scholarly journals Self-care support for the management of type 1 diabetes during the transition from childhood to adolescence

2018 ◽  
Vol 52 (0) ◽  
Author(s):  
Neusa Collet ◽  
Annanda Fernandes de Moura Bezerra Batista ◽  
Vanessa Medeiros da Nóbrega ◽  
Maria Helena do Nascimento Souza ◽  
Leiliane Teixeira Bento Fernandes
Keyword(s):  
Type 1 Diabetes ◽  
Health Care Professionals ◽  
Diabetes Management ◽  
Self Care ◽  
Family Health ◽  
Lifestyle Changes ◽  
Self Awareness ◽  
Structured Interviews ◽  
Care Support

ABSTRACT Objective: To analyze the needs of pre-adolescents with type 1 diabetes regarding self-care support for disease management. Method: Qualitative study conducted between October and December 2016 with pre-adolescents seen at a hospital outpatient clinic and at Family Health Units; semi-structured interviews were used. Data were analyzed using a thematic analysis based on the theoretical basis of self-care support. Results: Nine pre-adolescents participated in the study. It was identified that in order to build self-efficacy, pre-adolescents need to overcome the disease denial phase, know how to handle feelings triggered by the need for lifestyle changes, receive support from their families and social networks, and have the self-awareness and self-perception needed to feel secure in managing their diabetes. Conclusion: The intrinsic challenges of adolescence and the way pre-adolescents with diabetes handle the disease have an influence on diabetes management and create needs that must be appreciated by health care professionals in order to provide self-care support.

scholarly journals Identification of Psychological Factors Associated with Adherence to Self-Care Behaviors amongst Patients with Type 1 Diabetes

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Dácil Alvarado-Martel ◽  
M. Ángeles Ruiz Fernández ◽  
Maribel Cuadrado Vigaray ◽  
Armando Carrillo ◽  
Mauro Boronat ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Self Efficacy ◽  
Diabetes Management ◽  
Self Care ◽  
Therapeutic Education ◽  
Anxiety And Depression ◽  
Personality Variables ◽  
Age Range ◽  
Lower Adherence

Purpose. To explore the factors involved in adherence to self-care behaviors in patients with type 1 diabetes. Materials and Methods. Patients with type 1 diabetes (age range: 14-71 years) were invited to participate at seven Spanish hospitals. They completed a dossier which recorded sociodemographic and clinical variables and also measured personality variables, emotional state, beliefs, and concerns regarding the illness, by means of questionnaires. Results. A total of 428 patients with type 1 diabetes were included (58% women, age 36 (11.8) years, diabetes duration 18.3 (10.2) years, HbA1c 7.9 +/-1.3%). A total of 60.1% of patients found it difficult to follow the treatment recommendations for the care of their disease. The reasons given were mood (25.2%), lack of motivation (13.4%), work (12%), and economic difficulties (3.8%). Other personal reasons were reported by 5.7%. Motivation, training in diabetes management, importance the patient attributed to the disease, and self-efficacy were the variables that predicted adherence to self-care behaviors, together accounting for 32% of its variance. Anxiety and depression were highly prevalent in this study population (57.1% and 23.1%, respectively) and were associated with lower adherence. Conclusion. In the present study assessing patients with type 1 diabetes, motivation, training in diabetes management, beliefs regarding the disease, and self-efficacy were the main contributors to adherence to self-care behaviors. On the other hand, anxiety and depression were highly prevalent and associated with lower adherence. Thus, supplementing therapeutic education with strategies designed to raise levels of motivation, discussion of beliefs about the disease, and encouragement of self-efficacy might be a useful way to increase patient involvement in self-care.

scholarly journals “It Got Likes, But I Don’t Think People Understood”: A Qualitative Study of Adolescent Experiences Discussing Type 1 Diabetes on Social Media

2020 ◽  
pp. 193229682096558
Author(s):  
Kristen Chalmers ◽  
Mia Smith ◽  
Megan Moreno ◽  
Faisal Malik
Keyword(s):  
Social Media ◽  
Type 1 Diabetes ◽  
Diabetes Management ◽  
Social Consequences ◽  
Structured Interviews ◽  
Daily Lives ◽  
Social Media Engagement ◽  
Social Media Platforms ◽  
Management Advice

