Fitzgerald Katie, Jones Christina, Partridge Helen, Rouse Lindsey, Satherley Rose-Marie
Department of Psychological Interventions, Faculty of Health and Medical Sciences, School of Psychology, University of Surrey, Guildford, UK.
Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust - Bournemouth Diabetes and Endocrine Centre, Bournemouth, UK.
Diabet Med. 2025 May;42(5):e70003. doi: 10.1111/dme.70003. Epub 2025 Feb 13.
Eating disorders and disordered eating behaviours are prevalent among adults with type 1 diabetes, making early identification essential for improving health outcomes. Although screening tools exist to detect disordered eating in type 1 diabetes (T1DE), their application in clinical practice remains limited. This study investigates healthcare professionals' perspectives and attitudes towards screening for disordered eating in adult diabetes services.
This qualitative study employed semi-structured interviews with 13 healthcare professionals from adult diabetes services. Purposive sampling was used to ensure a broad range of healthcare professional viewpoints. The interviews centred on their perceptions of screening for disordered eating in type 1 diabetes.
Reflexive thematic analysis was used to identify four themes: (1) Uncertainty and Inevitabiltiy of T1DE: 'A bit of a black hole', (2) Asking about T1DE: 'My fear is…am I overstepping the line', (3) Patient-provider relationships: 'A backward step', and (4) Lack of support for T1DE: 'Where do you go?'. While healthcare professionals recognised the link between diabetes management and disordered eating, they lacked confidence in screening for these challenges due to limited time and the scarcity of specialist disordered eating resources for type 1 diabetes.
This study highlights the challenges healthcare professionals face in screening for disordered eating in type 1 diabetes. By highlighting the need for enhanced training and clear clinical guidelines, this research suggests pathways to improve healthcare professional confidence in addressing these critical conversations with patients, ultimately supporting better health outcomes.
饮食失调和紊乱的饮食行为在1型糖尿病成年人中很普遍，因此早期识别对于改善健康结果至关重要。尽管存在筛查工具来检测1型糖尿病（T1DE）中的饮食紊乱情况，但其在临床实践中的应用仍然有限。本研究调查了医疗保健专业人员对成人糖尿病服务中饮食紊乱筛查的看法和态度。
本定性研究对13名来自成人糖尿病服务机构的医疗保健专业人员进行了半结构化访谈。采用目的抽样以确保广泛的医疗保健专业人员观点。访谈集中在他们对1型糖尿病饮食紊乱筛查的看法上。
采用反思性主题分析确定了四个主题：（1）T1DE的不确定性和必然性：“有点像黑洞”，（2）询问T1DE：“我担心的是……我是否越界了”，（3）医患关系：“向后退一步”，以及（4）对T1DE缺乏支持：“你该何去何从？”。虽然医疗保健专业人员认识到糖尿病管理与饮食紊乱之间的联系，但由于时间有限以及1型糖尿病专门的饮食紊乱资源稀缺，他们对筛查这些问题缺乏信心。
本研究突出了医疗保健专业人员在筛查1型糖尿病饮食紊乱方面面临的挑战。通过强调加强培训和明确临床指南的必要性，本研究提出了提高医疗保健专业人员在与患者进行这些关键对话时的信心的途径，最终支持更好的健康结果。
