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ADCES 2023 Research Abstracts ADCES 2023研究摘要
IF 1.9 4区 医学 Q1 Health Professions Pub Date : 2023-08-01 DOI: 10.1177/26350106231186159
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引用次数: 0
ADCES 2022 Research Abstracts ADCES 2022研究摘要
IF 1.9 4区 医学 Q1 Health Professions Pub Date : 2022-06-22 DOI: 10.1177/26350106221105805
E. Taghadom, J. Kandari, S. Murad, Dherar Alroudhan, Amal Abdullah, Amira Megahed, M. Azizieh, Mohammad Irshad
Background/Purpose: Hispanic individuals are disproportionately affected by diabetes and the associated morbidity and mortality. Peers are a major source of diabetes information and support within the Hispanic community. Ongoing peer support that reinforces diabetes education is highly desired by Hispanics living with diabetes. This study had the following goals: (1) to describe the training experiences of Hispanic peer facilitators (PFs) and (2) to understand PFs’ perspectives on their role in an online peer support community that facilitates continuous glucose monitoring (CGM) use. Methods: Peer Facilitators completed The Association of Diabetes Care & Education Specialists (ADCES) paraprofessional and study-specific training for a 12-week online peer support intervention using CGM for Hispanics living with diabetes. An exit interview was conducted at the conclusion of the pilot study, titled “Combining CGM and an Online Peer Support Community for Hispanic Adults With T2DM.” A qualitative descriptive analysis was conducted using a triangulated approach and thematic analysis. The PFs developed 7 web-based training videos to augment the ADCES paraprofessional training for a larger CGM and Online Peer Support Intervention study Results: Five PFs Background/Purpose: The semiautomated insulin delivery systems currently available require individualized insulin regimens to start therapy and meal doses based on carbohydrate counting for routine operation. In contrast, the bionic pancreas (BP), initialized only with body weight, makes all dosing decisions and delivers insulin autonomously. The BP uses a Meal Announcement that does not require carbohydrate counting, using instead a qualitative estimate of carbohydrate content relative to the user’s typical meal. This 13-week trial was designed to test the hypothesis that in persons living with type 1 diabetes (T1DM), the BP would reduce A1C compared to standard of care (any insulin delivery method with continuous glucose monitoring [CGM]) without increasing hypoglycemia. Methods: A total of 326 persons 6 to 79 years old with T1DM (baseline A1C 5.5%-13.1%) were randomly assigned 2:1 to BP treatment with insulin aspart or lispro (n = 219) or standard of care (any insulin delivery