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Diabetes care provision: barriers, enablers and service needs of young adults with Type 1 diabetes from a region of social disadvantage

Kibbey, K. J., Speight, J., Wong, J. L. A., Smith, L. A. and Teede, H. J. 2013, Diabetes care provision: barriers, enablers and service needs of young adults with Type 1 diabetes from a region of social disadvantage, Diabetic medicine, vol. 30, no. 7, pp. 878-884, doi: 10.1111/dme.12227.

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Title Diabetes care provision: barriers, enablers and service needs of young adults with Type 1 diabetes from a region of social disadvantage
Author(s) Kibbey, K. J.
Speight, J.ORCID iD for Speight, J. orcid.org/0000-0002-1204-6896
Wong, J. L. A.
Smith, L. A.
Teede, H. J.
Journal name Diabetic medicine
Volume number 30
Issue number 7
Start page 878
End page 884
Total pages 7
Publisher Wiley-Blackwell Publishing
Place of publication Chichester, England
Publication date 2013-07
ISSN 0742-3071
1464-5491
Keyword(s) psychology
diabetes mellitus
emotional distress
optimal engagement
Summary AIMS:
To determine the barriers to and enablers of engaging with specialist diabetes care and the service requirements of young adults with Type 1 diabetes mellitus from a low socio-economic, multicultural region.

METHODS:
A cross-sectional survey targeted 357 young adults with Type 1 diabetes, aged 18-30 years. Participants completed questions about barriers/enablers to accessing diabetes care and service preferences, self-reported HbA(1c), plus measures of diabetes-related distress (Problem Areas in Diabetes), depression/anxiety (Hospital Anxiety and Depression Scale), and illness perceptions (Brief Illness Perceptions Questionnaire).

RESULTS:
Eighty-six (24%) responses were received [55 (64%) female; mean ± sd age 24 ± 4 years; diabetes duration 12 ± 7 years; HbA(1c) 68 ± 16 mmol/mol (8.4 ± 1.5%)]. Logistical barriers to attending diabetes care were reported; for example, time constraints (30%), transportation (26%) and cost (21%). However, 'a previous unsatisfactory diabetes health experience' was cited as a barrier by 27%. Enablers were largely matched to overcoming these barriers. Over 90% preferred a multidisciplinary team environment, close to home, with after-hours appointment times. Forty per cent reported severe diabetes-related distress, 19% reported moderate-to-severe depressive symptoms and 50% reported moderate-to-severe anxiety.

CONCLUSIONS:
Among these young adults with Type 1 diabetes, glycaemic control was suboptimal and emotional distress common. They had identifiable logistical barriers to accessing and maintaining contact with diabetes care services, which can be addressed with flexible service provision. A substantial minority were discouraged by previous unsatisfactory experiences, suggesting health providers need to improve their interactions with young adults. This research will inform the design of life-stage-appropriate diabetes services targeting optimal engagement, access, attendance and ultimately improved healthcare outcomes in this vulnerable population.
Language eng
DOI 10.1111/dme.12227
Field of Research 170106 Health, Clinical and Counselling Psychology
111712 Health Promotion
111714 Mental Health
Socio Economic Objective 920401 Behaviour and Health
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2013, Wiley-Blackwell Publishing
Persistent URL http://hdl.handle.net/10536/DRO/DU:30056022

Document type: Journal Article
Collection: School of Psychology
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Created: Tue, 17 Sep 2013, 14:10:57 EST by Claudia Gasch

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