Comprehensive psychosocial screening in a pediatric diabetes clinic
| Autor: | Courtney Lynn, Janine Sanchez, Kaitlyn E Brodar, Joyce H. L. Lui, Lolly Starr-Glass, Eileen M. Davis, Alan M Delamater |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Blood Glucose
Male medicine.medical_specialty Adolescent Endocrinology Diabetes and Metabolism medicine.medical_treatment 030209 endocrinology & metabolism Ambulatory Care Facilities Medication Adherence 03 medical and health sciences 0302 clinical medicine Diabetes mellitus Internal Medicine medicine Humans Hypoglycemic Agents Insulin Mass Screening 030212 general & internal medicine Disordered eating Glycemic Blood glucose monitoring Type 1 diabetes medicine.diagnostic_test business.industry Mental Disorders medicine.disease Diabetes Mellitus Type 1 Adolescent Health Services Family medicine Pediatrics Perinatology and Child Health Anxiety Female medicine.symptom business Psychosocial |
| Zdroj: | Pediatric Diabetes. 22:656-666 |
| ISSN: | 1399-5448 1399-543X |
| DOI: | 10.1111/pedi.13193 |
| Popis: | The ISPAD recommends routine, comprehensive psychosocial screening for adolescents with diabetes. However, few clinics have implemented procedures consistent with these guidelines. This study describes the results of a universal, comprehensive psychosocial screening program in an integrated pediatric diabetes clinic located within an academic medical center. Subjects: Participants included 232 ethnically diverse adolescents with type 1 diabetes (55.5% female; M age = 14.85; 58.5% Hispanic; 20% Black). Adolescents completed screening measures on iPads in the waiting room before their medical visit. The proportion of adolescents screening positive on each psychosocial measure was assessed, and regression analyses evaluated how psychosocial variables accounted for variance in insulin non-adherence and glycemic control (measured by A1c). Psychosocial concerns were common and ranged from 7% of adolescents screening positive for disordered eating and suicide risk to 52% screening positive for low motivation to manage diabetes. A1c and insulin non-adherence were positively correlated with suicide risk, depressive symptoms, anxiety, disordered eating, diabetes stress, blood glucose monitoring stress, family conflict, and total number of elevations, and negatively correlated with intrinsic motivation. Insulin non-adherence, disordered eating, diabetes stress, and family conflict uniquely predicted A1c. Age, motivation, and family conflict uniquely predicted insulin non-adherence. Eighty-three percent of eligible youth completed the screener. Referrals by physicians to the team psychologist increased by 25% after the screening program was implemented. Comprehensive psychosocial screening can be effectively implemented as part of routine pediatric diabetes care and can identify adolescents in need of additional supports. This article is protected by copyright. All rights reserved. |
| Databáze: | OpenAIRE |
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