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Zaremba N, Watson A, Kan C, Broadley M, Partridge H, Figuereido C, Hopkins D, Treasure J, Ismail K, Harrison A, Stadler M. Multidisciplinary healthcare teams' challenges and strategies in supporting people with type 1 diabetes to recover from disordered eating. Diabet Med 2020; 37:1992-2000. [PMID: 31833586 DOI: 10.1111/dme.14207] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/10/2019] [Indexed: 11/30/2022]
Abstract
AIM To examine the challenges healthcare teams face when treating people with type 1 diabetes and disordered eating and the strategies these teams have developed to facilitate effective treatment. METHODS Four semi-structured focus groups were conducted including two tertiary diabetes specialist teams and three tertiary eating disorders specialist teams between July and December 2018. Thematic analysis of the transcripts followed a six-phase process. RESULTS Twenty-nine experienced healthcare professionals (16 diabetes and 13 eating disorder specialists, 16±12 years' professional experience) were interviewed. The challenges identified in treating people with type 1 diabetes and disordered eating included subthemes the 'challenges specific to the healthcare professional' (feeling not competent enough and perceived emotional burden), 'challenges pertaining to patient factors' (e.g. difficulties with engaging in therapy) and 'challenges created by the healthcare system' (time pressure and staff shortage). Healthcare professionals expressed the need for a consensus on diagnosis and the definition of disordered eating in type 1 diabetes, as well as the need for training and educational resources specific to type 1 diabetes and disordered eating. Healthcare professionals gave practical examples of strategies of communication for better patient engagement and felt that multidisciplinary working in joint clinics with the other specialty were facilitators for recovery from disordered eating. CONCLUSIONS Healthcare professionals require multidisciplinary team support when treating people with type 1 diabetes and to improve their own competencies. The development of effective screening and assessment tools, educational resources and training for healthcare professionals, and developing multidisciplinary treatment pathways will be key to improving outcomes for their service users with type 1 diabetes and disordered eating.
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Affiliation(s)
- N Zaremba
- Diabetes Research Group, Weston Education Centre, King's College London, London, UK
| | - A Watson
- Division of Medicine, University College London, London, UK
| | - C Kan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - M Broadley
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - H Partridge
- Diabetes Centre, Royal Bournemouth and Christchurch Hospital, Bournemouth, UK
| | - C Figuereido
- Dorset Eating Disorders Service, Royal Bournemouth and Christchurch Hospital, Bournemouth, UK
| | - D Hopkins
- Institute of Diabetes Endocrinology and Obesity, King's Health Partners, London, UK
| | - J Treasure
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - K Ismail
- Institute of Diabetes Endocrinology and Obesity, King's Health Partners, London, UK
- Department of Psychological Medicine, Diabetes Psychology and Psychiatry Research Group, Weston Education Centre, King's College London, London, UK
| | - A Harrison
- Diabetes Research Group, Weston Education Centre, King's College London, London, UK
- University College London, Institute of Education, London, UK
| | - M Stadler
- Diabetes Research Group, Weston Education Centre, King's College London, London, UK
- Department of Psychological Medicine, Diabetes Psychology and Psychiatry Research Group, Weston Education Centre, King's College London, London, UK
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