Department of Food and Nutrition, Lady Irwin College, University of Delhi, New Delhi, India.
Department of Food and Nutrition, Lady Irwin College, University of Delhi, New Delhi, India.
Diabetes Metab Syndr. 2021 Jul-Aug;15(4):102150. doi: 10.1016/j.dsx.2021.05.023. Epub 2021 May 21.
There is a lack of data on effectiveness of diabetes self-management education and support (DSMES) programs for South Asian adults with type 1 diabetes mellitus (T1DM). This formative research was conducted to explore existing practices on the said subject and gather information for planning an intervention program.
We conducted in-depth semi-structured interviews with endocrinologists, dieticians, diabetes educators and adults with T1DM. The participants were selected from a mix of public and private health facilities. Thematic analysis using inductive and deductive approach was undertaken. The intervention was developed and refined using the principles of FUSED and COM-B models.
In total, 28 in-depth interviews were conducted, 18 with health care professionals and 10 with adult individuals with T1DM. The results demonstrated deficiencies in the implementation of a structured self-management program for diabetes owing to several patient and healthcare system-related factors. A detailed nutritional counseling was provided at all sites by a qualified dietitian, however, carbohydrate counting was not routinely practiced. The interviews of this formative research revolved around: (a) evaluation of the existing usual care and gaps in implementation of a structured DSMES program, and (b) development of themes that will help in formulation of an intervention package and its effective delivery to the participants.
This research study comprehensively investigated the existing practices among diabetes-health care professionals caring for persons living with T1DM and rendered insights towards development of a scientific DSMES program.
缺乏关于 1 型糖尿病（T1DM）南亚成年患者糖尿病自我管理教育和支持（DSMES）计划有效性的数据。这项探索性研究旨在探讨现有实践，并为规划干预计划收集信息。
我们对内分泌学家、营养师、糖尿病教育者和 T1DM 成年人进行了深入的半结构化访谈。参与者是从公共和私人医疗设施中挑选出来的。使用归纳和演绎方法进行主题分析。该干预措施是使用 FUSED 和 COM-B 模型的原则开发和完善的。
共进行了 28 次深入访谈，其中 18 次是与医疗保健专业人员进行的，10 次是与 T1DM 成年患者进行的。结果表明，由于一些患者和医疗系统相关因素，实施结构化糖尿病自我管理计划存在缺陷。所有地点都由合格的营养师提供详细的营养咨询，但碳水化合物计数并未常规进行。该探索性研究的访谈围绕以下主题展开：（a）评估现有的常规护理和结构化 DSMES 计划实施方面的差距；（b）制定主题，以帮助制定干预包并将其有效地提供给参与者。
这项研究全面调查了为 T1DM 患者提供护理的糖尿病医疗保健专业人员的现有实践，并深入了解了开发科学的 DSMES 计划的思路。
