-efficacy and emotional autonomy on diabetic control index. J Pediatr Nurs 2024; 78:60-65. [PMID: 38875849 DOI: 10.1016/j.pedn.2024.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 06/06/2024] [Accepted: 06/06/2024] [Indexed: 06/16/2024]
Abstract
AIM This study aims to explore the relationship between self-efficacy, emotional autonomy, and diabetic control index in adolescents with type 1 diabetes. METHODS From January to September 2023, this cross-sectional study involved 112 adolescents aged 14-18 with type 1 diabetes who were seeking medical check-ups at the Medical Faculty Hospital in Konya, Turkey. Data collection included demographic information, the Diabetes Management Self-Efficacy Scale for Adolescents with Type 1 Diabetes, the Emotional Autonomy Scale, and diabetic control index values based on their most recent Hemoglobin A1c levels measurement. Data analysis was performed using SPSS statistical software, with statistical significance set at a p-value <0.05. RESULTS The results showed a good overall self-efficacy score, indicating a balanced level of confidence in diabetes management. The emotional autonomy findings revealed a moderate level of independence, emphasizing a healthy process of differentiation from parents while acknowledging them as individuals. The ability of adolescents to openly discuss their diabetes may be associated with more favorable glycemic outcomes. However, high emotional autonomy was significantly associated with high Hemoglobin A1c levels. CONCLUSION This study highlights positive outcomes in adolescent diabetes management, with strong self-efficacy and balanced emotional autonomy. Open communication about diabetes correlates with favorable glycemic outcomes, but caution is necessary as high emotional autonomy is linked to elevated Hemoglobin A1c levels. The importance of receiving parental support in managing diabetes, especially in adolescents with high emotional autonomy should be highlighted.
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Affiliation(s)
- Semra Köse
- Necmettin Erbakan University, Faculty of Nursing, Konya, Turkey
| | - Emine Geçkil
- Necmettin Erbakan University, Faculty of Nursing, Konya, Turkey.
| | | | - Serpil Bolat
- Necmettin Erbakan University, Faculty of Nursing, Konya, Turkey
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Villaécija J, Luque B, Cuadrado E, Vivas S, Tabernero C. Psychometric Properties of the Revised Self-Efficacy for Diabetes Self-Management Scale among Spanish Children and Adolescents with Type 1 Diabetes. CHILDREN (BASEL, SWITZERLAND) 2024; 11:662. [PMID: 38929241 PMCID: PMC11201513 DOI: 10.3390/children11060662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 05/24/2024] [Accepted: 05/26/2024] [Indexed: 06/28/2024]
Abstract
A longitudinal design was used to examine the psychometric properties of the Self-Efficacy for Diabetes Self-Management (SEDM) for children and adolescents with a diagnosis of type 1 diabetes (T1D). The SEDM was adapted to Spanish and the best factorial solution was selected to test the invariance of the measures of age and gender. Individuals between the ages of 10 and 19 years old with a diagnosis of T1D completed a self-reported questionnaire (167 at Time 1 [mean age = 14.49, SD = 2.76; 56.9% boys] and 122 at Time 2 [mean age = 14.77, SD = 2.58; 56.6% boys]). Two unifactorial solutions were tested. The psychometric properties of the scale were validated. The proposed validation obtained excellent reliability indices (χ2 (26) = 25.59, p > 0.49, RMSEA = 0.00, 95% CI [0.00, 0.07], CFI = 1.00, GFI = 0.96, AGFI = 0.92, TLI = 1.00, and CMIN = 0.98), and it appeared to be invariant for gender and for age groups. The Cronbach's α was 0.85. The test-retest reliability was high (r = 0.69 [p < 0.001]). Convergent, discriminant, and external validity were proven. The nine-item SEDM is a brief measure with satisfactory structural validity. From our knowledge, this study provides the first reliable tool to assess self-efficacy in the management of T1D for Spanish children and adolescents.
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Affiliation(s)
- Joaquín Villaécija
- Department of Psychology, University of Cordoba, 14071 Cordoba, Spain; (J.V.); (S.V.)