method with CGM, n = 107). The primary outcome was A1C level at 13 weeks. The key secondary outcome was the percentage of time CGM glucose was < 54 mg/dl (3.0 mmol/l). Results: Participants’ race and ethnicity were 74% non-Hispanic White, 10% non-Hispanic Black, 10% Hispanic or Latino, and 3% more than 1 race. Participants’ education level was 33% less than a bachelor’s degree, 35% bachelor’s degree, and 29% master’s degree or above. A1C levels decreased from 7.9% to 7.3% in the BP group and did not change (7.7% to 7.7%) in the standard-of-care group (mean adjusted difference at 13 weeks −0.5 percentage points, 95% confidence interval [CI] −0.6 to −0.3; P Background/Purpose: Only 14% of emerging adults, aged 18 to 25 years, living
背景/目的:西班牙裔个体受糖尿病及其相关发病率和死亡率的影响不成比例。在西班牙裔社区中,同伴是糖尿病信息和支持的主要来源。西班牙裔糖尿病患者非常需要持续的同伴支持来加强糖尿病教育。本研究有以下目标:(1)描述西班牙裔同伴辅导员(PFs)的培训经验;(2)了解PFs在促进持续血糖监测(CGM)使用的在线同伴支持社区中的角色。方法:同伴促进者完成了糖尿病护理与教育专家协会(ADCES)的辅助专业和研究特异性培训,使用CGM对西班牙裔糖尿病患者进行了为期12周的在线同伴支持干预。在试点研究结束时进行了一次离职面谈,题为“结合CGM和西班牙裔2型糖尿病成人在线同伴支持社区”。采用三角法和专题分析进行定性描述性分析。PFs开发了7个基于网络的培训视频,以增加ADCES的辅助专业培训,用于更大的CGM和在线同伴支持干预研究。结果:5个PFs背景/目的:目前可用的半自动胰岛素输送系统需要个性化的胰岛素方案来开始治疗,日常操作需要基于碳水化合物计数的膳食剂量。相比之下,仅以体重初始化的仿生胰腺(BP)可以自主决定所有剂量并递送胰岛素。BP使用不需要碳水化合物计数的膳食公告,而是使用相对于用户典型膳食的碳水化合物含量的定性估计。这项为期13周的试验旨在验证1型糖尿病(T1DM)患者的假设,与标准护理(任何持续血糖监测的胰岛素输送方法[CGM])相比,血压会降低A1C,而不会增加低血糖。方法:共有326名6至79岁的T1DM患者(基线A1C 5.5%-13.1%)被随机分为2:1组,分别接受胰岛素分离或利斯pro治疗(n = 219)或标准治疗(任何伴有CGM的胰岛素给药方法,n = 107)。主要终点是13周时的A1C水平。关键的次要终点是CGM葡萄糖< 54 mg/dl (3.0 mmol/l)的时间百分比。结果:参与者的种族和民族是非西班牙裔白人占74%,非西班牙裔黑人占10%,西班牙裔或拉丁裔占10%,超过一个种族的占3%。参与者的教育程度为33%低于学士学位,35%为学士学位,29%为硕士及以上学位。糖化血红蛋白水平在BP组从7.9%降至7.3%,在标准治疗组没有变化(7.7%至7.7%)(13周时调整后的平均差异为- 0.5个百分点,95%可信区间[CI] - 0.6至- 0.3;背景/目的:在18至25岁的1型糖尿病(T1DM)患者中,只有14%的新成年患者的A1C达到最佳水平,高经济压力和低健康保险素养是重要因素。缺乏适合发展的金融和健康保险资源,但它们对于能够独立应对医疗保健需求至关重要。因此,本研究旨在评估金融和健康保险素养教育工具包对新兴成年T1DM患者的初步效果。本研究的目的如下:(1)确定各研究组(干预组与对照组)在主要结局(即财务压力、健康保险素养、糖尿病特异性生活质量[QoL]和医疗保健导航准备)方面的差异;(2)确定各组之间在主要结局(即财务压力、健康保险素养、糖尿病特异性生活质量和医疗保健导航准备)方面的差异是否随时间而变化。方法:对干预组进行随机对照试验的初步效果(T1 Financial Toolkit;N = 20)或对照组(临床实践中使用的常用在线资源;n = 19)的财务压力、健康保险素养、医疗保健导航准备和糖尿病特异性生活质量在3个月内进行评估。资源审查的完成是通过Qualtrics分析确认的。结果:各研究组主要结局随时间的双向方差分析显示,各研究组的主要结局无差异,但两组的所有主要结局均随时间改善,Greenhouse-Geiser F = 7.068 (df = 1.636), P = 0.003(财务压力);背景/目的:实时连续血糖监测(rtCGM)有助于优化糖尿病患者的血糖管理。先前的研究发现,对于接受胰岛素治疗的1型糖尿病(T1DM)或2型糖尿病(T2DM)患者有显著的益处。 最近的研究表明,非密集胰岛素使用者也受益于rtCGM。因为胰岛素剂量不是一个因素,所以rtCGM数据一定会影响糖尿病相关行为。在这项研究中,研究人员回顾了参与Dexcom G6系统和Welldoc BlueStar平台项目的2型糖尿病患者的数据。我们之前报道过参与者血糖得到改善。本研究的目的是了解参与联合解决方案如何影响糖尿病护理和教育专家协会的ADCES7自我护理行为TM (ADCES7行为)。方法:调查参与者对数字健康解决方案的参与情况。对数据进行鉴定以供分析。队列1 (n = 37)连续使用rtCGM 24周。队列2 (n = 55)采用间歇性rtCGM。支持ADCES7行为的数字健康解决方案的特定功能使用计数,如食物、药物跟踪、活动、睡眠、血压和体重,被制成表格。结果:56%的rtCGM使用者为男性;40 ~ 54岁占44%,55 ~ 64岁占36%。平均基线A1C为9.5%。每个用户每周的平均参与频率反映出队列1与数字健康解决方案的每周互动频率高于队列2。