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2019冠状病毒病大流行期间管理1型糖尿病需要团队协作:一项关于年轻人及其父母经历的定性研究

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.

作者信息

Parkinson Anne, Brew-Sam Nicola, Hall Dykgraaf Sally, Nolan Christopher, Lafferty Antony, Schmidli Robert, Brown Ellen, Brown Karen, Pedley Lachlan, Ebbeck Harry, Pedley Elizabeth, Wright Kristine, Phillips Christine, Desborough Jane

机构信息

Department of Health Services Research and Policy, Australian National University, Canberra, Australian Capital Territory, Australia.

Medical School, Australian National University, Canberra, Australian Capital Territory, Australia.

出版信息

Integr Healthc J. 2021 Nov 9;3(1):e000082. doi: 10.1136/ihj-2021-000082. eCollection 2021.

Abstract

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.

摘要

目的

探讨1型糖尿病(T1DM)青少年及其父母在新冠疫情期间于澳大利亚首都地区获得以家庭为中心的综合护理的经历。

方法与分析

这是一项实用的定性描述性研究,我们对11名年龄在12至16岁的T1DM青少年及其10名父母进行了半结构化访谈,他们均在澳大利亚堪培拉的一家糖尿病门诊就诊。按照布劳恩和克拉克概述的方法进行了主题分析。

结果

确定了三个主题:感到脆弱、获得护理的新方式以及对跨学科糖尿病医疗团队的信任。参与者认为,感染新冠病毒后,患有T1DM会使他们更容易出现不良后果,从而导致避免面对面护理。电话咨询提供了一种方便且无接触的方式来进行每三个月一次的复查。电话咨询与面对面咨询之间最大的差异在于,远程医疗咨询时无法一次见到整个跨学科糖尿病支持团队、进行体格检查和糖化血红蛋白检测。参与者相信临床医生会在需要时安排面对面会议。一些人认为视频选项可能比电话更好,这部分反映出远程咨询的沟通技巧需要更多培训。

结论

T1DM青少年及其父母需要协作护理,并与多名医疗保健专业人员联系,以促进自我管理和血糖控制。虽然在新冠疫情期间电话咨询为获得医疗保健专业人员的服务提供了方便、安全、无接触的途径,但在未来远程医疗的临床实施中,需要考虑视频咨询的附加价值以及便于接触整个跨学科糖尿病支持团队的问题。

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