Townson Julia, Gallagher Dunla, Cowley Laura, Channon Susan, Robling Michael, Williams David, Hughes Clare, Murphy Simon, Lowes Lesley, Gregory John W
Centre for Trial Research (CTR) Cardiff University Cardiff UK.
Division of Population Medicine Cardiff University Cardiff UK.
Endocrinol Diabetes Metab. 2017 Dec 18;1(1):e00008. doi: 10.1002/edm2.8. eCollection 2018 Jan.
The aim of this study was to explore from the perspectives of key stakeholders involved in the pathway to diagnosis, the barriers and facilitators to a timely diagnosis of type 1 diabetes in childhood.
Qualitative interviews and free-text analyses were undertaken in 21 parents with a child diagnosed with type 1 diabetes, 60 parents without a child diagnosed with type 1 diabetes, 9 primary healthcare professionals, 9 teachers and 3 community diabetes liaison nurses Data were analysed thematically and 30% double coded.
Two key themes were identified, namely the importance of widespread awareness and knowledge and seeking healthcare professional help Parents with a child diagnosed with type 1 diabetes described seeking opinions from a number of individuals prior to seeking health professional help. Healthcare professionals recognized the rarity of the condition and the need for it to be kept on their "radar", to ensure they considered it when examining an unwell child. The process of obtaining a primary healthcare appointment was identified as potentially playing a crucial role in the diagnostic process. However, most parents with a child diagnosed with type 1 diabetes described receiving an appointment on the day they sought it.
Knowledge and awareness of type 1 diabetes in childhood remain limited in the general population and misconceptions persist relating to how children present with this serious condition. An effective community-based intervention to raise awareness amongst key stakeholders is required to ensure children receive a timely diagnosis once symptomatic.
本研究旨在从参与诊断途径的关键利益相关者的角度,探讨儿童1型糖尿病及时诊断的障碍和促进因素。
对21名有1型糖尿病患儿的家长、60名无1型糖尿病患儿的家长、9名初级医疗保健专业人员、9名教师和3名社区糖尿病联络护士进行了定性访谈和自由文本分析。对数据进行了主题分析,并进行了30%的双重编码。
确定了两个关键主题,即广泛的认识和知识以及寻求医疗保健专业人员帮助的重要性。有1型糖尿病患儿的家长描述了在寻求医疗专业人员帮助之前向许多人征求意见的情况。医疗保健专业人员认识到这种疾病的罕见性,以及需要将其“放在心上”,以确保在检查身体不适的儿童时考虑到这种疾病。获得初级医疗预约的过程被认为可能在诊断过程中发挥关键作用。然而,大多数有1型糖尿病患儿的家长描述说在寻求预约的当天就得到了预约。
普通人群中对儿童1型糖尿病的认识和了解仍然有限,对于儿童患这种严重疾病的表现存在误解。需要开展基于社区的有效干预措施,以提高关键利益相关者的认识,确保儿童一旦出现症状就能得到及时诊断。