El-Dassouki Noor, Taylor Madison, Pfisterer Kaylen J, Saragadam Ashish, Nakhla Meranda, Greenberg Marley, Landry Alanna, Mukerji Geetha, Mok Elise, Brazeau Anne-Sophie, Kichler Jessica C, Cafazzo Joseph A, Shulman Rayzel
Centre for Digital Therapeutics University Health Network, 190 Elizabeth Street Toronto, M5G 2C4, Toronto, ON, Canada.
Department of Systems Design Engineering University of Waterloo, 200 University Avenue W, Waterloo N2L 3G1, ON, Canada.
Pediatr Diabetes. 2024 Jul 15;2024:3721768. doi: 10.1155/2024/3721768. eCollection 2024.
The time during which adolescents and young adults (AYAs) living with Type 1 Diabetes (T1D) transition from pediatric to adult care is associated with blood sugar levels outside of target ranges, care gaps, and an increased risk of acute diabetes complications. The aim of this study was to understand (1) the perspectives of AYAs and providers about the strengths, challenges, and opportunities of transition care and (2) the role of digital technologies in supporting the transition to adult care. . We conducted a qualitative descriptive study that involved 43 semistructured interviews in French or English with AYA living with T1D (aged 16-25; = 22) and pediatric or adult diabetes health care providers (HCPs) ( = 21).
We identified three themes. First, transition care is not standardized and varies widely, and there is a lack of awareness of transition guidelines. Second, virtual care can simultaneously hinder and help relationship-building between providers and AYA. Third, AYAs value a holistic approach to care; both HCPs and AYA highlighted the opportunity to better support overall mental wellbeing.
The design of digital technologies to support T1D transition care should consider methods for standardizing holistic care delivery and integrating hybrid diabetes care visits to support access to transition care. These findings can inform future transition intervention development that leverages existing transition guidelines, targets holistic care model integration, and considers quantitative diabetes metrics in conjunction with broader life experiences of AYA when providing transition care.
1型糖尿病(T1D)青少年及青年患者从儿科护理过渡到成人护理期间,血糖水平易超出目标范围,存在护理缺口,且急性糖尿病并发症风险增加。本研究旨在了解:(1)青少年及青年患者和医疗服务提供者对过渡护理的优势、挑战及机遇的看法;(2)数字技术在支持向成人护理过渡中的作用。我们开展了一项定性描述性研究,对43名1型糖尿病青少年及青年患者(年龄16 - 25岁;n = 22)以及儿科或成人糖尿病医疗服务提供者(HCPs)(n = 21)进行了法语或英语的半结构化访谈。
我们确定了三个主题。第一,过渡护理不规范且差异很大,对过渡指南缺乏认识。第二,虚拟护理可能同时阻碍和有助于医疗服务提供者与青少年及青年患者之间建立关系。第三,青少年及青年患者重视整体护理方法;医疗服务提供者和青少年及青年患者都强调了更好地支持整体心理健康的机会。
支持1型糖尿病过渡护理的数字技术设计应考虑规范整体护理服务的方法,并整合混合式糖尿病护理问诊,以支持获得过渡护理。这些发现可为未来过渡干预措施的开发提供参考,这些措施应利用现有的过渡指南,以整体护理模式整合为目标,并在提供过渡护理时结合青少年及青年患者更广泛的生活经历考虑糖尿病量化指标。