在前12周,队列1的每周平均参与度明显高于队列2 (P = 0.005)。结论:rtCGM结合数字健康解决方案可以帮助T2DM患者(未开胰岛素)改善ADCES7行为。在连续使用队列中,对数字健康解决方案的参与度更高。这些数据提示临床医生应考虑rtCGM佩戴时间如何影响自我护理行为,以指导和治疗糖尿病患者。背景/目的:青少年糖尿病患病率呈上升趋势。儿童和青少年独特的生理和社会动态使糖尿病的自我管理复杂化。国家质量论坛强调生活质量(QoL)是医疗保健提供的关键人文结果,包括糖尿病自我管理教育(DSME)。本研究的目的是描述DSME对青少年糖尿病患者自我报告的生活质量的影响的科学现状。这项改进的Cochrane方法系统评价的主要目的是探索和报告随机对照试验(RCTs)中DSME对青年1型糖尿病和2型糖尿病(T2DM)患者自我报告的生活质量的影响的文献中的证据和空白。方法:在相关数据库中进行结构化检索后,2位作者独立进行了3层文章综述,采用以下纳入标准:(1)随机对照试验,(2)针对青年参与者的> 1 ADCES7自我护理行为TM (ADCES7行为)干预措施,(3)建立的生活质量测量,(4)2007年1月至2020年3月发表的英文文献。保留和背景/目的:糖尿病在聋人或听力障碍(DHH)人群中比在听力正常人群中更常见,很可能是由于信息差异。信息差异可能是由于缺乏语言渠道造成的。语言获取可确保聋人或听力障碍者(DHH-PWD)以其母语(美国手语[ASL])获得信息,例如糖尿病教育。DHH-PWD在医疗预约期间通常没有机会获得美国手语翻译。本研究的目的是使用基于社区的参与式方法来了解(1)DHH-PWD在接受糖尿病教育时遇到的障碍和促进因素;(2)为DHH-PWD提供最好的糖尿病教育的关键因素。方法:与DHH-PWD国家社区咨询委员会举行两次虚拟会议。开放式问题集中于糖尿病信息寻求,获得糖尿病教育的障碍,以及DHH-PWD希望在他们的糖尿病教育中看到什么。会议进行了录音和翻译/转录,并由研究小组的2名成员作了实地记录。然后评估实地记录的共同主题。结果:8例不同类型DHH-PWD(女性占50%;50%为2型糖尿病;年龄范围36-67岁)参与。最重要的主题是迫切需要针对不同文化的糖尿病教育,提供语言访问。障碍子主题包括缺乏
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引用次数: 0
Impact of a Digitally Enhanced Diabetes Self-Management Program on Glycemia and Medical Costs 数字增强糖尿病自我管理计划对血糖和医疗成本的影响
IF 1.9 4区 医学 Q1 Health Professions Pub Date : 2022-06-04 DOI: 10.1177/26350106221100779
Fang Chen, Carolyn B. Jasik, Timothy M. Dall, C. V. Siego
Objective: To analyze economic savings and health impacts associated with a virtual digitally enhanced diabetes self-management education and support (DSMES) program. Research design and methods: Participants (n = 1,494) were nonpregnant adults with diagnosed type 2 diabetes and baseline body mass index (BMI) of 25 kg/m2 (23 kg/m2 if of Asian descent) or higher who enrolled in virtual DSMES between February 2019 and April 2020 for at least 4 months. Participants’ changes in glycated hemoglobin (A1C) and body weight were calculated as the difference between program start and last recorded values between months 4 and 6. Outcomes for all participants were analyzed; subanalyses were done on 628 participants with starting A1C >7% (53 mmol/mol), who could benefit most from DSMES. Markov-based microsimulation approach was used to model the potential reductions in diabetes sequalae and medical expenditures if observed improvements in A1C and BMI were maintained. Results: DSMES participants with starting A1C >7% experienced average reductions of 0.9% A1C and 2.1 kg of body weight (−1.7% of BMI) within 6 months. If these improvements were maintained, simulated outcomes include reduced 5-year onset of ischemic heart disease by 9.2%, myocardial infarction by 10.6%, stroke by 12.1%, chronic kidney disease by 16.5%, and reduced onset of other sequelae. Simulated cumulative reduction in medical expenditures is $1160 after 1 year, $4150 after 3 years, $7790 after 5 years, and $18 020 after 10 years. Conclusions: Participation in virtual DSMES improves A1C and body weight, with the potential to slow onset of diabetes sequelae and reduce medical expenditures.
