RESUMO
AIMS: To identify key gaps in the research evidence base that could help to improve the mental well-being of people with diabetes, and to provide recommendations to researchers and research funders on how best to address them. METHODS: A 2-day international research workshop was conducted, bringing together research experts in diabetes and in mental health, people living with diabetes and healthcare professionals. RESULTS: The following key areas needing increased financial investment in research were identified: understanding the mechanisms underlying depression; understanding the multifactorial impact of social stigma; improving the language used by healthcare professionals; supporting people who find it difficult to engage with their diabetes; supporting significant others; supporting people with diabetes and eating disorders; improving models of care by learning from best practice; the potential benefits of screening and managing diabetes distress in routine diabetes care pathways; primary prevention of mental health issues at the time of diagnosis of diabetes; establishing the effectiveness of diabetes therapies on mood and other mental health issues; and understanding the impact of current diabetes technologies on mental health. Research recommendations as to how to address each of these priority areas were also developed. CONCLUSIONS: This inaugural position statement outlines recommendations to address the urgent unmet need related to the mental well-being of people living with diabetes, and calls on the research community and funders to develop research programmes and strategies to reduce this need.
Assuntos
Diabetes Mellitus/psicologia , Saúde Mental , Afeto , Pesquisa Biomédica , Depressão/epidemiologia , Depressão/terapia , Educação , Medicina Baseada em Evidências , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Humanos , Idioma , Transtornos Mentais/epidemiologia , Transtornos Mentais/prevenção & controle , Qualidade de Vida , Estigma Social , Reino Unido/epidemiologiaRESUMO
AIMS: To compare clinical, psychological, education and social variables in emerging adults (aged 18-30 years) with Type 1 diabetes with their adult counterparts aged >30 years. METHODS: A single assessment multinational sample was surveyed as part of the larger second Diabetes Attitudes, Wishes and Needs (DAWN2) study. Participants completed a series of surveys incorporating demographic as well as clinical questions (comorbidities, hypoglycaemia) and validated self-report scales concerning psychosocial (health impact, quality of life, beliefs and attitudes, self-management behaviours, healthcare experience and family support) and diabetes education factors. RESULTS: Emerging adults differed from adults aged >30 years with regard to a number of psychosocial variables. Emerging adults reported better overall quality of life, social support and support from their healthcare team compared with adults aged >30 years of age; however, emerging adults experienced greater diabetes-specific distress and were less engaged in self-management. Diabetes education was related to a number of indicators, while experience of discrimination was harmful, but these impacts did not differ between emerging adults and adults aged >30 years. An analysis of geographical regions suggested that emerging adults in North America and Europe had better well-being than older adults, while the opposite was observed in Asia. CONCLUSIONS: Emerging adults, particularly those in the later phase (ages 25-30 years) are especially at risk in terms of diabetes-specific distress. There is a need for novel interventions to meet the needs of these vulnerable emerging adults more effectively.
Assuntos
Diabetes Mellitus Tipo 1/psicologia , Adolescente , Adulto , Atitude Frente a Saúde , Glicemia/metabolismo , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 1/terapia , Relações Familiares , Feminino , Humanos , Hipoglicemia/sangue , Hipoglicemia/etiologia , Masculino , Educação de Pacientes como Assunto , Preconceito , Qualidade de Vida , Autogestão , Apoio Social , Estresse Psicológico/etiologia , Transição para Assistência do Adulto , Adulto JovemRESUMO
The language used by healthcare professionals can have a profound impact on how people living with diabetes, and those who care for them, experience their condition and feel about living with it day-to-day. At its best, good use of language, both verbal and written, can lower anxiety, build confidence, educate and help to improve self-care. Conversely, poor communication can be stigmatizing, hurtful and undermining of self-care and can have a detrimental effect on clinical outcomes. The language used in the care of those with diabetes has the power to reinforce negative stereotypes, but it also has the power to promote positive ones. The use of language is controversial and has many perspectives. The development of this position statement aimed to take account of these as well as the current evidence base. A working group, representing people with diabetes and key organizations with an interest in the care of people with diabetes, was established to review the use of language. The work of this group has culminated in this position statement for England. It follows the contribution of Australia and the USA to this important international debate. The group has set out practical examples of language that will encourage positive interactions with those living with diabetes and subsequently promote positive outcomes. These examples are based on a review of the evidence and are supported by a simple set of principles.
Assuntos
Comunicação , Diabetes Mellitus/terapia , Pessoal de Saúde , Idioma , Assistência Centrada no Paciente/normas , Relações Profissional-Paciente , Comitês Consultivos , Barreiras de Comunicação , Inglaterra , Pessoal de Saúde/educação , Pessoal de Saúde/normas , Humanos , Habilidades Sociais , Terminologia como AssuntoRESUMO
National Audit Data highlight persistent sub-optimum control among increasing numbers of people living with diabetes, with severe consequences for the individual and the NHS. The aim of the present review was to introduce a new cohesive, holistic model of care, tailored to individual needs to support optimum diabetes outcomes. This model of diabetes is necessary in order to understand the driving forces behind behaviour and their impact on diabetes management. Feelings (an emotional state or reaction) and beliefs (an acceptance that something is true or real) are fundamental behavioural drivers and influence diabetes self-management choices. Individually, these explain some of the complexities of behaviour and, collectively, they impact on personal motivation (rationale/desire to act) to achieve a specific outcome. Inevitably, they independently affect diabetes self-management and the environment in which individuals live. A model of care that proposes the encompassing of environment, intrinsic thought and therapy regimens to provide tailored, personalized healthcare should support enhanced diabetes self-management and outcomes from diagnosis. The Kaleidoscope model of care could be deliverable in routine care, incorporating each of the influences on diabetes self-management, and should benefit both individuals with diabetes and healthcare professionals.
Assuntos
Diabetes Mellitus/terapia , Saúde Holística/tendências , Autocuidado/tendências , Diabetes Mellitus/psicologia , Humanos , Psicologia , Grupos de Autoajuda , Resultado do TratamentoAssuntos
Comunicação , Idioma , Relações Médico-Paciente , Habilidades Sociais , Comportamento Verbal/fisiologia , Barreiras de Comunicação , Diabetes Mellitus/terapia , Educação Médica Continuada , Promoção da Saúde/métodos , Promoção da Saúde/tendências , Humanos , Assistência Centrada no Paciente/organização & administração , Assistência Centrada no Paciente/normas , Assistência Centrada no Paciente/tendências , Terminologia como AssuntoRESUMO
Diabetes UK is the charity that cares for, connects with and campaigns on behalf of all people affected by and at risk of diabetes. Founded in 1934 by the novelist H. G. Wells and Dr R. D. Lawrence, the charity has always combined the expertise of lay and professional members to achieve its mission to improve the lives of people with diabetes and to work towards a future without diabetes.