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain
- Reina Sofia University Hospital (HURS), 14004 Cordoba, Spain
| | - Bárbara Luque
- Department of Psychology, University of Cordoba, 14071 Cordoba, Spain; (J.V.); (S.V.)
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain
- Reina Sofia University Hospital (HURS), 14004 Cordoba, Spain
| | - Esther Cuadrado
- Department of Psychology, University of Cordoba, 14071 Cordoba, Spain; (J.V.); (S.V.)
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain
- Reina Sofia University Hospital (HURS), 14004 Cordoba, Spain
| | - Sebastián Vivas
- Department of Psychology, University of Cordoba, 14071 Cordoba, Spain; (J.V.); (S.V.)
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Cordoba, Spain
- Reina Sofia University Hospital (HURS), 14004 Cordoba, Spain
| | - Carmen Tabernero
- Department of Social Psychology and Anthropology, University of Salamanca, 37005 Salamanca, Spain;
- Instituto de Neurociencias de Castilla y León (INCYL), University of Salamanca, 37005 Salamanca, Spain
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4
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Choi JS, Ma D, Wolfson JA, Wyman JF, Adam TJ, Fu HN. Associations Between Psychosocial Needs, Carbohydrate-Counting Behavior, and App Satisfaction: A Randomized Crossover App Trial on 92 Adults With Diabetes. Comput Inform Nurs 2023; 41:1026-1036. [PMID: 38062548 PMCID: PMC10746294 DOI: 10.1097/cin.0000000000001073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
To examine whether psychosocial needs in diabetes care are associated with carbohydrate counting and if carbohydrate counting is associated with satisfaction with diabetes applications' usability, a randomized crossover trial of 92 adults with type 1 or 2 diabetes requiring insulin therapy tested two top-rated diabetes applications, mySugr and OnTrack Diabetes. Survey responses on demographics, psychosocial needs (perceived competence, autonomy, and connectivity), carbohydrate-counting frequency, and application satisfaction were modeled using mixed-effect linear regressions to test associations. Participants ranged between 19 and 74 years old (mean, 54 years) and predominantly had type 2 diabetes (70%). Among the three tested domains of psychosocial needs, only competence-not autonomy or connectivity-was found to be associated with carbohydrate-counting frequency. No association between carbohydrate-counting behavior and application satisfaction was found. In conclusion, perceived competence in diabetes care is an important factor in carbohydrate counting; clinicians may improve adherence to carbohydrate counting with strategies designed to improve perceived competence. Carbohydrate-counting behavior is complex; its impact on patient satisfaction of diabetes application usability is multifactorial and warrants consideration of patient demographics such as sex as well as application features for automated carbohydrate counting.
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Affiliation(s)
- Joshua S. Choi
- Center for Biomedical Informatics, Regenstrief Institute, Inc., Indianapolis, IN, United States
- School of Medicine, Indiana University, Indianapolis, IN, United States
| | - Darren Ma
- Minnetonka High School, Minnetonka, MN, United States
| | - Julian A. Wolfson
- School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Jean F. Wyman
- School of Nursing, University of Minnesota, Minneapolis, MN, United States
| | - Terrence J. Adam
- College of Pharmacy, University of Minnesota, Minneapolis, MN, United States
- Institute for Health Informatics, University of Minnesota, Minneapolis MN, United States
| | - Helen N. Fu
- Center for Biomedical Informatics, Regenstrief Institute, Inc., Indianapolis, IN, United States
- Richard M. Fairbank School of Public Health, Indiana University, Indianapolis, MN, United States
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5
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Leocadio P, Kelleher C, Fernández E, Hawkes CP. Adolescents' Experiences of Transition to Self-Management of Type 1 Diabetes: Systematic Review and Future Directions. Sci Diabetes Self Manag Care 2023; 49:477-492. [PMID: 37927049 PMCID: PMC10666500 DOI: 10.1177/26350106231206779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
PURPOSE The purpose of this systematic literature review was to explore studies that report the experiences of adolescents, their families, and health care professionals of adolescents' transition to self-management of type 1 diabetes (T1DM). METHODS SocINDEX, PsycInfo, APA PsycArticles, and MEDLINE electronic databases were searched. Studies reporting on experiences of transition to self-management of T1DM for adolescents, their parents, siblings, and health care professionals published between January 2010 amd December 2021 were included. The Mixed Methods Appraisal Tool guided trustworthiness and relevance of selected studies. RESULTS A total of 29 studies met the inclusion criteria. Findings indicate that adolescents' experiences of transitioning to self-management of T1DM are interconnected with the supports provided by others (eg, family, teachers, friends). Considering interdependence and collective lived experiences is essential to developing effective and personalized family, peer, and social interventions to facilitate transition and to avoid negative outcomes in later life. The renegotiation of roles within the network of supports that impact adolescents' transition and adolescents' self-negotiation have been neglected. CONCLUSION Transition to self-management of T1DM is a dynamic and iterative process comprising of continuous shifts between interdependence and independence, making it challenging for all involved. A number of research gaps and avenues for future research are outlined.
