Zaremba Natalie, Robert Glenn, Allan Jacqueline, Harrison Amy, Brown Jennie, Konstantara Emmanouela, Rosenthal Miranda, Pillay Divina, Beckwith Anita, Treasure Janet, Hopkins David, Ismail Khalida, Stadler Marietta
Department of Diabetes, Faculty of Life Sciences and Medicine, King's College London, London, UK.
Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK.
Diabet Med. 2022 Apr;39(4):e14749. doi: 10.1111/dme.14749. Epub 2021 Dec 23.
To develop a cognitive behavioural therapy-based intervention for people with type 1 diabetes and disordered eating using Experience-Based Co-Design as part of the Safe management of people with Type 1 diabetes and EAting Disorders studY (STEADY).
Fifteen people with type 1 diabetes and experience of disordered eating (33 ± 11 years old, 22 ± 12 years diabetes duration) and 25 healthcare professionals working in type 1 diabetes or eating disorders (44 ± 9 years old; 14 ± 10 years of professional experience) attended six Experience-Based Co-Design workshops from July 2019 to March 2020 to collaboratively develop intervention content.
We developed a cognitive behaviour therapy intervention 'toolkit' that can be tailored for individual patient needs. Participants designed and revised toolkit materials to ensure acceptability and relevance for people with diabetes and disordered eating by engaging in guided discussion, brainstorming, and rapid testing to review toolkit prototypes in an iterative process. Workshop themes were 'Insulin titration'; 'Hypoglycaemia'; 'Coming to terms with diabetes'; 'Fear of weight gain'; 'Toolkit revision'; and 'Practical elements of STEADY therapy'. The intervention is focussed on improving diabetes self-care and embedded in a multidisciplinary healthcare approach. The intervention will be delivered in 12 sessions by a diabetes specialist nurse trained in cognitive behavioural therapy.
Through an iterative co-design process, people with type 1 diabetes and healthcare professionals collaboratively developed a novel intervention toolkit that can be used with a wide range of disordered eating presentations. The intervention will be tested in the STEADY feasibility randomised controlled trial.
作为1型糖尿病与饮食失调安全管理研究（STEADY）的一部分，采用基于体验的协同设计方法，为1型糖尿病合并饮食失调患者开发一种基于认知行为疗法的干预措施。
15名患有1型糖尿病且有饮食失调经历的患者（年龄33±11岁，糖尿病病程22±12年）以及25名从事1型糖尿病或饮食失调治疗工作的医疗保健专业人员（年龄44±9岁；专业经验14±10年）参加了2019年7月至2020年3月期间举办的六次基于体验的协同设计研讨会，共同制定干预内容。
我们开发了一种认知行为疗法干预“工具包”，可根据个体患者需求进行定制。参与者通过引导性讨论、头脑风暴和快速测试等方式，对工具包原型进行反复审查，设计并修订工具包材料，以确保其对糖尿病合并饮食失调患者的可接受性和相关性。研讨会主题包括“胰岛素滴定”；“低血糖”；“接受糖尿病”；“对体重增加的恐惧”；“工具包修订”；以及“STEADY疗法的实际要素”。该干预措施专注于改善糖尿病自我护理，并融入多学科医疗保健方法。该干预将由一名接受过认知行为疗法培训的糖尿病专科护士进行12次授课。
通过反复的协同设计过程，1型糖尿病患者和医疗保健专业人员共同开发了一种新型干预工具包，可用于多种饮食失调表现。该干预将在STEADY可行性随机对照试验中进行测试。
