Active involvement of young people with T1DM during outpatient hospital consultations: Opportunities and challenges in transitional care services |
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Affiliation: | 1. Research Centre (American English) Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands;2. Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands;3. Nutrition and Dietetics, Hanze University of Applied Sciences, Groningen, The Netherlands |
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Abstract: | ObjectiveLittle is known about active involvement of young people (YP) with type 1 diabetes (T1DM) in transitional care. This study aims to gain insight into patient-provider interactions during outpatient hospital consultations.MethodsSemi-structured observations (n = 61) of outpatient consultations with YP with T1DM (15–25 years) treated in 12 hospitals in the Netherlands. The consultations concerned pediatric care (n = 23), adult care (n = 17), and joint consultations (n = 21). Thematic data analysis focused on whether professionals engaged in open, in-depth conversations; used motivational interviewing techniques; involved YP in shared decision-making; and addressed non-medical topics.ResultsApart from some good examples, the healthcare professionals generally had difficulty interacting adequately with YP. They paid little attention to the YP’s individual attitudes and priorities regarding disease management; non-medical topics remained generally underexposed. Conversations about daily life often remained shallow, as YP’s cues were not taken up. Furthermore, decisions about personal and health-related goals were often not made together.ConclusionBy adopting a more person-centered approach, professionals could empower YP to take an active role in their diabetes management.Practice implicationsUsing a structured conversation model combined with a tool to encourage YP’s agenda-setting and shared decision-making is recommended for more person-centered transitional care in T1DM. |
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Keywords: | Young people Type 1 diabetes mellitus Transition Outpatient consultations Interaction Communication Active patient involvement Self-management Developmentally appropriate care Person-centered care |
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