目的:分析与虚拟数字增强糖尿病自我管理教育和支持(DSMES)计划相关的经济节约和健康影响。研究设计和方法:参与者(n = 1494)是诊断为2型糖尿病且基线体重指数(BMI)为25的非孕妇 kg/m2(23 kg/m2,如果是亚裔)或更高,在2019年2月至2020年4月期间参加虚拟DSMES至少4年 月。参与者糖化血红蛋白(A1C)和体重的变化被计算为第4个月至第6个月期间项目开始和最后记录值之间的差异。对所有参与者的结果进行了分析;对628名起始A1C>7%的参与者进行了亚分析(53 mmol/mol),谁能从DSMES中获益最多。如果观察到A1C和BMI的改善得到维持,则使用基于马尔可夫的微观模拟方法来模拟糖尿病后遗症和医疗支出的潜在减少。结果:起始A1C>7%的DSMES参与者平均A1C降低0.9%,平均降低2.1 6个月内体重为kg(BMI的-1.7%)。如果这些改善得以维持,模拟结果包括缺血性心脏病的5年发病率减少9.2%,心肌梗死减少10.6%,中风减少12.1%,慢性肾脏疾病减少16.5%,以及其他后遗症的发病率减少。医疗支出的模拟累计减少额为1年后1160美元,3年后4150美元,5年后7790美元,10年后18020美元。结论:参与虚拟DSMES可以改善A1C和体重,有可能减缓糖尿病后遗症的发作并减少医疗支出。
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引用次数: 0
Understanding Hypoglycemia in the Real World 了解现实世界中的低血糖症
IF 1.9 4区 医学 Q1 Health Professions Pub Date : 2022-06-04 DOI: 10.1177/26350106221102855
J. Dickinson, Michelle L. Litchman
Purpose: The purpose of this study was to gain a better understanding of real-world hypoglycemia experiences from people living with diabetes. Methods: An exploratory cross-sectional study of a convenience sample of 374 English-speaking adults affected by diabetes using an online survey was conducted. Results: Participant mean age was 37 years with an average diabetes duration of 21 years. On average, participants reported feeling hypoglycemia at 64 mg/dL (3.6 mmol/L), worrying about hypoglycemia at 63 mg/dL (3.5 mmol/L), and treating hypoglycemia at 72 mg/dL (4 mmol/L). Terminology used by study participants did not match the current classifications of hypoglycemia used in clinical research. Participants who have been told they have hypoglycemia unawareness treat at a significantly lower level compared to those without hypoglycemia unawareness. Only 58% always carry hypoglycemia treatment; there was a relationship with increasing age and always carrying hypoglycemia treatment. Thirty-eight percent of participants treat hypoglycemia with the recommended 15 g of carbohydrate (CHO). Survey respondents who wore continuous glucose monitors reported using significantly less CHO to treat hypoglycemia. Conclusions: In the real world, experiences related to feeling, worrying about, and treating hypoglycemia trend higher than what is noted in the standardized hypoglycemia classifications. Study findings have implications for teaching and supporting people with diabetes who experience hypoglycemia. Consuming less CHO to treat hypoglycemia could lead to fewer episodes of rebound hyperglycemia and less weight gain. Increased support for continuous glucose monitoring is warranted.