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Affiliation(s)
- Paula Leocadio
- Department of Management and Marketing, University College Cork, Cork, Ireland
| | - Carol Kelleher
- Department of Management and Marketing, University College Cork, Cork, Ireland
| | - Eluska Fernández
- School of Applied Social Studies, University College Cork, Cork, Ireland
| | - Colin P. Hawkes
- Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
- INFANT Research Centre, University College Cork, Cork, Ireland
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
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6
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Campbell MS, Butner JE, Wiebe DJ, Berg CA. Daily diabetes-specific family conflict, problems, and blood glucose during adolescence. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2023; 37:223-231. [PMID: 36521134 PMCID: PMC9972298 DOI: 10.1037/fam0001055] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Diabetes-related family conflict is widely regarded as a risk factor for diabetes outcomes, yet it has not been examined on a daily basis. Parental acceptance may attenuate the degree to which family conflict is associated with diabetes outcomes. The present study examined (a) within- and between-person fluctuations in diabetes problems and family conflict, (b) within- and between-person links between conflict and blood glucose (BG) mean, and (c) whether parental acceptance moderated these associations. One hundred eighty adolescents (Mage = 12.92 years) with T1D completed a 14-day diary measuring diabetes problems, conflict with mother, conflict with father, and parental acceptance at the end of each day. Daily average BG values were calculated from glucometer readings. Higher diabetes problems on average across the 14-day diary were associated with more average conflict with mothers (between-person), but daily fluctuations in the number of diabetes problems were not related to daily conflict (within-person). Adolescents with higher conflict with mothers and fathers on average across the 14 days had higher BG means (between-person); however, on days when adolescents reported higher conflict, they had greater risk for low BG (within-person). Daily parental acceptance did not moderate associations between problems and conflict nor conflict and BG mean. This study was the first to examine daily diabetes-specific conflict with mothers and fathers during adolescence. The number of diabetes problems did not predict daily conflict. Fluctuations in daily conflict were associated with greater risk for low BG, underscoring the need for future research examining in-the-moment relations among conflict and BG extremes. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | | | - Deborah J. Wiebe
- Psychological Sciences and the Health Sciences Research Institute, University of California, Merced, Merced, CA
| | - Cynthia A. Berg
- Department of Psychology, University of Utah, Salt Lake City, UT
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de Wit M, Gajewska KA, Goethals ER, McDarby V, Zhao X, Hapunda G, Delamater AM, DiMeglio LA. ISPAD Clinical Practice Consensus Guidelines 2022: Psychological care of children, adolescents and young adults with diabetes. Pediatr Diabetes 2022; 23:1373-1389. [PMID: 36464988 PMCID: PMC10107478 DOI: 10.1111/pedi.13428] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 09/30/2022] [Indexed: 12/12/2022] Open
Affiliation(s)
- Maartje de Wit
- Amsterdam UMC, Vrije Universiteit Amsterdam, Medical Psychology, Amsterdam Public Health, Amsterdam, Netherlands
| | - Katarzyna A Gajewska
- Diabetes Ireland, Dublin, Ireland.,School of Public Health, University College Cork, Cork, Ireland
| | | | | | - Xiaolei Zhao
- The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Given Hapunda
- Department of Psychology, University of Zambia, Lusaka, Zambia
| | - Alan M Delamater
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Linda A DiMeglio
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida, USA.,Department of Pediatrics, Division of Pediatric Endocrinology and Diabetology, Indiana University School of Medicine, Riley Hospital for Children, Indianapolis, Indiana, USA
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8
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Fremont ER, Friedrich EA, Feudtner C, Grimberg A, Miller VA. Perceptions of Youth and Parent Decision-Making Roles Regarding Recombinant Human Growth Hormone Treatment. ENDOCRINES 2022; 3:590-600. [PMID: 37152718 PMCID: PMC10162591 DOI: 10.3390/endocrines3040050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023] Open
