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第五次英国儿科糖尿病服务调查:符合指南和建议吗?

The fifth UK paediatric diabetes services survey: meeting guidelines and recommendations?

机构信息

Diabetes UK, Macleod House, 10 Parkway, London NW1 7AA, UK.

出版信息

Arch Dis Child. 2010 Oct;95(10):837-40. doi: 10.1136/adc.2009.176925. Epub 2010 Jul 6.

Abstract

AIM

To assess the provision of UK paediatric and adolescent diabetes services and examine changes in service delivery since 2002.

METHOD

Questionnaires were sent to the lead paediatric consultant from all paediatric and adolescent diabetes services (n=205). Questions were based on National Institute for Health and Clinical Excellence and Scottish Intercollegiate Guidelines recommendations for diabetes care in childhood. Results were analysed using parametric and non-parametric tests.

RESULTS

129 Services (63%) returned questionnaires involving 220 clinics. Staffing has improved and 98% of consultants have a special interest in diabetes (89%, 2002). In 88% of services, the diabetes specialist nurse worked solely in paediatric diabetes (53%, 2002). Only 21% of clinics have a psychological professional integrated within the diabetes team (20%, 2002). Over 94% of services offered support with intensive insulin regimens causing problems at school for 36% of services. Almost all services offer annual microvascular screening (98-100%) but transitional care was variable; only 76% of services have specific local protocols for transition and 21% organise transfer by letter only.

CONCLUSION

Paediatric and adolescent diabetes services are rising to the challenge of providing high-quality care despite rising prevalence and increasingly complex insulin regimes. Services have improved in a number of key areas but serious deficiencies remain.

摘要

目的

评估英国儿科和青少年糖尿病服务的提供情况,并检查自 2002 年以来服务提供方式的变化。

方法

向所有儿科和青少年糖尿病服务的首席儿科顾问发送了问卷(n=205)。问题基于国家卫生与临床优化研究所和苏格兰校际指南中针对儿童期糖尿病护理的建议。使用参数和非参数检验对结果进行分析。

结果

129 个服务机构(63%)返回了涉及 220 个诊所的问卷。工作人员配备有所改善,98%的顾问对糖尿病有特殊兴趣(89%,2002 年)。在 88%的服务中,糖尿病专科护士专门从事儿科糖尿病工作(53%,2002 年)。只有 21%的诊所拥有整合在糖尿病团队中的心理专业人员(20%,2002 年)。超过 94%的服务机构提供有问题的强化胰岛素方案的支持,占服务机构的 36%。几乎所有服务机构都提供年度微血管筛查(98-100%),但过渡性护理存在差异;只有 76%的服务机构有专门的本地过渡协议,21%的服务机构仅通过信件安排转院。

结论

尽管患病率不断上升,胰岛素治疗方案也越来越复杂,但儿科和青少年糖尿病服务机构正在努力提供高质量的护理。在许多关键领域,服务都有所改善,但仍存在严重缺陷。

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