Gray D L, Langefeld C D, Golden M P, Orr D P
Department of Pediatrics, Indiana University School of Medicine, Indianapolis.
Diabetes Care. 1993 May;16(5):705-7. doi: 10.2337/diacare.16.5.705.
To determine the impact of participation in a multidisciplinary diabetes team on pediatric residents' perceptions of team members' roles.
Pediatric residents were assigned to a traditional diabetes clinical rotation (n = 34) or to an ambulatory multidisciplinary diabetes team within their continuity clinic (n = 21). The residents and a small sample of practicing pediatricians (n = 46) completed a Likert-type instrument at the completion of the 18-mo study.
Multidisciplinary diabetes team residents were significantly more positive about the roles for endocrinological evaluation in monitoring compliance, for the nurse educator/certified diabetes educator in assisting with sick-day management and school behavioral problems, and for the dietician in helping with cholesterol problems. They were significantly more like practicing pediatricians in their perceptions of pediatric roles in teaching sick-day management, implementing weight reduction, assisting with conflict resolution about diabetes, screening for microvascular complications, and developing behavioral strategies for metabolic control than residents in the traditional rotation. The groups did not differ in their beliefs about patient empowerment.
Multidisciplinary diabetes team participation may be useful in modifying specific role perceptions of pediatric residents about diabetes care. It does not appear to alter perceptions favoring greater patient empowerment.
确定参与多学科糖尿病团队对儿科住院医师对团队成员角色认知的影响。
将儿科住院医师分配到传统糖尿病临床轮转组(n = 34)或其连续性诊所内的门诊多学科糖尿病团队组(n = 21)。在为期18个月的研究结束时,住院医师和一小部分执业儿科医生(n = 46)完成了一份李克特式问卷。
多学科糖尿病团队组的住院医师对内分泌评估在监测依从性方面的作用、护士教育者/认证糖尿病教育者在协助处理患病日管理和学校行为问题方面的作用以及营养师在帮助解决胆固醇问题方面的作用,明显更为积极。与传统轮转组的住院医师相比,他们在对儿科医生在教授患病日管理、实施体重减轻、协助解决糖尿病相关冲突、筛查微血管并发症以及制定代谢控制行为策略等方面的角色认知上,明显更类似于执业儿科医生。两组在患者赋权观念上没有差异。
参与多学科糖尿病团队可能有助于改变儿科住院医师对糖尿病护理特定角色的认知。但似乎并未改变有利于更大程度患者赋权的观念。