患有糖尿病的年轻人经常报告对护理不满意,并且与糖尿病相关的健康结果较差。随着糖尿病患病率的持续上升,基于小组的护理可以为传统的一对一咨询提供可持续的替代方案,通过生活阶段吸引年轻人-,对上下文和文化敏感的方法。在这项研究中,我们将为社会经济贫困地区的糖尿病和复杂的健康和社会需求的年轻人共同设计和评估基于小组的护理模式。
这项参与式研究将包括三个阶段。在第1阶段,我们将进行现实主义者的审查,以综合有关糖尿病年轻人的团体护理的文献。这种理论驱动的理解将为第二阶段提供基础,我们将借鉴基于经验的共同设计方法来开发一种新的,针对年轻人的基于群体的护理模式(年龄<25岁,在成人糖尿病服务的照顾下)。在第3阶段,我们将使用研究人员在驻地方法来实施和评估共同设计的小组临床模型,并与传统护理进行比较。我们将采用定性观察(在诊所,患者和工作人员访谈和文件分析)和定量方法(例如,生物标记,患者支持仪器和糖尿病困扰量表),包括成本分析。
已获得国家卫生服务伦理批准(参考17/NI/0019)。该项目将直接告知服务重新设计,以更好地满足社会经济贫困地区的糖尿病年轻人的需求,并可能指导可能的集群随机试验。为临床和成本效益结果提供动力。这项研究的结果可能会转移到其他长期条件和/或年龄组。项目产出将包括简报,摘要和学术论文,为不同的受众量身定制,包括糖尿病患者,临床医生,政策制定者和战略决策者。
PROSPERO(CRD42017058726)。
Young adults with diabetes often report dissatisfaction with care and have poor diabetes-related health outcomes. As diabetes prevalence continues to rise, group-based care could provide a sustainable alternative to traditional one-to-one consultations, by engaging young people through life stage-, context- and culturally-sensitive approaches. In this
study, we will co-design and evaluate a group-based care model for young adults with diabetes and complex health and social needs in socioeconomically deprived areas.
This participatory
study will include three phases. In phase 1, we will carry out a realist review to synthesise the literature on group-based care for young adults with diabetes. This theory-driven understanding will provide the basis for phase 2, where we will draw on experience-based co-design methodologies to develop a new, group-based care model for young adults (aged <25 years, under the care of adult diabetes services). In phase 3, we will use a researcher-in-residence approach to implement and evaluate the co-designed group clinic model and compare with traditional care. We will employ qualitative (observations in clinics, patient and staff interviews and document analysis) and quantitative methods (eg, biological markers, patient enablement instrument and diabetes distress scale), including a cost analysis.
National Health Service ethics approval has been granted (reference 17/NI/0019). The project will directly inform service redesign to better meet the needs of young adults with diabetes in socioeconomically deprived areas and may guide a possible cluster-randomised
trial, powered to clinical and cost-effectiveness outcomes. Findings from this
study may be transferable to other long-term conditions and/or age groups. Project outputs will include briefing statements, summaries and academic papers, tailored for different audiences, including people living with diabetes, clinicians, policy makers and strategic decision makers.
PROSPERO (CRD42017058726).