目的:本研究的目的是为了更好地了解糖尿病患者的实际低血糖经历。方法:通过在线调查,对374名英语成人糖尿病患者进行了一项探索性横断面研究。结果:参与者平均年龄为37岁,平均糖尿病病程为21年。平均而言,参与者报告感觉低血糖为64毫克/分升(3.6毫摩尔/升),担心低血糖为63毫克/分升(3.5毫摩尔/升),治疗低血糖为72毫克/分升(4毫摩尔/升)。研究参与者使用的术语与目前临床研究中使用的低血糖分类不匹配。被告知患有低血糖无意识症的参与者的治疗水平明显低于没有低血糖无意识症的参与者。只有58%的人经常进行低血糖治疗;与年龄增长和长期接受低血糖治疗有关。38%的参与者使用推荐的15克碳水化合物(CHO)治疗低血糖。佩戴连续血糖监测仪的调查对象报告说,治疗低血糖时使用的CHO显著减少。结论:在现实世界中,与低血糖的感觉、担忧和治疗相关的体验趋势高于标准化低血糖分类。研究结果对教育和支持经历低血糖的糖尿病患者具有启示意义。服用更少的CHO治疗低血糖可以减少反跳性高血糖发作和减轻体重增加。增加对连续血糖监测的支持是必要的。
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引用次数: 0
Mothers’ Perspectives on a Mother/Infant Dyad Postpartum Primary Care Program Following Gestational Diabetes Mellitus: A Qualitative Pilot Study 母亲对妊娠期糖尿病后母婴死亡产后初级保健计划的看法:一项定性试点研究
IF 1.9 4区 医学 Q1 Health Professions Pub Date : 2022-06-04 DOI: 10.1177/26350106221100539
Jordyn A. Brown, Melissa Leonard, Tiffany Clinton, J. Bower, S. Gillespie, Naleef Fareed, Nikki Thomas, Laura C. Prater, Allison Lorenz, Sara May, Christiane Voisin, S. Thung, R. Oza‐Frank, S. Bose Brill
Purpose: The purpose of this study is to characterize mothers’ experiences within a mother/infant dyad postpartum primary care program (Dyad) following gestational diabetes mellitus (GDM) to inform improvements in the delivery of care. Methods: A qualitative pilot study of women (n = 10) enrolled in a mother/infant Dyad program was conducted in a primary care practice at a large, urban academic medical center. Respondents were asked a series of open-ended questions about their experience with GDM, the Dyad program, and health behaviors. Interviews were audio-recorded, transcribed verbatim, and analyzed using ground theory with NVivo 12 Plus software. Results: Three key themes emerged: (1) Dyad program experience, (2) implementation of health behavior changes, and (3) acknowledgment of future GDM and type 2 diabetes mellitus (T2DM) health risks. Respondents felt that the program conveniently served mother and infant health care needs in a single appointment. Respondents also valued support from primary care providers when implementing health behavior changes. The Dyad program provided an opportunity for respondents to understand their current and future risk for developing GDM and T2DM. Conclusions: Postpartum women enrolled in the Dyad program received highly personalized primary care services. The results of our study will help integrate patient-centered strategies into models for GDM care to maintain patient engagement in postpartum clinical services.