Abstract
Recombinant human growth hormone (rhGH) is prescribed to youth with growth hormone deficiency (GHD) to support normal growth and ensure healthy physical development, and to youth without GHD to address height concerns. Perceptions of youth involvement in rhGH treatment decisions have not been explored. This study aimed to examine perceptions of youth and parent roles in decisions around rhGH treatment. Youth (n = 22, 11.5 ± 2.0 years) who had undergone evaluation for short stature and their parents (n = 22) participated in semi-structured interviews after stimulation test results had been received. Interviews revealed the following themes: 1) parent provided youth with support; 2) parent facilitated youth's decision-making involvement; 3) youth had no role or did not remember their role; and 4) youth did not remember conversations with their parents or providers. Parents facilitated their children's involvement by sharing information and seeking their opinions. Whereas some participants described youth as having a substantial decision-making role, not all youth felt they were involved, and some youth could not recall conversations about rhGH. Parents can bolster youth involvement by having conversations using developmentally appropriate language, which is critical to youth feeling empowered and developing efficacy over their own care.
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Affiliation(s)
- Ettya R. Fremont
- Division of Adolescent Medicine, Children’s Hospital of Philadelphia
| | | | - Chris Feudtner
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania
| | - Adda Grimberg
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania
- Division of Endocrinology and Diabetes, Children’s Hospital of Philadelphia
| | - Victoria A. Miller
- Division of Adolescent Medicine, Children’s Hospital of Philadelphia
- Correspondence:
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Gregory JW, Cameron FJ, Joshi K, Eiswirth M, Garrett C, Garvey K, Agarwal S, Codner E. ISPAD Clinical Practice Consensus Guidelines 2022: Diabetes in adolescence. Pediatr Diabetes 2022; 23:857-871. [PMID: 36250644 PMCID: PMC9828225 DOI: 10.1111/pedi.13408] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 08/24/2022] [Indexed: 01/12/2023] Open
Affiliation(s)
- John W. Gregory
- Division of Population Medicine, School of MedicineCardiff UniversityCardiffUK
| | - Fergus J. Cameron
- Royal Children's HospitalMelbourneAustralia,Murdoch Children's Research InstituteMelbourneAustralia,Department of PaediatricsUniversity of MelbourneMelbourneAustralia
| | - Kriti Joshi
- Department of Endocrinology & DiabetesQueensland Children's HospitalSouth BrisbaneAustralia
| | - Mirjam Eiswirth
- Department of Anglophone StudiesUniversität Duisburg EssenEssenGermany
| | - Christopher Garrett
- Institute of Psychiatry, Psychology and NeuroscienceBart's Health and East London Foundation TrustLondonUK
| | - Katharine Garvey
- Division of EndocrinologyBoston Children's HospitalBostonMassachusettsUSA
| | - Shivani Agarwal
- Department of Medicine (Endocrinology), Albert Einstein College of MedicineMontefiore Medical CenterBronxNew YorkUSA
| | - Ethel Codner
- Instituto de Investigaciones Materno Infantil, Facultad de MedicinaUniversity of ChileSantiagoChile
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Seibert LK, Grieskamp RM, Schmidt H, Menrath I, Pawils S, Rumpf HJ, von Sengbusch S. Behandlungsverhalten und Wünsche an die Therapie aus Sicht von jungen Erwachsenen mit Diabetes mellitus Typ 1. DIABETOL STOFFWECHS 2022. [DOI: 10.1055/a-1879-0326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Zusammenfassung
Hintergrund Bei Jugendlichen und jungen Erwachsenen (JujE) mit Diabetes mellitus Typ 1 (DMT1) werden gehäuft Behandlungsverhaltensweisen beobachtet, die mit ungünstigen Gesundheitsoutcomes assoziiert sind. Darüber hinaus verläuft der in diesem Alter erforderliche Transitionsprozess oft problematisch. Insgesamt ist diese Altersspanne mit einem erhöhten Risiko für akute Komplikationen und langfristige Folgeschäden assoziiert. Ziel der Studie ist es, Gründe für Therapieunzufriedenheit und ungünstiges Behandlungsverhalten aus Sicht der JujE zu explorieren und den Bedarf sowie konkrete Empfehlungen für ein zusätzliches psychologisches Coaching abzuleiten.
