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Exploring the Needs of Adults Living With Type 1 or 2 Diabetes Distress Using the Problem Areas in Diabetes 5 Tool

Published:August 09, 2022DOI:https://doi.org/10.1016/j.jcjd.2022.07.008

      Abstract

      Objectives

      This study investigated the feasibility and acceptability of implementing a screening tool as a part of routine care and the subsequent screening experiences of patients and clinicians. Additionally, potential sources of DD were identified in this clinical population.

      Methods

      Our investigation was a cross-sectional, mixed-methods, convenience sample of 203 patients living with type 1 or 2 diabetes from 2 Canadian tertiary hospital–based clinics. The PAID5 scale was used to assess DD. Structured telephone interviews of patients with high DD scores and care provider focus group transcriptions were analyzed using a deductive thematic content analysis.

      Results

      The prevalence of DD was 45%. Lack of medication coverage (p=0.02) and presence of neuropathy (p=0.04) were approximately 5- and 2-fold more likely to be predictors of high DD, respectively. Patient interviews identified DD screening as an opportunity to share and feel supported but demonstrated their fear of discussing mental health concerns. Patients found discussion about mental health helpful and often did not require a referral to a mental health specialist. Staff focus groups discussed screening as a feasible tool, but also acknowledged barriers and knowledge gaps that preclude DD screening integration in routine clinical practice. Specialized training for clinicians may help increase confidence and improve uptake of DD screening into routine clinical practice.

      Conclusions

      The prevalence of DD in outpatient care settings is high. Findings suggest that integrating the PAID5 screening tool into regular clinical practice is feasible by patients and care providers.

      Résumé

      Objectifs

      L’objectif de notre étude était de déterminer la prévalence et les prédicteurs de la détresse liée au diabète (DD) et d’explorer la faisabilité et les répercussions de la mise en œuvre de l’outil de dépistage Problem Areas In Diabetes 5 (PAID5) dans la pratique clinique.

      Méthodes

      Notre enquête transversale, par méthodes mixtes, portait sur un échantillon de commodité composé de 203 patients qui vivaient avec le diabète de type 1 ou de type 2 de 2 centres de soins tertiaires en milieu hospitalier du Canada. Nous avons utilisé l’échelle PAID5 pour évaluer la DD. Nous avons utilisé l’approche déductive de l’analyse thématique de contenu pour explorer les entretiens téléphoniques structurés avec des patients dont les scores de DD étaient élevés et les transcriptions des groupes de discussion composés de prestataires de soins.

      Résultats

      La prévalence de la DD était de 45 %. L’absence d’assurance médicaments (p = 0,02) et la présence de neuropathie (p = 0,04) étaient approximativement et respectivement 5 et 2 fois plus susceptibles d’être des prédicteurs d’une grande DD. Les entretiens avec les patients nous ont appris que le dépistage de la DD est une occasion pour eux de partager et de se sentir soutenus, mais ces entretiens nous ont toutefois démontré leur crainte de parler des problèmes de santé mentale. Les patients ont trouvé utile la discussion sur la santé mentale et n’ont pas souvent demandé de les diriger vers un spécialiste en santé mentale. Les groupes de discussion composés du personnel ont mentionné que le dépistage est un outil réalisable, mais ont aussi reconnu les obstacles et les lacunes en matière de connaissances qui empêchent d’intégrer le dépistage de la DD à la pratique clinique courante. Une formation spécialisée des cliniciens peut contribuer à accroître la confiance et favoriser l’adoption du dépistage de la DD dans la pratique clinique courante.

      Conclusions

      La prévalence de la DD dans le contexte des soins externes est élevée. Les résultats montrent que l’intégration de l’outil de dépistage PAID5 à la pratique clinique courante est réalisable par les patients et les prestataires de soins.

      Keywords

      Mots clés

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