Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.
Monash Centre for Health Research and Implementation-MCHRI, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
BMJ Open. 2022 Dec 16;12(12):e067209. doi: 10.1136/bmjopen-2022-067209.
Type 1 diabetes (T1D) is a chronic and incurable autoimmune disease, diagnosed in early childhood and managed initially in paediatric healthcare services. In many countries, including Australia, national audit data suggest that management and care of T1D, and consequently glycaemic control, are consistently poor. This can lead to adverse outcomes such as cardiovascular disease and nephropathy. T1D treatment is complex, multidisciplinary, multiagency and life-long and should involve patient-centred, developmentally appropriate care. Although an emerging body of literature describes T1D models of care, their components, implementation determinants and associated outcomes are poorly understood.
To provide a study protocol to describe methods to map existing models of care for children and young adults living with T1D. It will identify the gaps and needs in care delivery as viewed by healthcare providers and by children, young people and their families accessing care in metropolitan and rural or remote regions throughout Australia.
A mixed-method study that includes provider and consumer-specific surveys and interviews about current T1D care provisions. Data will be analysed thematically (qualitative) and statistically (quantitative) and synthesised to describe the key characteristics of effective and sustainable models of care for T1D and to identify gaps.
Ethics approval was granted by the Macquarie University Human Research Ethics Committee in July 2022 (#520221154439676). Results will be disseminated via publication in peer-reviewed journals and at relevant conferences.
1 型糖尿病（T1D）是一种慢性且无法治愈的自身免疫性疾病，通常在儿童早期确诊，并在儿科保健服务中进行初步管理。在许多国家，包括澳大利亚，国家审计数据表明，T1D 的管理和护理，以及由此产生的血糖控制，一直都不理想。这可能导致心血管疾病和肾病等不良后果。T1D 的治疗复杂、多学科、多机构且需要终身治疗，应该以患者为中心，提供适合其发展阶段的护理。尽管越来越多的文献描述了 T1D 的护理模式，但它们的组成部分、实施决定因素和相关结果仍了解甚少。
提供一份研究方案，描述用于绘制儿童和青少年 T1D 现有护理模式的方法。它将确定澳大利亚大都市和农村或偏远地区的医疗保健提供者以及接受护理的儿童、年轻人及其家庭所认为的护理提供中的差距和需求。
这是一项混合方法研究，包括针对提供者和消费者的特定调查和访谈，以了解当前 T1D 护理的规定。数据将通过主题分析（定性）和统计分析（定量）进行分析，并进行综合描述，以确定有效的和可持续的 T1D 护理模式的关键特征，并确定差距。
麦考瑞大学人类研究伦理委员会于 2022 年 7 月批准了这项研究（#520221154439676）。研究结果将通过发表在同行评议的期刊和相关会议上进行传播。
