scholarly journals Characterizing the transition from paediatric to adult care among emerging adults with Type 1 diabetes

2013 ◽  
Vol 30 (5) ◽  
pp. 610-615 ◽  
Author(s):  
V. S. Helgeson ◽  
K. A. Reynolds ◽  
P. R. Snyder ◽  
D. K. Palladino ◽  
D. J. Becker ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Emerging Adults ◽  
Adult Care

scholarly journals Experiences and perspectives of the parents of emerging adults living with type 1 diabetes

2020 ◽  
Vol 8 (1) ◽  
pp. e001125
Author(s):  
Cheryl Pritlove ◽  
Benjamin Markowitz ◽  
Geetha Mukerji ◽  
Andrew Advani ◽  
Janet A Parsons
Keyword(s):  
Type 1 Diabetes ◽  
Emerging Adulthood ◽  
Emerging Adults ◽  
Diabetes Management ◽  
Self Management ◽  
Comparative Approach ◽  
Transition To Adult Care ◽  
Adult Care ◽  
Difficult Time

IntroductionWhereas it is widely recognized that emerging adulthood can be a difficult time in the life of an individual living with type 1 diabetes, relatively little is known about the experiences of their parents or guardians. These individuals once shouldered much of the burden for their child’s diabetes ‘self’-management, yet their contribution is often overlooked by the adult healthcare system. Here, we set out to gain an understanding of the perspectives of parents of emerging adults living with type 1 diabetes.Research design and methodsSemi-structured interviews were performed with a purposeful sample of parents of emerging adults with type 1 diabetes recruited from two urban young adult diabetes clinics and through a national diabetes charity. Thematic coding was derived using a constant comparative approach.ResultsAnalysis of interviews with 16 parents of emerging adults with type 1 diabetes identified three themes: parental experiences of the transition to adult care; negotiating parent–child roles, responsibilities and relationships; and new and evolving fears. Parents spoke in detail about the time surrounding their child’s diagnosis of type 1 diabetes to emphasize the complexity of diabetes care and the need to establish a ‘new normal’ for the family. In turn, adolescence and emerging adulthood required a renegotiation of roles and responsibilities, with many parents continuing to play a role in high-level diabetes management. Several parents of emerging adults with type 1 diabetes (particularly those of young men) vocalized worries about their child’s readiness to assume responsibility for their self-care, and some expressed frustration with the apparent dichotomy in the role expectations of parents between the pediatric and adult care settings.ConclusionsAdult healthcare providers should recognize both the ongoing involvement of parents in the ‘self’-management of emerging adults with type 1 diabetes and the unique aspects of the caregiver burden that they experience.

scholarly journals Opportunities for Enhanced Transition of Care Preparation for Adolescents and Emerging Adults With Type 1 Diabetes: Use of the READDY Transition Tool

2021 ◽  
Author(s):  
Camilia L. Kamoun ◽  
Jane C. Khoury ◽  
Sarah J. Beal ◽  
Nancy Crimmins ◽  
Sarah D. Corathers
Keyword(s):  
Type 1 Diabetes ◽  
Emerging Adults ◽  
Retrospective Chart Review ◽  
Educational Interventions ◽  
Adult Care ◽  
Patient Reported ◽  
The Impact ◽  
Transition Preparation ◽  
Confidence Ratings

There is an ongoing need to determine best practices for effective transition from pediatric to adult care for adolescents and emerging adults EAs with type 1 diabetes given the potential for poor health outcomes post-transfer. This study evaluated self-reported confidence ratings as measured by the Readiness of Emerging Adults with Diabetes Diagnosed in Youth (READDY) tool among adolescents and EAs with type 1 diabetes and the association of the confidence ratings with clinical and demographic characteristics, as well as provider documentation of relevant anticipatory guidance topics. The READDY is a diabetes-specific tool used to collect patient-reported confidence in transition preparation topics to target educational interventions. These interventions are divided into four domains: Diabetes Knowledge, Health System Navigation, Insulin Self-Management, and Health Behaviors. A retrospective chart review was conducted of patients 15–24 years of age with type 1 diabetes who completed the READDY between January 2017 and January 2018 at a single center. Overall patient-reported confidence levels were high. However, adolescents and EAs endorsed their lowest levels of confidence on items assessing knowledge of alcohol, tobacco, sexual health, and the impact of diabetes on pregnancy (females only), with the percentages of low scores of 20.7, 25.9, 35.9, and 42.9%, respectively. Documentation of provider counseling about screening and prevention of diabetes comorbidities, alcohol use, and tobacco use was associated with scores in the higher range for the corresponding item in the READDY. These findings highlight an opportunity to create interventions related to developmentally important topics for adolescents and EAs with type 1 diabetes to enhance successful transition preparation.

scholarly journals Group education for adolescents with type 1 diabetes during transition from paediatric to adult care: study protocol for a multisite, randomised controlled, superiority trial (GET-IT-T1D)

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e033806
Author(s):  
Elise Mok ◽  
Melanie Henderson ◽  
Kaberi Dasgupta ◽  
Elham Rahme ◽  
Mohammad Hajizadeh ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Cost Effectiveness ◽  
Emerging Adults ◽  
Adult Care ◽  
Group Education ◽  
Transition Care ◽  
Superiority Trial ◽  
Adult Diabetes ◽  
Secondary Outcomes

