Diabetes Canada, Toronto, Ontario, Canada.
Dalhousie University and Capital Health, Halifax, Nova Scotia, Canada.
Can J Diabetes. 2018 Aug;42(4):389-394.e2. doi: 10.1016/j.jcjd.2017.09.004. Epub 2017 Nov 9.
Addressing psychosocial issues is critical for diabetes self-management. This work explores health-care professionals' (HCPs') 1) perceived relevance of various psychosocial issues in diabetes management and 2) confidence in working on these issues within their services.
An online cross-sectional survey was developed based on the Capacity-Opportunity-Motivation Behaviour Model. It assessed self-rated confidence in supporting patients with psychosocial issues (capability), perceived relevance of these issues (motivation) and facilitators of skill development (opportunity). An e-mail invitation was sent to all Diabetes Canada's professional members, conference delegates and committee members. Qualitative responses were analyzed using thematic analysis.
Of the 260 responses received (25% response rate), many were Diabetes Canada professional members (83%) and/or certified diabetes educators (66%). The largest professional groups in the sample were registered nurses (44%) and registered dietitians (33%). All psychosocial issues were perceived as somewhat or extremely important by at least 80% of respondents (range, 80% to 97%). However, HCPs were less confident in supporting their patients with these psychosocial issues; significantly fewer respondents reported that they felt somewhat or extremely confident (range, 26% to 62%). Depression (80%) and anxiety (80%) were the issues in which guidance was most desired. Most respondents wanted some form of formal self-management support training (83%). Preferred training methods included in-person workshops (56%), webinars (56%) and conference sessions (51%).
Motivation to address psychosocial issues in diabetes was high, but capacity to do so and opportunity to learn how were both low. These findings can be used to develop a targeted strategy to help address this gap.
解决心理社会问题对于糖尿病的自我管理至关重要。本研究探讨了医疗保健专业人员(HCP)的以下方面:1)在糖尿病管理中对各种心理社会问题的感知相关性;2)在其服务中处理这些问题的信心。
根据能力-机会-动机行为模型,开发了一项在线横断面调查。它评估了支持有心理社会问题的患者的自我评估的信心(能力),对这些问题的感知相关性(动机)以及技能发展的促进因素(机会)。向所有加拿大糖尿病协会的专业会员、会议代表和委员会成员发送了电子邮件邀请。使用主题分析对定性回复进行分析。
在收到的 260 份回复中(回复率为 25%),许多人是加拿大糖尿病协会的专业会员(83%)和/或认证糖尿病教育者(66%)。样本中最大的专业群体是注册护士(44%)和注册营养师(33%)。所有心理社会问题都被至少 80%的受访者认为有些重要或非常重要(范围为 80%至 97%)。然而,HCP 在支持他们的患者处理这些心理社会问题方面的信心较低;报告感到有些或非常有信心的受访者明显较少(范围为 26%至 62%)。最希望得到指导的问题是抑郁(80%)和焦虑(80%)。大多数受访者希望接受某种形式的正式自我管理支持培训(83%)。首选的培训方法包括现场研讨会(56%)、网络研讨会(56%)和会议(51%)。
解决糖尿病心理社会问题的动机很高,但解决这些问题的能力和学习机会都很低。这些发现可用于制定有针对性的策略来帮助解决这一差距。