Children's Hospital Los Angeles, University of Southern California, Keck School of Medicine, Los Angeles, California.
Chan Division of Occupational Science and Occupational Therapy, Ostrow School of Dentistry, University of Southern California, Los Angeles, California.
Diabetes Educ. 2019 Aug;45(4):420-430. doi: 10.1177/0145721719858080. Epub 2019 Jun 27.
To assess the impact of a home telemedicine clinic model (CoYoT1 Clinic) on psychosocial and behavioral outcomes designed for young adults (YAs) with type 1 diabetes (T1D).
YAs self-selected to participate in the CoYoT1 Clinic or serve as a usual care control. CoYoT1 Clinic visits consisted of an individual appointment with a provider and a group appointment with other YAs with T1D using home telemedicine. Psychosocial and behavioral functioning was assessed by 4 measures: Diabetes Distress Scale, Self-Efficacy for Diabetes Scale, Self-Management of Type 1 Diabetes in Adolescence Scale, and Center for Epidemiologic Studies Depression Scale.
Forty-two patients participated in the CoYoT1 Clinic and 39 patients served as controls. CoYoT1 participants reported lower levels of distress ( = .03), increased diabetes self-efficacy ( = .01), and improved ability to communicate with others about diabetes ( = .04) over the study period compared to controls. YA males in the control group reported increases in depressive symptoms ( = .03) during the study period, but CoYoT1 participants showed no changes.
Group home telemedicine for YAs with T1D positively affects diabetes distress, self-efficacy, and diabetes-specific communication. These positive findings have the potential to also affect the YAs' long-term diabetes outcomes. Further investigation of the model is needed.
评估家庭远程医疗诊所模式（CoYoT1 诊所）对专为 1 型糖尿病（T1D）青年（YA）设计的心理社会和行为结果的影响。
YA 自行选择参加 CoYoT1 诊所或作为常规护理对照。CoYoT1 诊所就诊包括与提供者进行一次单独预约和与其他使用家庭远程医疗的 T1D 青年进行一次小组预约。通过 4 项措施评估心理社会和行为功能：糖尿病困扰量表、糖尿病自我效能量表、青少年 1 型糖尿病自我管理量表和流行病学研究中心抑郁量表。
42 名患者参加了 CoYoT1 诊所，39 名患者作为对照。与对照组相比，CoYoT1 参与者在研究期间报告的困扰程度较低（ =.03）、糖尿病自我效能感提高（ =.01）和改善与他人沟通糖尿病的能力（ =.04）。对照组中的男性 YA 在研究期间报告抑郁症状增加（ =.03），但 CoYoT1 参与者没有变化。
针对 T1D 青年的团体家庭远程医疗对糖尿病困扰、自我效能和糖尿病特定沟通产生积极影响。这些积极发现有可能也会影响 YA 的长期糖尿病结局。需要进一步研究该模型。
