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1.
Diabet Med ; 35(2): 203-213, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29171084

RESUMO

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 Jovem
2.
BMC Public Health ; 17(1): 938, 2017 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-29241444

RESUMO

BACKGROUND: The increasing number of people with chronic diseases challenges workforce capacity. Type 2 diabetes (T2D) can have work-related consequences, such as early retirement. Laws of most high-income countries require workplaces to provide accommodations to enable people with chronic disabilities to manage their condition at work. A barrier to successful implementation of such accommodations can be lack of co-workers' willingness to support people with T2D. This study aimed to examine the willingness to pay (WTP) of people with and without T2D for five workplace initiatives that help individuals with type 2 diabetes manage their diabetes at work. METHODS: Three samples with employed Danish participants were drawn from existing online panels: a general population sample (n = 600), a T2D sample (n = 693), and a matched sample of people without diabetes (n = 539). Participants completed discrete choice experiments eliciting their WTP (reduction in monthly salary, €/month) for five hypothetical workplace initiatives: part-time job, customized work, extra breaks with pay, and time off for medical consultations with and without pay. WTP was estimated by conditional logits models. Bootstrapping was used to estimate confidence intervals for WTP. RESULTS: There was an overall WTP for all initiatives. Average WTP for all attributes was 34 €/month (95% confidence interval [CI]: 27-43] in the general population sample, 32 €/month (95% CI: 26-38) in the T2D sample, and 55 €/month (95% CI: 43-71) in the matched sample. WTP for additional breaks with pay was considerably lower than for the other initiatives in all samples. People with T2D had significantly lower WTP than people without diabetes for part-time work, customized work, and time off without pay, but not for extra breaks or time off with pay. CONCLUSIONS: For people with and without T2D, WTP was present for initiatives that could improve management of diabetes at the workplace. WTP was lowest among people with T2D. Implementation of these initiatives seems feasible and may help unnecessary exclusion of people with T2D from work.


Assuntos
Comportamento de Escolha , Diabetes Mellitus Tipo 2/prevenção & controle , Emprego/economia , Serviços de Saúde do Trabalhador/economia , Adulto , Dinamarca/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Emprego/organização & administração , Feminino , Humanos , Relações Interprofissionais , Masculino , Pessoa de Meia-Idade
3.
Diabet Med ; 31(1): 15-23, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-23870045

RESUMO

AIMS: Family interventions are increasingly recognized as important in the care of people with diabetes. The aim of this study was to synthesize the existing literature on family interventions among adults with Type 1 and Type 2 diabetes and to determine the degree to which they were family centred. METHODS: The literature search was carried out in four databases (Scopus, CINAHL, PsycINFO and ERIC). Two reviewers independently screened the search results. Only English-language articles about interventions on education, care and/or support of adult individuals with diabetes involving the participation of both the individual with diabetes and at least one family member were included. RESULTS: From an initial 1480 citations, 10 reports were included. The intervention studies varied considerably in terms of design and population. The family dimension generally represented a modest part of the interventions: Two interventions applied a family-relevant theoretical framework. Disease knowledge and lifestyle changes were more prevalent intervention themes than family issues. Biological and behavioural outcomes were most prevalent, whereas psychosocial and family outcomes were used in six of the studies. CONCLUSIONS: The number of trials and statistically significant results in family interventions targeting adults with diabetes is limited. Because of inhomogeneity, it is difficult to come to a conclusion on effective approaches in family interventions. The interventions are inconsistent with regard to theoretical framework, intervention themes and measured outcomes. However, psychosocial and familial dimensions seem sensitive to family-based interventions. From development to evaluation, the family dimension needs to be included to prove the specific effect of family interventions.


Assuntos
Diabetes Mellitus Tipo 1/prevenção & controle , Diabetes Mellitus Tipo 2/prevenção & controle , Relações Familiares , Comportamentos Relacionados com a Saúde , Autocuidado , Adulto , Diabetes Mellitus Tipo 1/tratamento farmacológico , Diabetes Mellitus Tipo 1/psicologia , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/psicologia , Família , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Autocuidado/psicologia
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