目的:本研究的目的是描述母亲在妊娠期糖尿病(GDM)后的母婴二元产后初级保健计划(dyad)中的经历,为改善护理提供信息。方法:对女性(n = 10) 在一家大型城市学术医疗中心的初级保健实践中,参加了母亲/婴儿Dyad项目。受访者被问及一系列关于GDM、Dyad项目和健康行为的开放式问题。访谈被录音,逐字逐句转录,并使用NVivo 12 Plus软件使用基础理论进行分析。结果:出现了三个关键主题:(1)Dyad项目经验,(2)健康行为改变的实施,以及(3)对未来GDM和2型糖尿病(T2DM)健康风险的认识。受访者认为,该计划只需一次预约就可以方便地满足母婴保健需求。受访者在实施健康行为改变时也重视初级保健提供者的支持。Dyad项目为受访者提供了一个机会,让他们了解自己目前和未来患GDM和T2DM的风险。结论:参加Dyad计划的产后妇女得到了高度个性化的初级保健服务。我们的研究结果将有助于将以患者为中心的策略整合到GDM护理模型中,以保持患者参与产后临床服务。
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引用次数: 3
Regional Comparison of Diabetes Psychosocial Comorbidities Among Americans With Type 1 Diabetes During the COVID-19 Pandemic COVID-19大流行期间美国1型糖尿病患者糖尿病社会心理合并症的区域比较
IF 1.9 4区 医学 Q1 Health Professions Pub Date : 2022-05-31 DOI: 10.1177/26350106221102863
S. Abdoli, Evah W. Odoi, Mehri Doosti-Irani, P. Fanti, L. Beebe
Purpose The purpose of this study was to compare diabetes psychosocial comorbidities among adults with type 1 diabetes (T1D) across the United States during the onset of COVID-19 pandemic. Methods Adults with T1D from 4 main US geographic regions including South (n = 367), West (n = 234), Northeast (n = 250), and Midwest (n = 247) completed a cross-sectional online survey between April and June 2020. Data collection was done on psychosocial measures, glycemic variability, sociodemographic characteristics, and various challenges related to the COVID-19 pandemic. Chi-square, Fisher’s exact, Kruskal-Wallis tests, ordinary least squares, proportional odds, and ordinal logistic regression methods were used for data analysis. Results In the South, 51.2% of participants had moderate to high levels of diabetes distress, and this was significantly (P = .03) higher than other regions. Northeast region had the lowest prevalence of moderate to severe diabetes burnout (19.8%), but this was not significantly different compared to the other regions. Participants in the South had also the highest mean score on the 8-item Patient Health Questionnaire, with 30.3% of them reporting moderate to severe depressive symptoms. However, there were no significant differences in depressive symptoms among the regions. Glycemic control, demographic characteristics, and COVID-19-related challenges were associated with different psychosocial comorbidities in different regions. Conclusions When providing information and support to individuals with diabetes in time of crisis like the COVID pandemic, providers should consider psychosocial aspects of diabetes care. Diabetes disparities and contextual factors vary geographically in the United States; these factors may impact the psychosocial comorbidities of diabetes in each region.