Methode Insgesamt wurden 15 qualitative Interviews mit JujE (Alter M=20.2; SD=3.1 Jahre; 53.3% weiblich) geführt. Zudem wurden die Soziodemographie und depressive Symptomatik (PHQ-9; Patient Health Questionnaire) erhoben.
Ergebnisse Die Ergebnisse deuten darauf hin, dass Behandlungsunzufriedenheit und ungünstiges Behandlungsverhalten mit direktiven Kommunikationsmustern sowie einer fehlenden persönlichen Bindung zu den Behandler:innen assoziiert sind. Zudem werden psychische Belastungen aus Sicht der Befragten unzureichend thematisiert. Die JujE wünschten sich insbesondere Kontinuität im Behandlungsteam sowie einen empathischen Umgang. Die Idee eines zusätzlichen Coachings wurde positiv aufgenommen. Hierbei besteht der Wunsch nach bedürfnisorientierter Ausgestaltung.
Diskussion Mögliche Barrieren von Adhärenz und psychische Belastungen sollten offen erfragt und thematisiert werden. Insbesondere bei psychisch belasteten JujE könnte das Behandlungsverhalten möglicherweise durch zusätzliche niederschwellige Coachingangebote verbessert werden. Eine randomisiert-kontrollierte Studie ist noch ausstehend.
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Affiliation(s)
- Lea Kristin Seibert
- Department for Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | | | - Hannah Schmidt
- Department for Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Ingo Menrath
- Department for Pediatrics, University of Lübeck, Lübeck, Germany
| | - Silke Pawils
- Department for Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Jürgen Rumpf
- Department for Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Simone von Sengbusch
- Klinik für Kinder und Jugendmedizin, Universitätsklinikum Schleswig Holstein – Campus Lübeck, Lübeck, Germany
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Dos Santos TJ, Chobot A, Laimon W, Waldron S, Piona C, Giani E, Dovc K, Macedoni M, Mameli C, Cardona-Hernandez R, Aschemeier-Fuchs B, McGill M, Delamater AM, Wood J, Calliari LE, Scaramuzza A, De Beaufort C, Lion S, Danne T, Donaghue KC. Twenty years of the International Society for Pediatric and Adolescent Diabetes Science Schools programs: Assessment of their impact on the participants' personal careers and networking development. Pediatr Diabetes 2022; 23:536-544. [PMID: 35872603 DOI: 10.1111/pedi.13374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE The following report describes the evaluation of the ISPAD Science School for Physicians (ISSP) and for Healthcare Professionals (ISSHP) in terms of their efficiency and success. METHODS All past attendees from 2000-2019 ISSP and 2004-2019 ISSHP programs were invited to respond to an online survey to assess perceived outcomes of the programs on career development, scientific enhancement, scientific networking, and social opportunities. RESULTS One-third of the past ISSP (129/428), and approximately 43% of the past ISSHP attendees (105/245) responded to the surveys. Most of ISSP attendees reported that the programs supported their career (82%) by helping to achieve a research position (59%), being engaged with diabetes care (68%) or research (63%) or starting a research fellowship (59%). Responders indicated that ISSP was effective in increasing interest in diabetes research (87%) and enhancing the number (66%) and quality (83%) of scientific productions, and promotion of international collaborations (86%). After the ISSP, 34% of responders received research grants. From the first round of the ISSHP survey (2004-2013), responders reported have improved knowledge (60%), gained more confidence in research (69%), undertaken a research project (63%), and achieved a higher academic degree (27%). From the second round (2014-2019), participants indicated that the program was valuable/useful in workplace (94%) through understanding (89%) and conducting (68%) research and establishing communication from other participants (64%) or from faculty (42%). After the ISSHP, 17% had received awards. CONCLUSIONS From the participants' viewpoint, both programs were effective in improving engagement with diabetes research, supporting career opportunities, increasing scientific skills, and enhancing networking and research activities.
