Lin Perry1, Steven James2, Robyn Gallagher3, Janet Dunbabin4, Katharine Steinbeck5, Julia Lowe6. 1. Faculty of Health, University of Technology Sydney/South Eastern Sydney Local Health District, Prince of Wales Hospital, Randwick, Australia. 2. Faculty of Health, University of Technology Sydney, Ultimo, Australia. 3. Charles Perkins Centre, University of Sydney, Sydney, Australia. 4. Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia. 5. Sydney Medical School, University of Sydney/Academic Department of Adolescent Medicine, The Children's Hospital at Westmead, Westmead, Australia. 6. Department of Medicine, University of Toronto/Division of Endocrinology and Metabolism, Sunnybrook Health Sciences Centre, Toronto, Canada.
Abstract
RATIONALE, AIMS, AND OBJECTIVES: Use of continuous subcutaneous insulin infusion therapy in type 1 diabetes management is high. However, the incorporation of this technology into self-care is not without challenges, and the support of an appropriately skilled health care team is recommended. This study aimed to examine the support context for patients using continuous subcutaneous insulin infusion therapy from the health care professional perspective, as well as contextual influences for health care professionals and their patients. METHODS: This ethnographic qualitative study was undertaken in New South Wales, Australia. Recruitment occurred using a snowball sampling technique, beginning with members of an established diabetes service group. Data were collected through the use of semistructured interviews undertaken by telephone and analysed using thematic analysis. RESULTS: Data were obtained from 26 interviews with staff from diverse professional backgrounds. An overarching theme of difficulties, disconnections, and disarray emerged, with findings indicating that participants perceived difficulties in relation to shortages of health care professional continuous subcutaneous insulin infusion-related expertise, and disconnected and disarrayed service structures and process, with barriers to access to these devices. Individual health care professionals were left to manage somehow or opted not to engage with related care. CONCLUSIONS: Findings provide insights from health care professionals' perspectives into the complexity of providing support for patients using continuous subcutaneous insulin infusion therapy across diverse contexts, and provide a platform for further research and service development. The need for consistent and coordinated care, and the infrastructure to facilitate this, flags an opportunity to drive integration of care and teamworking across as well as within settings and disciplines.
RATIONALE, AIMS, AND OBJECTIVES: Use of continuous subcutaneous insulin infusion therapy in type 1 diabetes management is high. However, the incorporation of this technology into self-care is not without challenges, and the support of an appropriately skilled health care team is recommended. This study aimed to examine the support context for patients using continuous subcutaneous insulin infusion therapy from the health care professional perspective, as well as contextual influences for health care professionals and their patients. METHODS: This ethnographic qualitative study was undertaken in New South Wales, Australia. Recruitment occurred using a snowball sampling technique, beginning with members of an established diabetes service group. Data were collected through the use of semistructured interviews undertaken by telephone and analysed using thematic analysis. RESULTS: Data were obtained from 26 interviews with staff from diverse professional backgrounds. An overarching theme of difficulties, disconnections, and disarray emerged, with findings indicating that participants perceived difficulties in relation to shortages of health care professional continuous subcutaneous insulin infusion-related expertise, and disconnected and disarrayed service structures and process, with barriers to access to these devices. Individual health care professionals were left to manage somehow or opted not to engage with related care. CONCLUSIONS: Findings provide insights from health care professionals' perspectives into the complexity of providing support for patients using continuous subcutaneous insulin infusion therapy across diverse contexts, and provide a platform for further research and service development. The need for consistent and coordinated care, and the infrastructure to facilitate this, flags an opportunity to drive integration of care and teamworking across as well as within settings and disciplines.
Authors: Carla Castillo-Laborde; Macarena Hirmas-Adauy; Isabel Matute; Anita Jasmen; Oscar Urrejola; Xaviera Molina; Camila Awad; Catalina Frey-Moreno; Sofia Pumarino-Lira; Fernando Descalzi-Rojas; Tomás José Ruiz; Barbara Plass Journal: Public Health Rev Date: 2022-09-02
Authors: Barbara Kimbell; David Rankin; Nicole L Ashcroft; Lidiya Varghese; Janet M Allen; Charlotte K Boughton; Fiona Campbell; Atrayee Ghatak; Tabitha Randell; Rachel E J Besser; Nicola Trevelyan; Roman Hovorka; Julia Lawton Journal: Diabetes Technol Ther Date: 2020-03-06 Impact factor: 6.118