scholarly journals P240 How do you measure self-management behaviour in adolescents with type 1 diabetes mellitus? an integrative review of self-management measurement instruments

Author(s):  
Sinead Pembroke ◽  
Nicola Lagoda ◽  
Maria Brenner ◽  
Carol Hilliard ◽  
Declan Cody ◽  
...  
SIMULATION ◽  
2017 ◽  
Vol 93 (9) ◽  
pp. 781-793 ◽  
Author(s):  
Sara Montagna ◽  
Andrea Omicini

The impact of mobile technologies on healthcare is particularly evident in the case of self-management of chronic diseases, where they can decrease spending and improve life quality of patients. We propose the adoption of agent-based modeling and simulation techniques as built-in tools to dynamically monitor the state of patient health and provide recommendations for self-management. To demonstrate the feasibility of our proposal we focus on Type 1 diabetes mellitus as our case study, and provide simulation results where the dynamic evolution of signal parameters is shown in the case of healthy and Type 1 diabetes mellitus patients, focussing in particular on the beneficial effects that self-management interventions have on plasma glucose values.


2017 ◽  
Vol 24 (4) ◽  
pp. 255-263 ◽  
Author(s):  
Bettina Berger ◽  
Dominik Sethe ◽  
Dörte Hilgard ◽  
David Martin ◽  
Peter Heusser

Background: Children with type 1 diabetes mellitus (T1DM) must replace lacking endogenous insulin by daily insulin injections or insulin pumps. Standards of treatment include educational programs enabling self-management. The program ‘Herdecker Kids with Diabetes' (HeKiDi) is based on an anthroposophic understanding of the human being and intends to provide an individualized, patient-oriented approach to developing diabetes-related and comprehensive human competencies. Aim: Analysis of the HeKiDi program for children (6-12 years) with T1DM as the first part of an evaluation of a complex intervention. Methods: Ethnographic approach, following the Consolidated Criteria for Reporting Qualitative Research (COREQ), including field observations and interviews with responsible persons, content analysis of materials for determining the structure and the curriculum, presented according to the Template for Intervention Description and Replication (TIDieR). Results: The curriculum follows the standard but adds a learning circle between the child and the therapeutic team comprising 3 stages: (1) perception of the abilities and needs of the individual child supported by adult mentors themselves suffering from T1DM, (2) reflection within the therapeutic team, and (3) daily feedback to the child. Curricular Learning Objectives: Children feel recognized and supported in their individual developmental and diabetes-related competencies and develop motoric, artistic, communicative, and social skills to strengthen their self-efficacy and to understand T1DM as a lifelong awareness process. Conclusions: The curriculum including its associated learning goals and methods was presented. The program was explained and shown to be reproducible. Whether this program truly leads to better outcomes in regard to self-efficacy and hemoglobin A1c (HbA1c, glycated hemoglobin) and how parents and children perceive this will have to be assessed using a comparative interventional study.


2017 ◽  
Vol 87 (8) ◽  
pp. 623-629 ◽  
Author(s):  
Valéria de Cássia Sparapani ◽  
Raphael D.R. Liberatore ◽  
Elaine B.C. Damião ◽  
Isa R. de Oliveira Dantas ◽  
Rosangela A.A. de Camargo ◽  
...  

2022 ◽  
Vol 10 (1) ◽  
pp. e002583
Author(s):  
Elizabeth M Planalp ◽  
Harald Kliems ◽  
Betty A Chewning ◽  
Mari Palta ◽  
Tamara J LeCaire ◽  
...  

IntroductionTo optimize type 1 diabetes mellitus self-management, experts recommend a person-centered approach, in which care is tailored to meet people’s needs and preferences. Existing tools for tailoring type 1 diabetes mellitus education and support are limited by narrow focus, lack of strong association with meaningful outcomes like A1c, or having been developed before widespread use of modern diabetes technology. To facilitate comprehensive, effective tailoring for today’s working-aged adults with type 1 diabetes mellitus, we developed and validated the Barriers and Supports Evaluation (BASES).Research design and methodsParticipants 25–64 years of age with type 1 diabetes mellitus were recruited from clinics and a population-based registry. Content analysis of semistructured interviews (n=33) yielded a pool of 136 items, further refined to 70 candidate items on a 5-point Likert scale through cognitive interviewing and piloting. To develop and validate the tool, factor analyses were applied to responses to candidate items (n=392). Additional survey data included demographics and the Diabetes-Specific Quality of Life (QOL) Scale-Revised. To evaluate concurrent validity, hemoglobin A1c (HbA1c) values and QOL scores were regressed on domain scores.ResultsFactor analyses yielded 5 domains encompassing 30 items: Learning Opportunities, Costs and Insurance, Family and Friends, Coping and Behavioral Skills, and Diabetes Provider Interactions. Models exhibited good to adequate fit (Comparative Fit Index >0.88 and Root Mean Squared Error of Approximation <0.06). All domains demonstrated significant associations with HbA1c and QOL in the expected direction, except Family and Friends. Coping and Behavioral Skills had the strongest associations with both HbA1c and QOL.ConclusionsThe BASES is a valid, comprehensive, person-centered tool that can tailor diabetes support and education to individuals’ needs in a modern practice environment, improving effectiveness and uptake of services. Clinicians could use the tool to uncover patient-specific barriers that limit success in achieving HbA1c goals and optimal QOL.


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