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Affiliation(s)
- Tiago Jeronimo Dos Santos
- Pediatrics Unit, Hospital Vithas Almería, Instituto Hispalense de Pediatría, Almería, Andalusía, Spain
| | - Agata Chobot
- Department of Pediatrics, Institute of Medical Sciences, University of Opole, Opole, Poland.,Department of Pediatrics, University Clinical Hospital, Opole, Poland
| | - Wafaa Laimon
- Pediatric Endocrinology and Diabetes Unit, Department of Pediatrics, Mansoura Faculty of Medicine, Mansoura University Children's Hospital, Mansoura, Egypt
| | - Sheridan Waldron
- Multispecialty Outpatients Department, St James's University Hospital, Leeds, UK.,National Children & Young People's Diabetes Network, Leeds, UK
| | - Claudia Piona
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Elisa Giani
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Klemen Dovc
- Department of Pediatric Endocrinology, Diabetes and Metabolic Diseases, Faculty of Medicine, University Children's Hospital, University of Ljubljana, Ljubljana, Slovenia
| | | | - Chiara Mameli
- Department of Pediatrics, V. Buzzi Children's Hospital, Milan, Italy.,Department of Biomedical and Clinical Science L. Sacco, Università di Milano, Milan, Italy
| | | | - Bärbel Aschemeier-Fuchs
- Diabetes Centre for Children and Adolescents, Children's and Adolescent's Hospital AUF DER - BULT, Hannover, Germany
| | - Margaret McGill
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Diabetes Service, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Alan M Delamater
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Jamie Wood
- Rainbow Babies and Children's Hospital, University Hospitals Cleveland, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | | | - Andrea Scaramuzza
- Diabetes, Endocrinology and Nutrition, Paediatric Unit, ASST Cremona, Ospedale Maggiore, Cremona, Italy
| | - Carine De Beaufort
- Department of Pediatric Diabetes and Endocrinology, Clinique Pédiatrique, Centre Hospitalier, Luxembourg City, Luxembourg.,Department of Pediatric Endocrinology, UZ-VUB Free University Brussels, Brussels, Belgium
| | - Sylvia Lion
- ISPAD Corporate Affairs Advisor, Paris, France
| | - Thomas Danne
- Diabetes Center, Children's Hospital AUF DER BULT, Hannover Medical School, Hannover, Germany
| | - Kim C Donaghue
- Children's Hospital at Westmead, University of Sydney, Sydney, New South Wales, Australia
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12
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Berg CA, Campbell MS, Kent de Grey RG, Butner JE, Murray M, Wiebe DJ. Parental Relationships, Patient-Centered Communication With Healthcare Providers, and Diabetes Management Across Emerging Adulthood. J Pediatr Psychol 2022; 47:714-722. [PMID: 35167698 PMCID: PMC9425845 DOI: 10.1093/jpepsy/jsac004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 01/21/2022] [Accepted: 01/24/2022] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To examine whether yearly fluctuations in acceptance from and disclosure to parents were associated with fluctuations in perceptions of patient-centered communication (PCC) with the healthcare provider and whether fluctuations in PCC were associated with self-efficacy, type 1 diabetes self-care, and HbA1c across four annual assessments during early emerging adulthood (EA). METHODS A total of 228 high school seniors (M age = 17.76 years at time 1) reported on mothers' and fathers' acceptance and diabetes-related disclosure to parents, diabetes self-care, and PCC once per year for 4 years. HbA1c was collected from assay kits. RESULTS Multilevel models revealed within-person associations such that in years when individuals reported greater maternal acceptance than their average, they reported higher PCC. In addition, between-person differences indicated that individuals who reported more maternal acceptance on average relative to others also perceived greater PCC. Similar associations were found for EAs' reports of fathers. No significant effects were found for disclosure to either mother or father. Yearly fluctuations in PCC were associated with self-efficacy such that in years when perceived PCC was higher, self-efficacy was higher. Between person-effects were found for self-efficacy, self-care, and HbA1c such that individuals who reported more PCC on average relative to others reported higher self-efficacy, better self-care, and lower HbA1c. CONCLUSIONS Aspects of EA's relationships with parents fluctuate with perceptions of PCC with healthcare providers. Perceived PCC with the healthcare provider may be important in higher self-efficacy, diabetes self-care, and lower HbA1c across the early EA years.