Background: The majority of adolescents with type 1 diabetes (T1D) integrate social media engagement into their daily lives. The aim of this study was to explore adolescents’ experiences and perspectives discussing their T1D on social media. Methods: Semi-structured interviews with adolescents with T1D were conducted in person and via telephone. Questions focused on the participant’s experiences utilizing social media to discuss T1D and factors that informed the nature of T1D-related social media engagement. Open coding and thematic content analysis were used to identify emergent themes that aligned with accepted domains of social media affordances. Results: Participants included 35 adolescents with T1D. Adolescents’ experiences related to discussing T1D on social media aligned with four affordances of social media: identity, cognitive, emotional, and social. The identity affordances of social media platforms allowed adolescents to curate online personas that selectively included their diagnosis of T1D, while managing the potential negative emotional and social implications linked to the stigma of T1D. Adolescents who decided to discuss T1D on social media leveraged cognitive affordances by providing and receiving diabetes management advice, emotional affordances by obtaining affirmation from peers, and social affordances by extending their network to include other individuals with T1D. Conclusions: Adolescents with T1D flexibly leverage the affordances offered by social media to access emotional support, information, and identity affirmation resources while navigating stigma-based social consequences. Our findings highlight the value of developing tools to support adolescents with T1D in comfortably discussing and receiving appropriate support about T1D on social media.

scholarly journals Motivational Interviewing and Self-Care in Type 1 Diabetes: A Randomized Controlled Clinical Trial Study Protocol

2020 ◽  
Vol 11 ◽  
Author(s):  
Dácil Alvarado-Martel ◽  
Mauro Boronat ◽  
María del Pino Alberiche-Ruano ◽  
María Andrea Algara-González ◽  
Yolanda Ramallo-Fariña ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Clinical Trial ◽  
Type 1 Diabetes ◽  
Motivational Interviewing ◽  
Self Care ◽  
Lifestyle Changes ◽  
Control Group ◽  
Patient Relationship

BackgroundType 1 diabetes is a disease with complex therapeutic recommendations that require day-to-day lifestyle changes. Motivational Interviewing is a communication tool that has proved effective in changing behaviors in people with addictions, obesity and type 2 diabetes. Our objective is to evaluate the effects of a Motivational Interviewing intervention in people with type 1 diabetes.MethodsSixty-six patients with type 1 diabetes and hemoglobin A1c >= 8% have been included and randomly assigned (computer-generated sequence, sealed envelopes, ratio 1:1) either to the intervention or to the control group. In the intervention group, appointments every 4 months with the endocrinologist include Motivational Interviewing; in the control group, the appointments proceed as usual. Patients will be followed for 16 months. The primary outcome will be self-care behaviors, assessed by a validated questionnaire, the Diabetes Self-Care Inventory-Revised Version. Secondary outcomes include: HbA1c, motivation for self-care, self-efficacy, health-related quality of life, satisfaction with professional-patient relationship, and fulfillment of patients’ own objectives. The practitioners receive training in Motivational Interviewing in order to help them promote adherence to self-care, encourage patient motivation and improve the doctor-patient relationship. The Motivational Interviewing intervention will be evaluated by two psychologists, blinded to the assigned treatment, through video recordings of the sessions and the administration of a purpose-built questionnaire, the EVEM 2.0 scale.DiscussionThere is evidence that MI can improve self-care in type 2 diabetes. In this study, we aim to evaluate the effect of MI on self-care and HbA1c in people with type 1 diabetes.Clinical Trial Registrationhttps://clinicaltrials.gov/ct2/show/NCT03906786, identifier NCT03906786.

scholarly journals Promoção da saúde articulada aos determinantes sociais: possibilidade para a equidade

2019 ◽  
Vol 13 (4) ◽  
pp. 943
Author(s):  
Daniella Santos Figueredo ◽  
Ivonete Teresinha Schulter Buss Heidemann ◽  
Gisele Cristina Manfrini Fernandes ◽  
Aline Megumi Arakawa-Belaunde ◽  
Lays Souza De Oliveira ◽  
...  
Keyword(s):  
Health Care ◽  
Health Promotion ◽  
Primary Health Care ◽  
Social Determinants ◽  
Health Care Professionals ◽  
Family Health ◽  
Lifestyle Changes ◽  
Structured Interviews ◽  
Primary Health ◽  
Recursos Humanos

