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患者、母亲和医疗保健专业人员对 1 型糖尿病青少年家庭访视引入的看法。

The perception of patients, mothers and healthcare professionals regarding introduction of home visits for adolescents with type 1 diabetes.

机构信息

Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark.

Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark.

出版信息

J Eval Clin Pract. 2024 Feb;30(1):140-145. doi: 10.1111/jep.13899. Epub 2023 Aug 15.

Abstract

BACKGROUND AND OBJECTIVES

Despite advancements in diabetes management, a subgroup of patients does not achieve an acceptable level of metabolic control. To achieve treatment goals for high-risk patients, a higher frequency of contact with healthcare professionals is essential. However, socioeconomic challenges often lead to nonattendance at the outpatient clinic. Therefore, home visits were introduced as a supplement/an alternative to consultations at the paediatric diabetes clinic. The aim of this study was to uncover the perception of patients, mothers and healthcare professionals regarding home visits versus consultations at the outpatient clinic in order to being able to improve the services offered.

METHODS

Semistructured interviews with patients, mothers and healthcare professionals were conducted to explore the experiences and perspectives of the concept at two paediatric diabetes clinics in Denmark. Paired t tests were used to compare the glycated hemoglobin A1c (HbA1c) levels at the start of the intervention with HbA1c 1 year before and HbA1c at the end of the intervention.

RESULTS

Both patients, mothers and healthcare professionals found consultations in familiar surroundings to result in stronger relationships between healthcare professionals and families, creating greater opportunities to discuss personal issues aimed at improving the outcome of diabetes. Furthermore, home visits facilitated finding alternative methods of helping patients and the families integrating diabetes into everyday life.

CONCLUSION

Overall, home visits were found to contribute toward creating a more constructive relationship. However, it was still a challenge to keep the scheduled appointments, and during this short study, no improvement in metabolic control could be observed.

摘要

背景与目的

尽管糖尿病管理取得了进展,但仍有一部分患者无法达到可接受的代谢控制水平。为了实现高危患者的治疗目标,必须增加与医疗保健专业人员的接触频率。然而,社会经济方面的挑战往往导致患者无法按时到门诊就诊。因此,家庭访视被引入作为儿科糖尿病诊所就诊的补充/替代方式。本研究旨在了解患者、母亲和医疗保健专业人员对家庭访视和门诊就诊的看法,以便能够改进所提供的服务。

方法

在丹麦的两家儿科糖尿病诊所,对患者、母亲和医疗保健专业人员进行了半结构化访谈,以探讨该理念的经验和观点。采用配对 t 检验比较干预开始时的糖化血红蛋白 A1c(HbA1c)水平与干预前 1 年的 HbA1c 水平和干预结束时的 HbA1c 水平。

结果

患者、母亲和医疗保健专业人员均认为在熟悉的环境中就诊有助于建立医疗保健专业人员和家庭之间更紧密的关系,为讨论旨在改善糖尿病治疗效果的个人问题创造了更多机会。此外,家庭访视有助于寻找帮助患者和家庭将糖尿病融入日常生活的替代方法。

结论

总体而言,家庭访视有助于建立更具建设性的关系。然而,仍难以按时预约,并且在这项短期研究中,未观察到代谢控制的改善。

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