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Affiliation(s)
| | | | | | | | - Mary Murray
- Department of Pediatrics, University of Utah School of Medicine, USA
| | - Deborah J Wiebe
- Psychological Sciences and the Health Sciences Research Institute, University of California, USA
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Yi-Frazier JP, Senturia K, Wright DR, Lind C, Malik FS. The clock is ticking: Parental stress around emerging adulthood for adolescents with type 1 diabetes. J Pediatr Nurs 2022; 62:164-170. [PMID: 34294485 PMCID: PMC9273159 DOI: 10.1016/j.pedn.2021.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 07/13/2021] [Accepted: 07/13/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE Our goal was to explore parental views on the challenges and stressors of transition to young adulthood for adolescents with type 1 diabetes and to describe specific strategies used to reduce parents' own stress during this time. DESIGN AND METHODS Focus groups with 39 parents of adolescents with type 1 diabetes were conducted in the greater Seattle area. Semi-structured prompts addressed adolescents' self-care tasks, parental assistance with care, challenges and barriers with self-care tasks, and stress/pressure around self-care. Data was analyzed using qualitative methods for emerging themes. RESULTS Parental stress was heightened when adolescents were approaching common developmental milestones such as driving, moving out, and engaging in risky behaviors that could be exacerbated by poor diabetes management. Thus, most parents reported providing assistance even late into adolescence. Parents shared strategies for guiding adolescents' transition from assisted to independent care with an emphasis on active behaviors parents could continue, thereby lowering their own stress. CONCLUSIONS Parents of adolescents with type 1 diabetes experienced significant stress around their children's transition to independent diabetes self-care management. PRACTICE IMPLICATIONS As part of overall preparation for transition, care providers should be encouraged to communicate with parents about these common stressors and promising avenues for nurturing a teen's independence.
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Affiliation(s)
- Joyce P Yi-Frazier
- Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, WA, USA.
