Children's Hospital Los Angeles, Los Angeles, CA, USA.
Chan Division of Occupational Science and Occupational Therapy, University of Southern California, CA, USA.
J Diabetes Sci Technol. 2022 Nov;16(6):1419-1427. doi: 10.1177/19322968211035768. Epub 2021 Jul 30.
The purpose of this study was to analyze the impact of virtual group appointments (VGA) on self-reported health-related outcomes and care activities for young adults (YA) with type 1 diabetes (T1D).
Fifty-three YA (ages 18-25 years) with T1D participated in a randomized controlled trial (RCT) of the Colorado Young Adults with T1D (CoYoT1) Clinic intervention, encompassing telehealth (TH) with or without VGA. Both new patients ( = 32) and those who participated in a pilot phase ( = 26) were randomized to CoYoT1 Clinic (TH+VGA; = 23) or TH-only ( = 35) and followed for 1 year. YA completed the Diabetes Distress Scale (DDS), Diabetes Strengths and Resilience (D-STAR), Self-Efficacy in Diabetes (SED), Self-Management of Type 1 Diabetes in Adolescence (SMOD-A), Center for Epidemiologic Studies Depression (CES-D), and EuroQol (EQ-5D) scales at baseline and study end.
YA were 67% female, 84% white, 10% Latinx, and the mean age was 20.4 years old. At study end, participants in CoYoT1 Clinic reported significantly reduced diabetes distress compared to those in TH-only, who reported increased levels [Effect Size (ES) = -0.40, = .02]. Specifically, CoYoT1 Clinic participants reported relative reductions in Physician (ES = -2.87, = .02) and Regimen-related distress (ES = -0.35, = .01). In addition, participants in CoYoT1 Clinic reported improved self-management of T1D-related problem solving (ES = 0.47, = .051) and communication with care providers (ES = 0.39, = .07).
Virtual group attendance in CoYoT1 Clinic was associated with significant improvements in diabetes-related distress. Long-term exposure to VGA should be investigated in YA with T1D and other pediatric chronic conditions.
本研究旨在分析虚拟小组预约(VGA)对 1 型糖尿病(T1D)年轻患者(YA)自我报告的健康相关结果和护理活动的影响。
53 名 YA(年龄 18-25 岁)参加了科罗拉多州 YA 与 T1D 诊所干预的随机对照试验(RCT),该试验包含远程医疗(TH)加或不加 VGA。新患者(n=32)和参加了试验阶段的患者(n=26)均随机分配至 CoYoT1 诊所(TH+VGA;n=23)或仅 TH(n=35),随访 1 年。YA 在基线和研究结束时完成了糖尿病困扰量表(DDS)、糖尿病优势与韧性量表(D-STAR)、糖尿病自我效能量表(SED)、青少年 1 型糖尿病自我管理量表(SMOD-A)、流行病学研究抑郁量表(CES-D)和 EuroQol 量表(EQ-5D)。
YA 中 67%为女性,84%为白人,10%为拉丁裔,平均年龄为 20.4 岁。研究结束时,与仅接受 TH 的患者相比,参加 CoYoT1 诊所的患者报告糖尿病困扰显著降低[效应量(ES)=-0.40,P=.02]。具体而言,CoYoT1 诊所患者报告在医师(ES=-2.87,P=.02)和治疗方案相关困扰(ES=-0.35,P=.01)方面的相对减少。此外,参加 CoYoT1 诊所的患者报告在 T1D 相关问题解决的自我管理(ES=0.47,P=.051)和与医护人员的沟通(ES=0.39,P=.07)方面有所改善。
参加 CoYoT1 诊所的虚拟小组可显著改善与糖尿病相关的困扰。应在 T1D 和其他儿科慢性病的 YA 中进一步研究长期暴露于 VGA 的效果。