在2019冠状病毒病大流行期间管理1型糖尿病是一项团队努力:对年轻人及其父母的经历进行定性研究

Integrated healthcare journal Pub Date : 2021-11-09 eCollection Date: 2021-01-01 DOI:10.1136/ihj-2021-000082
Anne Parkinson, Nicola Brew-Sam, Sally Hall Dykgraaf, Christopher Nolan, Antony Lafferty, Robert Schmidli, Ellen Brown, Karen Brown, Lachlan Pedley, Harry Ebbeck, Elizabeth Pedley, Kristine Wright, Christine Phillips, Jane Desborough
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摘要

目的了解2019冠状病毒病(COVID-19)大流行期间澳大利亚首都地区1型糖尿病(T1DM)青少年及其父母获得以家庭为中心的综合护理的经历。方法和分析这是一项实用的定性描述性研究,我们对11名12-16岁的T1DM年轻人和10名他们的父母进行了半结构化访谈,他们在澳大利亚堪培拉参加了门诊糖尿病服务。主题分析是根据Braun和Clarke提出的方法进行的。结果确定了三个主题:感觉脆弱、获得护理的新途径和对跨学科糖尿病保健团队的信任。参与者认为,如果他们感染了COVID-19,患有T1DM的人更容易受到不良后果的影响,从而避免了面对面的护理。电话咨询提供了一种方便和无需联系的方式来进行3个月的审查。电话咨询和面对面咨询的最大区别在于,一次预约不能接触到整个跨学科糖尿病支持小组,在远程保健咨询期间不能进行体检和血红蛋白A1c检测。参加者相信,如有需要,临床医生会安排面对面的会议。有些人认为录象办法可能比电话办法更好,这部分反映出需要对远程协商的沟通技巧进行更多的培训。结论青年T1DM患者及其父母需要协同护理,并与多名医护人员联系,以促进自我管理和血糖控制。虽然在2019冠状病毒病大流行期间,电话咨询为医护人员提供了方便、安全、无接触的途径,但在未来的远程医疗临床实施中,需要考虑视频咨询的附加价值和促进整个跨学科糖尿病支持团队的获取。
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Managing type 1 diabetes during the COVID-19 pandemic is a team effort: a qualitative study of the experiences of young people and their parents.

Objective: To explore the experiences of young people with type 1 diabetes mellitus (T1DM) and their parents in accessing integrated family-centred care in the Australian Capital Territory during the COVID-19 pandemic.

Methods and analysis: This is a pragmatic, qualitative descriptive study for which we conducted semistructured interviews with 11 young people with T1DM aged 12-16 years and 10 of their parents who attended an outpatient diabetes service in Canberra, Australia. Thematic analysis was conducted in accordance with the methods outlined by Braun and Clarke.

Results: Three themes were identified: feeling vulnerable, new ways of accessing care and trust in the interdisciplinary diabetes healthcare team. Participants believed having T1DM made them more vulnerable to poor outcomes if they contracted COVID-19, resulting in avoidance of face-to-face care. Telephone consultations offered a convenient and contact-free way to undertake 3-monthly reviews. The greatest difference between telephone and face-to-face consultations was not having access to the whole interdisciplinary diabetes support team at one appointment, physical examination and haemoglobin A1c testing during telehealth consultations. Participants trusted that clinicians would arrange face-to-face meetings if required. Some felt a video option might be better than telephone, reflecting in part the need for more training in communication skills for remote consultations.

Conclusion: Young people with T1DM and their parents require collaborative care and contact with multiple healthcare professionals to facilitate self-management and glycaemic control. While telephone consultations offered convenient, safe, contact-free access to healthcare professionals during the COVID-19 pandemic, the added value of video consultations and facilitating access to the whole interdisciplinary diabetes support team need to be considered in future clinical implementation of telehealth.

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