| | - Kirsten Senturia
- Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, WA, USA
| | - Davene R Wright
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Cara Lind
- Center for Child Health Behavior and Development, Seattle Children's Research Institute, Seattle, WA, USA
| | - Faisal S Malik
- Center for Child Health Behavior and Development, Seattle Children's Research Institute, Seattle, WA, USA; Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA
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Versloot J, Ali A, Minotti SC, Ma J, Sandercock J, Marcinow M, Lok D, Sur D, de Wit M, Mansfield E, Parks S, Zenlea I. All together: Integrated care for youth with type 1 diabetes. Pediatr Diabetes 2021; 22:889-899. [PMID: 34173306 PMCID: PMC9290723 DOI: 10.1111/pedi.13242] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 06/14/2021] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE We describe the implementation and evaluation of an integrated, stepped care model aimed to identify and address the concerns of adolescents with type 1 diabetes (T1D) associated with diabetes-related quality of life (DRQoL), emotional well-being, and depression. RESEARCH DESIGN AND METHODS The care model with 4 steps: (1) Systematic identification and discussion of concerns salient to adolescents; (2) Secondary screening for depressive symptoms when indicated; (3) Developing collaborative treatment plans with joint physical and mental health goals; and (4) Psychiatric assessment and embedded mental health treatment; was implemented into an ambulatory pediatric diabetes clinic and evaluated using quantitative and qualitative methods. RESULTS There were 236 adolescents (aged 13-18 years) with T1D that were enrolled in the care model. On average adolescents identified three concerns associated with their DRQoL and 25% indicated low emotional well-being. Fifteen adolescents received a psychiatric assessment and embedded mental health treatment. Both adolescents and caregivers were appreciative of a broader, more holistic approach to their diabetes care and to the greater focus of the care model on adolescents, who were encouraged to self-direct the conversation. Parents also appreciated the extra level of support and the ability to receive mental health care for their adolescents from their own diabetes care team. CONCLUSION The initial findings from this project indicate the acceptability and, to limited extent, the feasibility of an integrated stepped care model embedded in an ambulatory pediatric diabetes clinic led by an interdisciplinary care team. The care model facilitated the identification and discussion of concerns salient to youth and provided a more holistic approach.
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Affiliation(s)
- Judith Versloot
- Institute for Better HealthTrillium Health PartnersMississaugaCanada,Institute for Health Policy, Evaluation and ManagementUniversity of TorontoTorontoCanada
| | - Amna Ali
- Institute for Better HealthTrillium Health PartnersMississaugaCanada
| | - Simona C. Minotti
- Institute for Better HealthTrillium Health PartnersMississaugaCanada,Department of Statistics and Quantitative MethodsUniversity of Milano‐BicoccaMilanItaly
| | - Julia Ma
- Institute for Better HealthTrillium Health PartnersMississaugaCanada,Precision AnalyticsQuebecCanada
| | - Jane Sandercock
- Institute for Better HealthTrillium Health PartnersMississaugaCanada
| | - Michelle Marcinow
- Institute for Better HealthTrillium Health PartnersMississaugaCanada
| | - Daphne Lok
- Women's and Children's Health ProgramTrillium Health PartnersMississaugaCanada
| | - Deepy Sur
- Ontario Association of Social WorkerTorontoCanada
| | - Maartje de Wit
- Department of Medical PsychologyAmsterdam University Medical Center, Vrije Universiteit AmsterdamAmsterdamNetherlands
| | - Elizabeth Mansfield
- Institute for Better HealthTrillium Health PartnersMississaugaCanada,Department of Occupational Science and Occupational Therapy, Faculty of MedicineUniversity of TorontoTorontoCanada
| | - Sheryl Parks
- Women's and Children's Health ProgramTrillium Health PartnersMississaugaCanada
| | - Ian Zenlea
- Institute for Better HealthTrillium Health PartnersMississaugaCanada,Department of Paediatrics, Temerty Faculty of MedicineUniversity of TorontoTorontoCanada
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Abstract
PURPOSE OF REVIEW This manuscript describes how person-reported outcomes (PROs) can be utilized in care for young people with diabetes in the context of motivation. RECENT FINDINGS The use of person-reported outcome measures (PROMS) in clinical care is feasible and acceptable, and helps focus the clinical encounter on life domains important to the person with diabetes. Results with regard to impact on self-management and glycemic outcomes are limited. Motivation is an important factor for self-management. Based on self-determination theory, autonomy-supportive, person-centered, and collaborative communication by diabetes care providers is associated with better outcomes. PROMs can facilitate this conversation. Understanding of youth motivation for maintaining or improving self-management behaviors requires a person-centered approach. PROMs can be used to facilitate an autonomy-supportive and person-centered conversation in clinical care. Training diabetes care providers in autonomy-supportive, person-centered conversation skills to discuss PROs might help to tap into youth's motivation, but further research is needed.
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Affiliation(s)
- Maartje de Wit
- Medical Psychology, Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
| | - Judith Versloot
- Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada
| | - Ian Zenlea
- Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada
- Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Eveline R Goethals
- Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA
- KU Leuven, Leuven, Belgium
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