RESUMO Objetivo: conhecer as práticas de promoção da saúde articuladas aos determinantes sociais e desenvolvidas por profissionais da Atenção Primária à Saúde. Método: trata-se de estudo qualitativo, descritivo, exploratório. Realizaram-se 19 entrevistas semiestruturadas com profissionais de saúde inseridos em duas Unidades Básicas de Saúde. Avaliaram-se os dados a partir da técnica de Análise de Conteúdo na modalidade Análise Temática. Resultados: desenvolvem-se as práticas de Promoção da Saúde, em sua maioria, em grupos de educação em saúde, com orientações sobre mudança de estilo de vida durante as consultas agendadas. Apontaram-se, como potencialidades, o adequado processo de trabalho das equipes de saúde, o apoio e o incentivo da gestão atual e o vínculo com a comunidade. Citaram-se, como principais desafios, a demanda excessiva de usuários para consultas individuais e a falta de recursos humanos, apontando algumas fragilidades da gestão. Conclusão: ressalta-se a pertinência da Promoção da Saúde na Atenção Primária como forma de cuidado e autonomia do indivíduo e da comunidade, considerando os determinantes sociais, mas requerendo investimentos na educação permanente frente aos desafios apontados. Descritores: Promoção da Saúde; Estratégia Saúde da Família; Determinantes Sociais da Saúde; Atenção Primária à Saúde; Enfermagem; Equidade em Saúde.ABSTRACT Objective: to know the practices of health promotion articulated to social determinants and developed by Primary Health Care professionals. Method: this is a qualitative, descriptive, exploratory study. Nineteen semi-structured interviews were conducted with health professionals enrolled in two Basic Health Units. Data were evaluated using the Content Analysis technique in the Thematic Analysis modality. Results: health promotion practices are developed, mostly in health education groups, with orientations on lifestyle changes during the scheduled consultations. As potentialities, the adequate work process of the health teams, the support and the incentive of the current management and the bond with the community were pointed out. The main challenges were the excessive user demand for individual consultations and the lack of human resources, pointing out some management weaknesses. Conclusion: the relevance of Health Promotion in Primary Care as a form of care and autonomy of the individual and of the community, considering the social determinants, but requiring investments in the permanent education facing the challenges pointed out. Descriptors: Health Promotion; Family Health Strategy; Social Determinants of Health; Primary Health Care; Nursing; Equity in Health.RESUMEN Objetivo: conocer las prácticas de promoción de la salud articuladas a los determinantes sociales y desarrolladas por profesionales de la Atención Primaria a la Salud. Método: se trata de un estudio cualitativo, descriptivo, exploratorio. Se realizaron 19 entrevistas semiestructuradas con profesionales de salud insertados en dos Unidades Básicas de Salud. Se evaluaron los datos a partir de la técnica de Análisis de Contenido en la modalidad Análisis Temático. Resultados: se desarrollan las prácticas de Promoción de la Salud, en su mayoría, en grupos de educación en salud, con orientaciones sobre cambio de estilo de vida durante las consultas programadas. Se señalaron, como potencialidades, el adecuado proceso de trabajo de los equipos de salud, el apoyo y el incentivo de la gestión actual y el vínculo con la comunidad. Se citaron, como principales desafíos, la demanda excesiva de usuarios para consultas individuales y la falta de recursos humanos, apuntando algunas debilidades de la gestión. Conclusión: se resalta la pertinencia de la Promoción de la Salud en la Atención Primaria como forma de cuidado y autonomía del individuo y de la comunidad, considerando los determinantes sociales, pero requiriendo inversiones en la educación permanente frente a los desafíos señalados. Descriptores: Promoción de la Salud, Estrategia de la Salud Familiar; Determinantes Sociales de la Salud; Enfermería; Equidad en Salud.

