Centre for Trials Research (CTR), College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK.
School of Healthcare Sciences, Cardiff University, Cardiff, UK.
Pediatr Diabetes. 2020 Aug;21(5):824-831. doi: 10.1111/pedi.13023. Epub 2020 Apr 30.
To explore the delivery of home and hospital management at diagnosis of type 1 diabetes in childhood and any impact this had on health professionals delivering care.
This qualitative study was undertaken as part of the Delivering Early Care in Diabetes Evaluation randomized controlled trial where participants were individually randomized to receive initiation of management at diagnosis, to home or hospital. Semi-structured telephone interviews were planned with a purposive sample of health professionals involved with the delivery of home and hospital management, to include consultants, diabetes and research nurses, and dieticians from the eight UK centres taking part. The interview schedule focused on their experiences of delivering the two models of care; preferences, impact, and future plans. Data were subject to thematic analysis.
Twenty-two health professionals participated, represented by consultants, diabetes and research nurses, and dieticians. Overall, nurses preferred home management and perceived it to be beneficial in terms of facilitating a unique opportunity to understand family life and provide education to extended family members. Nurses described a special bond and lasting relationship that they developed with the home managed children and families. Consultants expressed concern that it jeopardized their relationship with families. Dieticians reported being unable to deliver short bursts of education to families in the home managed arm. All health professionals were equally divided over which was logistically easier to deliver.
A hybrid approach, of a brief stay in hospital and early home management, offers a pragmatic solution to the advantages and challenges presented by both systems.
探讨儿童 1 型糖尿病诊断时的家庭和医院管理模式的实施情况，以及这种管理模式对提供护理的卫生专业人员有何影响。
本定性研究是“糖尿病早期护理评估”（Delivering Early Care in Diabetes Evaluation）随机对照试验的一部分，参与者被随机分为在家和住院两种管理模式组。对参与家庭和医院管理模式的卫生专业人员进行了有针对性的半结构式电话访谈，包括顾问、糖尿病和研究护士以及营养师，来自参与的 8 个英国中心。访谈计划侧重于他们提供两种护理模式的经验；偏好、影响和未来计划。数据进行了主题分析。
共有 22 名卫生专业人员参与，包括顾问、糖尿病和研究护士以及营养师。总体而言，护士更喜欢家庭管理，并认为这有利于了解家庭生活并为大家庭成员提供教育的独特机会。护士描述了他们与在家管理的儿童和家庭建立的特殊联系和持久关系。顾问表示担心这会危及他们与家庭的关系。营养师报告说，他们无法在家庭管理组中向家庭提供短暂的教育。所有卫生专业人员在逻辑上哪种更容易提供方面意见相当分歧。
医院短期停留和早期家庭管理的混合方法为两种系统带来的优势和挑战提供了一个切实可行的解决方案。