本研究的目的是比较2019冠状病毒病大流行期间美国1型糖尿病(T1D)成年患者的糖尿病社会心理合并症。方法2020年4月至6月,来自美国南部(n = 367)、西部(n = 234)、东北部(n = 250)和中西部(n = 247) 4个主要地理区域的成年T1D患者完成了一项横断面在线调查。收集了有关社会心理测量、血糖变异性、社会人口特征以及与COVID-19大流行相关的各种挑战的数据。采用卡方检验、Fisher精确检验、Kruskal-Wallis检验、普通最小二乘法、比例赔率和有序逻辑回归方法进行数据分析。在南方,51.2%的参与者有中度到高度的糖尿病困扰,这比其他地区显著(P = .03)高。东北地区中重度糖尿病倦怠患病率最低(19.8%),但与其他地区比较差异不显著。南方的参与者在8项患者健康问卷上的平均得分也最高,其中30.3%的人报告有中度至重度抑郁症状。然而,各地区在抑郁症状方面没有显著差异。不同地区的血糖控制、人口统计学特征和covid -19相关挑战与不同的社会心理合并症相关。在像COVID大流行这样的危机时期向糖尿病患者提供信息和支持时,提供者应考虑糖尿病护理的社会心理方面。在美国,糖尿病的差异和环境因素各不相同;这些因素可能影响每个地区糖尿病的社会心理合并症。
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引用次数: 3
Revisiting The Association of Diabetes Care & Education Specialists (ADCES) 2019-2023 Strategic Plan and Research Agenda 回顾糖尿病护理和教育专家协会(ADCES) 2019-2023年战略计划和研究议程
IF 1.9 4区 医学 Q1 Health Professions Pub Date : 2022-04-26 DOI: 10.1177/26350106221098995
J. Fain
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引用次数: 0
The Role of the Diabetes Care and Education Specialist in the Hospital Setting 糖尿病护理和教育专家在医院环境中的作用
IF 1.9 4区 医学 Q1 Health Professions Pub Date : 2022-04-21 DOI: 10.1177/26350106221094332
It is the position of Association of Diabetes Care & Education Specialists that all inpatient interdisciplinary teams include a diabetes care and education specialist to lead or support quality improvement initiatives that affect persons hospitalized with diabetes and/or hyperglycemia. This encompasses not only patient, family, and caregiver education but also education of interdisciplinary team members and achievement of diabetes-related organizational quality metrics and performance outcomes.
糖尿病护理与教育专家协会的立场是,所有住院跨学科团队都包括一名糖尿病护理和教育专家,以领导或支持影响糖尿病和/或高血糖住院患者的质量改进举措。这不仅包括患者、家庭和护理人员的教育,还包括跨学科团队成员的教育,以及糖尿病相关组织质量指标和绩效结果的实现。
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引用次数: 3
Exploring the Perspective of Diabetes, Diabetes Self-Management, and Quality of Life Among Older Adults With Type 2 Diabetes: A Qualitative Study Before and During the COVID-19 Pandemic 探索老年2型糖尿病患者的糖尿病、糖尿病自我管理和生活质量:一项在COVID-19大流行之前和期间的定性研究
IF 1.9 4区 医学 Q1 Health Professions Pub Date : 2022-04-21 DOI: 10.1177/26350106221094527
Jamaica Pei Ying Tan, S. J. Seah, S. Harding, Jin Yu Pay, Jing Wang, Su Aw, Jocelin Lam, Raymond Boon Tar Lim
Purpose The purpose of the study was to explore the perspective and impact of diabetes, diabetes self-management, and quality of life (QoL) among older adults with Type 2 diabetes (T2DM) before and during the COVID-19 pandemic to better inform T2DM self-management interventions. Methods A qualitative descriptive approach with focus group discussions (n = 5 sessions with 5-6 older adults per session) and in-depth interviews (n = 15) was conducted with community-dwelling older adults with T2DM. Results Five themes emerged. The definition of diabetes carries negative connotations, QoL is defined in terms of biopsychosocial health, diabetes self-management refers to the ability to adhere to medical advice and lifestyle changes, the QoL of older adults is differentially affected by COVID-19 measures, and important aspects of diabetes self-management activities are impacted by COVID-19 measures. Conclusions Understanding older adults’ perspectives on diabetes, diabetes self-management, and QoL provided insights into the facilitators and barriers to diabetes self-management practices before and during the COVID-19 pandemic. Findings inform the need for greater bottom-up initiatives and the need for a multipronged approach that considers the intra- and interpersonal and current policy factors to encourage diabetes self-management behaviors, especially during the COVID-19 era.
