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    Date Issued2019 (1)2016 (1)Author
    Ramchandani, Neesha (2)
    Lee, Mary M. (1)Maguire, Laura L. (1)Melkus, Gail D'Eramo (1)Quintos, Jose B. (1)View MoreUMass Chan AffiliationGraduate School of Nursing (2)Department of Pediatrics (1)Document TypeJournal Article (2)KeywordEndocrine System Diseases (1)Endocrinology, Diabetes, and Metabolism (1)Health Services Administration (1)Nursing (1)Nutritional and Metabolic Diseases (1)View MoreJournalPatient education and counseling (1)The Diabetes educator (1)

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    Challenges to Diabetes Self-Management in Emerging Adults With Type 1 Diabetes

    Ramchandani, Neesha; Way, Niobe; Melkus, Gail D'Eramo; Sullivan-Bolyai, Susan L. (2019-10-01)
    PURPOSE: The purpose of this qualitative descriptive study undergirded by Meleis's Transition Framework was to explore developmental, situational, and organizational challenges experienced by a diverse group of emerging adults (18-29 years old) with type 1 diabetes (T1DM). Their perspectives on creating a developmentally informed diabetes self-management (DSM) program that supports transitional care were also explored. METHODS: A purposive sample of emerging adults with T1DM was recruited from the pediatric and adult diabetes clinics of an urban academic medical center. Those who consented participated in either a single focus group or a single interview. Self-reported demographic and clinical information was also collected. RESULTS: The sample was comprised of 21 emerging adults, with an average age of 23.6 +/- 2.6 years, diabetes duration of 14.7 +/- 5.0 years, and 71% female. Four main themes emerged: (1) finding a balance between diabetes and life, (2) the desire to be in control of their diabetes, (3) the hidden burden of diabetes, and (4) the desire to have a connection with their diabetes provider. Use of insulin pumps and continuous glucose monitors and attendance at diabetes camp decreased some of the DSM challenges. Different groups of individuals had different perspectives on living with diabetes and different approaches to DSM. CONCLUSIONS: The emerging adults in this study had a strong desire to be in good glycemic control. However, all participants described having a hard time balancing DSM with other competing life priorities. They also desired personalized patient-provider interactions with their diabetes care provider in clinical follow-up services. Even though the study sample was small, important themes emerged that warrant further exploration.
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    PETS-D (parents education through simulation-diabetes): Parents' qualitative results

    Ramchandani, Neesha; Maguire, Laura L.; Stern, Kailyn; Quintos, Jose B.; Lee, Mary M.; Sullivan-Bolyai, Susan (Elsevier, 2016-08-01)
    OBJECTIVE: Parents who have a child newly diagnosed with type 1 diabetes (T1D) must quickly learn daily diabetes self-management. An RCT was conducted using human patient simulation (HPS) to enhance parents learning diabetes self-management with children with new-onset T1D. The purpose of this study was to describe parents' perspectives of using HPS to augment diabetes education. METHODS: A qualitative descriptive design was used with open-ended in-depth interviews of parents (n=49) post-intervention. Qualitative directed content analysis was used. RESULTS: The majority of parents were positive about learning with HPS. Although a few parents said the HPS was "hokey" or "creepy," most reported the visual and hands-on learning was realistic and very beneficial. Seeing a seizure increased their fear although they would have panicked if they had not had that learning experience, and it helped build their diabetes self-management confidence. Recommendations included teaching others with the HPS (grandparents, siblings, babysitters, and school nurses). CONCLUSION: HPS-enhanced education is an acceptable and viable option that was generally well-received by parents of children with new-onset T1D. PRACTICE IMPLICATIONS: The technique should be studied with parents of children with other chronic illnesses to see if the benefits found in this study are applicable to other settings.
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