|
Citation
|
d'Emden H, McDermott B, D'Silva N, Dover T, Ewais T, Gibbons K, O'Moore-Sullivan T. Intern. Med. J. 2017; 47(4): 415-423. |
|
Affiliation
|
Mater Research, University of Queensland, Brisbane, Australia, 4072. |
|
Abstract
|
BACKGROUND: Routine psychosocial screening and management of people with diabetes is recommended. AIMS: To profile demographic, medical and psychosocial characteristics of young people with diabetes, and to develop a screening tool and care pathway for routine use.
METHODS: Indices of diabetes control and recorded diabetes complications were complimented by psychosocial screening tools assessing psychological, diabetes specific, and perceived stress (K10, PAID, PSS), well-being (WHO-5), disordered eating ((EDI-3RC), compensatory behaviour questionnaire, social support (MSPSS), resilience (CD-2) and financial concerns. Service provision and demographic data was also collected. Diabetes and mental health clinicians then identified a subset of measures to use for routine screening along with care- pathways.
RESULTS: Psychosocial screening was well accepted. Participants (151) had suboptimal glycaemic control (HbA1c 8.0 IQR 1.8%/64 IQR 22 mmol/mol). Severe diabetes related distress (PAID≥40) was found in 19.4% and 26.0% reported difficulties managing health care costs. A mental health disorder was likely in 9.7%, whilst 23.4% had high K10 scores. Low WHO-5 scores (≤13) were seen in 29.0%. Risk for an eating disorder (EDI-3RC) was 12.7%, whereas approximately 36.0% had disturbed eating behaviours.
CONCLUSION: Psychosocial screening of young adults with diabetes identified complex needs. A brief psychosocial screening tool and associated care-pathways were developed for routine use in a young adult tertiary referral diabetes clinic. The tool assesses constructs such as diabetes distress, depression, anxiety, well-being, hypoglycaemia-unawareness, fear of hypoglycaemia, social support, weight, shape and eating concerns and financial concerns. This will provide a longitudinal data source for further research to inform clinical practice.
This article is protected by copyright. All rights reserved.
Language: en |