Parental perspectives following the implementation of advanced hybrid closed-loop therapy in children and adolescents with type 1 diabetes and elevated glycaemia.

IF 3.2 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Sin-Ting Tiffany Lai, Sara E Styles, Alisa Boucsein, Yongwen Zhou, Venus Michaels, Craig Jefferies, Esko Wilshire, Martin I De Bock, Benjamin J Wheeler
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引用次数: 0

Abstract

Aims: To identify from a parental perspective facilitators and barriers of effective implementation of advanced hybrid closed-loop (AHCL) therapy in children and adolescents with type 1 diabetes (T1D) with elevated glycaemia.

Methods: Semi-structured interviews were conducted with parents of participants while in a post-trial extension phase of the CO-PILOT randomized controlled trial. The Capability, Opportunity, Motivation, Behaviour Model and Theoretical Domain Framework informed the interviews and framework analysis.

Results: Eleven parents of 9 children and adolescents were interviewed. The median age of their children and adolescents was 14.2 years (IQR 13.3-14.7) with median HbA1c 78 mmol/mol (IQR 75-86) (9.3% IQR 9-10) before starting AHCL. Facilitators of implementing AHCL therapy included the following: (1) knowledge acquired from training, (2) establishing routines and action plans, (3) remote glucose monitoring, (4) achievement of glycaemic goals through automation, (5) children/adolescents' capability to use AHCL independently, (6) improved outcomes incentivized continued AHCL, (7) optimism about sustained improvements and (8) social support from healthcare providers, school staff, peers and parents. Barriers to AHCL implementation included the following: (1) challenges with device usability, (2) need for technical support, (3) forgotten knowledge and skills, (4) non-adherence to best practices, (5) negative social influences, (6) physical and psychosocial burden and (7) negative emotions.

Conclusions: This study provides comprehensive insights into parental perspectives of influences on implementing AHCL therapy in children and adolescents with elevated glycaemia. As parents remain key partners in diabetes care, these findings inform successful implementation of AHCL and development of future diabetes technology.

对患有 1 型糖尿病且血糖升高的儿童和青少年实施先进的混合闭环疗法后家长的看法。
目的:从家长的角度确定在血糖升高的 1 型糖尿病(T1D)儿童和青少年中有效实施高级混合闭环疗法(AHCL)的促进因素和障碍:在 CO-PILOT 随机对照试验的试验后推广阶段,对参与者的父母进行了半结构化访谈。能力、机会、动机、行为模型和理论领域框架为访谈和框架分析提供了依据:对 9 名儿童和青少年的 11 位家长进行了访谈。他们的子女和青少年的年龄中位数为 14.2 岁(IQR 13.3-14.7),开始接受 AHCL 治疗前的 HbA1c 中位数为 78 mmol/mol(IQR 75-86)(9.3% IQR 9-10)。实施 AHCL 治疗的促进因素包括以下几点:(1) 从培训中获得知识;(2) 制定常规和行动计划;(3) 远程血糖监测;(4) 通过自动化实现血糖目标;(5) 儿童/青少年具备独立使用 AHCL 的能力;(6) 持续使用 AHCL 的激励因素包括治疗效果的改善;(7) 对持续改善持乐观态度;(8) 来自医疗服务提供者、学校教职员工、同伴和家长的社会支持。AHCL实施的障碍包括以下几点:(1)设备可用性方面的挑战,(2)需要技术支持,(3)忘记知识和技能,(4)不遵守最佳实践,(5)负面社会影响,(6)身体和心理负担,(7)负面情绪:本研究从家长的角度全面探讨了对血糖升高的儿童和青少年实施 AHCL 治疗的影响因素。由于家长仍然是糖尿病护理的重要合作伙伴,这些研究结果为成功实施 AHCL 和开发未来的糖尿病技术提供了参考。
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来源期刊
Diabetic Medicine
Diabetic Medicine 医学-内分泌学与代谢
CiteScore
7.20
自引率
5.70%
发文量
229
审稿时长
3-6 weeks
期刊介绍: Diabetic Medicine, the official journal of Diabetes UK, is published monthly simultaneously, in print and online editions. The journal publishes a range of key information on all clinical aspects of diabetes mellitus, ranging from human genetic studies through clinical physiology and trials to diabetes epidemiology. We do not publish original animal or cell culture studies unless they are part of a study of clinical diabetes involving humans. Categories of publication include research articles, reviews, editorials, commentaries, and correspondence. All material is peer-reviewed. We aim to disseminate knowledge about diabetes research with the goal of improving the management of people with diabetes. The journal therefore seeks to provide a forum for the exchange of ideas between clinicians and researchers worldwide. Topics covered are of importance to all healthcare professionals working with people with diabetes, whether in primary care or specialist services. Surplus generated from the sale of Diabetic Medicine is used by Diabetes UK to know diabetes better and fight diabetes more effectively on behalf of all people affected by and at risk of diabetes as well as their families and carers.”
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