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改善1型糖尿病儿童和青少年获取糖尿病技术的情况:医疗保健专业人员的观点和看法。

Improving access to diabetes technologies in children and young people with type 1 diabetes: Healthcare professionals' perspectives and views.

作者信息

Dlugatch Rachel, Rankin David, Evans Mark, Oliver Nick, Ng Sze May, Lawton Julia

机构信息

Usher Institute, Medical School, University of Edinburgh, Edinburgh, UK.

Institute of Metabolic Science and Department of Medicine, University of Cambridge, Cambridge, UK.

出版信息

Diabet Med. 2025 Apr 25:e70058. doi: 10.1111/dme.70058.

Abstract

AIMS

To understand and explore the strategies, resources, and interventions healthcare professionals are implementing, or recommend implementing, to promote more equitable access to diabetes technology amongst children and young people (CYP) with type 1 diabetes in the UK.

METHODS

Interviews were conducted with (n = 29) healthcare professionals working in paediatric diabetes in England from (n = 15) purposively selected sites. Data were analysed thematically.

RESULTS

Healthcare professionals reported many strategies to help address diabetes technology access disparities in CYP, structured under the following themes: 'Re-evaluating staff levels, roles, and efficiency'; 'Improving communication'; 'Promoting peer support and community outreach'; 'Providing financial and social support for deprived CYP/caregivers'; 'Encouraging CYP/caregiver choice;' and 'Funding, sustainability, and burnout.' Many of these strategies appeared to be local (e.g., site-specific) solutions, made possible by short-term, one-off funding schemes and innovation by individual team members. While some proposed strategies appeared to improve staff time-efficiencies allowing greater numbers of CYPs to be moved onto technology, others, as interviewees noted, could add to individual team members' workloads and stress.

CONCLUSIONS

Healthcare professionals appeared highly committed to addressing technology access disparities in CYP. While some of their recommendations may be easier to implement than others, our findings underscore the importance of adopting a joined-up, integrated approach to promoting equitable technology access across the UK. This would require closer collaboration and resource-sharing within and across sites, backed by sustainable, long-term funding, with a significant portion dedicated to increasing staffing capacity to support the practical implementation of these strategies.

摘要

目的

了解并探索医疗保健专业人员正在实施或建议实施的策略、资源和干预措施,以促进英国1型糖尿病儿童和青少年(CYP)更公平地获得糖尿病技术。

方法

对来自英格兰(n = 15)个有目的选择地点的(n = 29)名从事儿科糖尿病工作的医疗保健专业人员进行了访谈。对数据进行了主题分析。

结果

医疗保健专业人员报告了许多有助于解决CYP中糖尿病技术获取差距的策略,这些策略分为以下主题:“重新评估人员水平、角色和效率”;“改善沟通”;“促进同伴支持和社区外展”;“为贫困的CYP/照顾者提供经济和社会支持”;“鼓励CYP/照顾者选择”;以及“资金、可持续性和职业倦怠”。许多这些策略似乎是局部(例如特定地点)的解决方案,由短期、一次性的资金计划和个别团队成员的创新得以实现。虽然一些提议的策略似乎提高了工作人员的时间效率,使更多的CYP能够使用技术,但正如受访者所指出的,其他一些策略可能会增加个别团队成员的工作量和压力。

结论

医疗保健专业人员似乎高度致力于解决CYP中的技术获取差距问题。虽然他们的一些建议可能比其他建议更容易实施,但我们的研究结果强调了在英国采用联合、综合方法促进公平技术获取的重要性。这将需要各地点内部和之间更密切的合作和资源共享,并得到可持续的长期资金支持,其中很大一部分用于增加人员配备能力,以支持这些策略的实际实施。

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