Halper Jillian B, Yazel Lisa G, El Mikati Hala, Hatton Amy, Tully Jennifer, Li Xiaochun, Carroll Aaron E, Hannon Tamara S
Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, United States.
Front Clin Diabetes Healthc. 2022 May 6;3:769116. doi: 10.3389/fcdhc.2022.769116. eCollection 2022.
Patient engagement in the process of developing a diabetes treatment plan is associated with person-centered care and improved treatment outcomes. The objective of the present study was to evaluate the self-reported patient and parent-centered satisfaction and well-being outcomes associated with the three treatment strategies utilized in a comparative effectiveness trial of technology-enhanced blood glucose monitoring and family-centered goal setting. We evaluated data from 97 adolescent-parent pairs at baseline and 6-months during the randomized intervention. Measures included: Problem Areas in Diabetes (PAID) child and parent scales, pediatric diabetes-related quality of life, sleep quality, and satisfaction with diabetes management. Inclusion criteria were 1) ages 12-18 years, 2) a T1D diagnosis for at least six months and 3) parent/caregiver participation. Longitudinal changes in survey responses were measured at 6 months from baseline. Differences between and within participant groups were evaluated using ANOVA. The average age of youth participants was 14.8 ± 1.6 years with half of the participants being female (49.5%). The predominant ethnicity/race was Non-Hispanic (89.9%) and white (85.9%). We found that youth perceived 1) greater of diabetes-related communication when using a meter capable of transmitting data electronically, 2) increased engagement with diabetes self-management when using family-centered goal setting, and 3) worse sleep quality when using both strategies together (technology-enhanced meter and family-centered goal setting). Throughout the study, scores for self-reported satisfaction with diabetes management were higher in youth than parents. This suggests that patients and parents have different goals and expectations regarding their diabetes care management and care delivery. Our data suggest that youth with diabetes value communication technology and patient-centered goal setting. Strategies to align youth and parent expectations with the goal of improving satisfaction could be utilized as a strategy to improve partnerships in diabetes care management.
患者参与糖尿病治疗计划的制定过程与以患者为中心的护理及改善治疗效果相关。本研究的目的是评估在一项技术增强型血糖监测和以家庭为中心的目标设定的比较有效性试验中,与三种治疗策略相关的患者及家长自我报告的满意度和幸福感结果。我们在随机干预的基线期和6个月时评估了97对青少年-家长的数据。测量指标包括:糖尿病问题领域(PAID)儿童和家长量表、儿科糖尿病相关生活质量、睡眠质量以及对糖尿病管理的满意度。纳入标准为:1)年龄在12至18岁之间,2)1型糖尿病诊断至少6个月,3)家长/照顾者参与。在基线期6个月时测量调查回复的纵向变化。使用方差分析评估参与者组间和组内的差异。青少年参与者的平均年龄为14.8±1.6岁,一半参与者为女性(49.5%)。主要种族/族裔为非西班牙裔(89.9%)和白人(85.9%)。我们发现,青少年认为:1)使用能够电子传输数据的血糖仪时,与糖尿病相关的沟通更多;2)使用以家庭为中心的目标设定时,糖尿病自我管理的参与度增加;3)同时使用两种策略(技术增强型血糖仪和以家庭为中心的目标设定)时,睡眠质量更差。在整个研究过程中,青少年自我报告的糖尿病管理满意度得分高于家长。这表明患者和家长对糖尿病护理管理和护理提供有不同的目标和期望。我们的数据表明,患有糖尿病的青少年重视通信技术和以患者为中心的目标设定。使青少年和家长的期望与提高满意度的目标相一致的策略可作为改善糖尿病护理管理中伙伴关系的一种策略。