IntroductionTransition from paediatric to adult care is challenging for adolescents and emerging adults (ages 18 to 30 years) with type 1 diabetes (T1D). This transition is characterised by a deterioration in glycaemic control (haemoglobin A1c (HbA1c)), decreased clinical attendance, poor self-management and increased acute T1D-related complications. However, evidence to guide delivery of transition care is lacking. Given the effectiveness of group education in adult diabetes glycaemic control and improvements in qualitative measures in paediatric diabetes, group education is a potentially feasible and cost-effective alternative for the delivery of transition care. In emerging adults with T1D, we aim to assess the effectiveness of group education visits compared with usual care on HbA1c, T1D-related complications, psychosocial measures and cost-effectiveness after the transfer to adult care.Methods and analysisIn a multisite, assessor-blinded, randomised, two-arm, parallel-group, superiority trial, 212 adolescents with T1D (ages 17 years) are randomised to 12 months group education versus usual T1D care before transfer to adult care. Visits in the active arm consist of group education sessions followed by usual T1D care visits every 3 months. Primary outcome is change in HbA1c measured at 24 months. Secondary outcomes are delays in establishing adult diabetes care, T1D-related hospitalisations and emergency department visits, severe hypoglycaemia, stigma, self-efficacy, diabetes knowledge, transition readiness, diabetes distress, quality of life and cost-effectiveness at 12 and 24 months follow-up. Analysis will be by intention-to-treat. Change in HbA1c will be calculated and compared between arms using differences (95% CI), along with cost-effectiveness analysis. A similar approach will be conducted to examine between-arm differences in secondary outcomes.Ethics and disseminationThe study was approved by McGill University Health Centre Research Ethics Board (GET-IT/MP-37-2019-4434, version ‘Final 1.0 from November 2018). Study results will be disseminated through peer-reviewed publications.Trial registration numberNCT03703440.

scholarly journals Opportunities for Enhanced Transition of Care Preparation for Adolescents and Emerging Adults With Type 1 Diabetes: Use of the READDY Transition Tool

2021 ◽  
Author(s):  
Camilia L. Kamoun ◽  
Jane C. Khoury ◽  
Sarah J. Beal ◽  
Nancy Crimmins ◽  
Sarah D. Corathers
Keyword(s):  
Type 1 Diabetes ◽  
Emerging Adults ◽  
Retrospective Chart Review ◽  
Educational Interventions ◽  
Adult Care ◽  
Patient Reported ◽  
The Impact ◽  
Transition Preparation ◽  
Confidence Ratings

There is an ongoing need to determine best practices for effective transition from pediatric to adult care for adolescents and emerging adults EAs with type 1 diabetes given the potential for poor health outcomes post-transfer. This study evaluated self-reported confidence ratings as measured by the Readiness of Emerging Adults with Diabetes Diagnosed in Youth (READDY) tool among adolescents and EAs with type 1 diabetes and the association of the confidence ratings with clinical and demographic characteristics, as well as provider documentation of relevant anticipatory guidance topics. The READDY is a diabetes-specific tool used to collect patient-reported confidence in transition preparation topics to target educational interventions. These interventions are divided into four domains: Diabetes Knowledge, Health System Navigation, Insulin Self-Management, and Health Behaviors. A retrospective chart review was conducted of patients 15–24 years of age with type 1 diabetes who completed the READDY between January 2017 and January 2018 at a single center. Overall patient-reported confidence levels were high. However, adolescents and EAs endorsed their lowest levels of confidence on items assessing knowledge of alcohol, tobacco, sexual health, and the impact of diabetes on pregnancy (females only), with the percentages of low scores of 20.7, 25.9, 35.9, and 42.9%, respectively. Documentation of provider counseling about screening and prevention of diabetes comorbidities, alcohol use, and tobacco use was associated with scores in the higher range for the corresponding item in the READDY. These findings highlight an opportunity to create interventions related to developmentally important topics for adolescents and EAs with type 1 diabetes to enhance successful transition preparation.

Adult care providers’ perspectives on the transition to adult care for emerging adults with Type 1 diabetes: a cross-sectional survey

2018 ◽  
Vol 35 (7) ◽  
pp. 846-854 ◽  
Author(s):  
S. Michaud ◽  
K. Dasgupta ◽  
L. Bell ◽  
J.-F. Yale ◽  
N. Anjachak ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Emerging Adults ◽  
Transition To Adult Care ◽  
Care Providers ◽  
Cross Sectional Survey ◽  
Adult Care ◽  
Cross Sectional

"It Was All Trial and Error"—The Perspective of Parents of Emerging Adults with Type 1 Diabetes during the Transition to Independence

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 719-P
Author(s):  
ANASTASIA ALBANESE-O'NEILL ◽  
SARAH C. WESTEN ◽  
NICOLE T. THOMAS ◽  
MICHAEL J. HALLER ◽  
DESMOND SCHATZ
Keyword(s):  
Type 1 Diabetes ◽  
Emerging Adults ◽  
Trial And Error ◽  
Transition To Independence

817-P: Financial Stress Factors, Psychological Factors, and Self-Management Outcomes in Emerging Adults with Type 1 Diabetes

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 817-P
Author(s):  
JULIA E. BLANCHETTE ◽  
VALERIE B. TOLY ◽  
JAMIE R. WOOD ◽  
CAROL M. MUSIL ◽  
DIANA L. MORRIS ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Emerging Adults ◽  
Psychological Factors ◽  
Financial Stress ◽  
Stress Factors ◽  
Self Management
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