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Active involvement of young people with T1DM during outpatient hospital consultations: opportunities and challenges in transitional care services

Publication of Innovations in Care

M.A.C. Peeters, H.G. Haan,de, R.A. Bal, A.L. Staa,van, J.N.T. Sattoe | Article | Publication date: 30 September 2021
Objective: Little 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. Methods: Semi-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. Results: Apart 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. Conclusion: By adopting a more person-centered approach, professionals could empower YP to take an active role in their diabetes management. Practice implications: Using 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.

Author(s) - affiliated with Rotterdam University of Applied Sciences

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