本研究的目的是探讨在COVID-19大流行之前和期间老年2型糖尿病(T2DM)患者的糖尿病、糖尿病自我管理和生活质量(QoL)的观点和影响,以更好地为T2DM自我管理干预提供信息。方法采用定性描述方法,对社区居住的老年T2DM患者进行焦点小组讨论(n = 5次,每次5-6名老年人)和深度访谈(n = 15)。结果出现了5个主题。糖尿病的定义带有负面含义,生活质量是根据生物心理社会健康来定义的,糖尿病自我管理是指坚持医疗建议和改变生活方式的能力,老年人的生活质量受到COVID-19措施的不同影响,糖尿病自我管理活动的重要方面受到COVID-19措施的影响。了解老年人对糖尿病、糖尿病自我管理和生活质量的看法,有助于了解2019冠状病毒病大流行之前和期间糖尿病自我管理实践的促进因素和障碍。调查结果表明,需要采取更多自下而上的举措,并需要采取多管齐下的方法,考虑到内部和人际以及当前的政策因素,以鼓励糖尿病自我管理行为,特别是在COVID-19时代。
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引用次数: 0
The Feasibility and Acceptability of a Community-Developed Health Insurance and Financial Toolkit for Emerging Adults With Type 1 Diabetes 社区开发的1型糖尿病新兴成年人健康保险和金融工具包的可行性和可接受性
IF 1.9 4区 医学 Q1 Health Professions Pub Date : 2022-03-15 DOI: 10.1177/26350106221087474
Julia E. Blanchette, Nancy A. Allen, Michelle L. Litchman
Purpose: The purpose of the study was to assess the feasibility and acceptability of a financial stress and health insurance education toolkit developed by a community advisory board for emerging adults, ages 18 to 25, with type 1 diabetes. Methods: This study is a longitudinal, randomized controlled trial that enrolled 39 emerging adults with type 1 diabetes. Participants randomized to the intervention group were given access to the T1D Financial Toolkit, an online financial and health insurance education toolkit, over 30 days. For the present analysis, feasibility was assessed by enrollment and attrition. Optional, qualitative interviews were conducted upon the conclusion of the intervention to evaluate feasibility, acceptability, satisfaction, and key recommendations for improvement. Results: Of the 39 participants who enrolled, 36 completed the study. The intervention period had 100% completion in both the control and intervention groups. Eleven participants from the intervention group completed interviews. Participants described few challenges accessing the toolkit and were highly satisfied with the intervention aesthetics, display, and content. Key recommendations included integrating more applied problem-solving into the experience of watching the videos. Conclusions: The T1D Financial Toolkit is a financial and health insurance education intervention tailored to emerging adults with type 1 diabetes. This resource is feasible, acceptable, and satisfactory. Diabetes care and education specialists can utilize this tool in practice to provide relevant, developmentally tailored education to emerging adults with type 1 diabetes, prompt applied problem-solving, reduce barriers to self-management, and improve psychosocial outcomes.
目的:该研究的目的是评估一个社区咨询委员会为18至25岁的1型糖尿病新兴成年人开发的经济压力和健康保险教育工具包的可行性和可接受性。方法:本研究是一项纵向随机对照试验,纳入了39名新出现的1型糖尿病成年人。随机分配到干预组的参与者可以使用T1D金融工具包,这是一个在线金融和健康保险教育工具包,超过30人 天。在本分析中,可行性是通过招生和自然减员进行评估的。在干预结束后进行了可选的定性访谈,以评估可行性、可接受性、满意度和关键的改进建议。结果:在39名参与者中,36人完成了研究。对照组和干预组的干预期均达到100%。干预组的11名参与者完成了访谈。参与者描述了访问工具包的一些挑战,并对干预美学、展示和内容非常满意。主要建议包括将更多的应用性问题解决融入观看视频的体验中。结论:T1D财务工具包是一种针对1型糖尿病新兴成年人的财务和健康保险教育干预措施。这种资源是可行的、可接受的和令人满意的。糖尿病护理和教育专家可以在实践中利用这一工具,为新出现的1型糖尿病成年人提供相关的、针对发展的教育,促进应用性解决问题,减少自我管理的障碍,并改善心理社会结果。
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引用次数: 1
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Science of Diabetes Self-Management and Care
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