scholarly journals Understanding the Lived Experience of Children With Type 1 Diabetes in Kenya: Daily Routines and Adaptation Over Time

2021 ◽  
pp. 104973232110497
Author(s):  
Tom Palmer ◽  
Cynthia Waliaula ◽  
Geordan Shannon ◽  
Francesco Salustri ◽  
Gulraj Grewal ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Focus Group ◽  
Lived Experience ◽  
Diabetes Management ◽  
Structured Interviews ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Daily Routines ◽  
Over Time

Focusing only on biomedical targets neglects the important role that psychosocial factors play in effective diabetes self-management. This study aims to understand the lived experiences of children with Type 1 Diabetes (T1DM) in Kenya. Children ( n = 15) participated in focus group discussions and photo diary data collection. Focus group discussions and semi-structured interviews were also conducted with caregivers ( n = 14). We describe an adaptation to diabetes over time, identifying four overarching themes: knowledge and awareness, economic exclusion, the importance of social support, and striving for normality. Photo diaries are then categorized to explore daily realities of diabetes management. Children with T1DM in Kenya face varied barriers to care but can lead a “normal” and fulfilling life, provided adequate support is in place. To improve the lives of children with diabetes in this context and others like it, stakeholders must take note of children’s experiences and recognize their multidimensional needs.

scholarly journals A systematic review of parent/peer-based group interventions for adolescents with type 1 diabetes: interventions based on theoretical/therapeutic frameworks

2018 ◽  
Vol 18 (2) ◽  
pp. 51-65
Author(s):  
Kalsoom Akhter ◽  
Triece Turnbull ◽  
David Simmons
Keyword(s):  
Systematic Review ◽  
Type 1 Diabetes ◽  
Glycaemic Control ◽  
Systematic Reviews ◽  
Diabetes Management ◽  
Self Care ◽  
Effect Sizes ◽  
Cochrane Library ◽  
The Impact

Objective: Although interventions which provide psychosocial support can have a positive impact on diabetes self-care, the impact of family/peer- and theory-based interventions has not yet been clearly identified. This systematic review investigates the randomised controlled trials (RCTs) employing family/peer-based interventions (based on theoretical/ therapeutic frameworks) which aim to improve adolescents’ glycaemic control, psychosocial and/or behavioural functioning.Methods: The Cochrane Library, database of systematic reviews, database of abstracts of reviews of effectiveness and Health Technology Assessment database were searched (from start date until February 2016) for any previously conducted systematic reviews. Seventeen RCTs/interventions were included. The literature was also identified by contacting the leading researchers. Glycaemic control was measured by HbA1c and psychosocial functioning by measures of self-care, knowledge and communication, collaboration/teamwork, quality of life, problem solving, social functioning and family functioning. Only those interventions which reported the use of theories/therapies to manage type 1 diabetes and other psychosocial issues among adolescents (aged 12–17) were included in the present review. Data summarising the key features of the interventions was extracted from each article. Where possible, the effect sizes were calculated.Results: The effect sizes could be computed for HbA1c in six of the 17 interventions. The overall outcomes indicated that interventions including parents have a small to large effect size on a variety of diabetes management and psychosocial outcomes. This review identified interventions, mostly including parents and rarely including peers.Conclusion: The results of this systematic review demonstrate that multicomponent interventions may be more successful for adolescents than ones that just focus on one aspect. Effectiveness is also greater if they demonstrate inter-relatedness with the various aspects of diabetes management. Short-term behavioural approach-based interventions promote improvements in parent/adolescent relationships. Outreach home-based interventions could be a more accessible alternative for intervening with families than office/hospital-based interventions. This approach may also be more acceptable to adolescents and their families. There is a need to develop evaluated interventions for adolescents involving parents. Development should involve stakeholders (ie, adolescents, their families and healthcare professionals) to co-design potentially cost-effective and feasible interventions in the context of NHS diabetes services.

scholarly journals Content of Heart failure education by Health-care professionals in Noorder-Kempen, Belgium and Maastricht, the Netherlands: the INTERACT-in-HF study

2021 ◽  
Vol 20 (Supplement_1) ◽  
Author(s):  
K Baldewijns ◽  
HP Brunner-La-Rocca ◽  
S Bektas ◽  
C Rhode ◽  
L De Maesschalck ◽  
...  
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Patient Education ◽  
Health Care Professionals ◽  
Pharmacological Treatment ◽  
Qualitative Content Analysis ◽  
Self Care ◽  
Structured Interviews ◽  
Pharmacological Interventions ◽  
Care Support

Abstract Funding Acknowledgements INTERREG NWE IVb Background According to ESC-guidelines non-pharmacological interventions such as patient-education on lifestyle and self-care support are important to maintain quality of life (QOL) and to prevent (re)hospitalisation in Heart-Failure (HF). Additionally, these guidelines state that HF treatment should be organised in multidisciplinary programs. However, at this moment it remains unclear what kind of information and self-care support is provided by which health care (HC) professional in the regions Noorder-Kempen and Maastricht. Purpose The aim of this study is to describe which part of patient-education and self-care support is provided by different HC-providers in both regions Methods Semi-structured interviews with Cardiologists (CA), General Practitioners (GP’s) and Heart Failure Nurse (HFN) took place, followed by qualitative content analysis with a five-step approach, resulting in 2 main and 9 sub-themes. Results GP’s in both region express they spend very little time on life-style adjustments, symptom monitoring and self-care support.  GP’s in Noorder-Kempen spend most consultation time on physical follow-up and pharmacological treatment of HF-patients, leaving no or little time for non-pharmacological interventions. GP’s in Maastricht notice that non-pharmacological treatment is someone else"s responsibility e.g. practice nurses, HFN, CA. All interviewed HC-professionals  inform patients considering their diagnosis. GP’s and CA in both regions educate patients considering pharmacological treatment and implanted devices. Moreover GP’s and CA in Noorder-Kempen emphasize the importance of compliance to therapy.  HFN in both regions offer comprehensive advice regarding lifestyle adjustments. HFN in Maastricht explicitly mention self-care support as an important part of their interventions. Conclusion Little regional differences could be found in the non-pharmacological interventions offered by the different HC professions involved in HF-management, however each profession has its own focus. GP’s and CA mainly focus on pharmacological and device therapy and therefore educate patients considering these aspects of HF-treatment. HFN mainly focus on lifestyle adjustments and self-care support.

scholarly journals Parental Self-Control as a Moderator of the Association Between Family Conflict and Type 1 Diabetes Management

2019 ◽  
Vol 44 (8) ◽  
pp. 999-1008 ◽  
Author(s):  
MaryJane S Campbell ◽  
Cynthia A Berg ◽  
Deborah J Wiebe
Keyword(s):  
Type 1 Diabetes ◽  
Family Conflict ◽  
Health Care Professionals ◽  
Diabetes Management ◽  
Self Control ◽  
Mothers And Fathers ◽  
Time Points ◽  
Related Family ◽  
Lower Adherence

Abstract Objective To examine whether parental self-control (i.e., parents’ ability to regulate their emotions, cognitions, and behaviors) moderates the detrimental association between type 1 diabetes (T1D)-specific family conflict and adherence and HbA1c, such that conflict is most detrimental when parental self-control is low. Methods One hundred and forty-nine adolescents diagnosed with T1D (Mage = 14.09; 53% female) reported on their T1D-specific conflict with their mothers and fathers and their adherence to the T1D regimen at two time points (6 months apart). Mothers and fathers reported on their self-control. Glycated hemoglobin (HbA1c) was obtained from the medical record at both time points. Results Higher adolescent-reported conflict with father was associated concurrently with higher HbA1c and lower adherence only for fathers with low self-control (ps < .05). Higher adolescent-reported conflict with mother was also associated concurrently with lower adherence only for mothers with lower self-control (p < .05); no significant moderation was found for mothers’ self-control in predicting HbA1c. Longitudinal analyses indicated family conflict with mother predicted changes in adherence and HbA1c, but there were no significant moderating effects of either mother or father self-control. Conclusions Lower parental self-control may prevent parents from handling diabetes-related family conflict in a productive manner. We discuss the implications of parental self-control as an intervention target for health care professionals working with adolescents with T1D and their families.

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