families, adolescents & children teamwork study 2 ipswich paediatric diabetes team hr murphy, c...
TRANSCRIPT
Families, Adolescents & Children Teamwork Study 2
Ipswich Paediatric Diabetes Team
HR Murphy, C Wadham, AJ Byard, J Almond, TC Skinner, J Hassler-Hurst, J Buck, S Cradock, A Scott, G Rayman
FACTS Evidence base
Parent and child behaviours for optimal self-care 1-2 years after diagnosis as HbA1c
(Anderson BJ, 1997)
Parental involvement most important predictor of positive adolescent outcomes (Anderson BJ, 1999)
3 x teamwork intervention studies with consistently beneficial results (Anderson BJ 1999, Laffel L 2003, Svoren 2003)
Background…..
Pilot study completed 2004– 78 adolescents FACTS vs Standard outpatient
care
Practice: 4 group sessions 2 skills session and 2 focused on family
responsibility and diabetes communication
Larger RCT - commenced 2007
300 adolescents
East - Ipswich - Norwich - Peterborough
Midlands - Coventry - Leicester - Nuneaton
South - Poole - Portsmouth
Study design…
Meets NICE structured education recommendations
Increased contact time- 6 group sessions, 60 – 90 mins duration, monthly
T1DM 11 – 16 yr olds, age-banded
Parents involved
Local educators Facilitated not taught
Course content…..
Skills training BG monitoring, insulins, hypoglycaemia, exercise,
healthy eating, sick days, etc
Adolescent development…..
Physical / psychological development Parent / child responsibility Dependence / interdependence /
independence
Conflict resolution…
Conflict resolution skills– Schedule arguments– Stay on topic– I NOT U– Never say Never– Shut Up– Mistakes Happen
BG monitoring/communication
‘High’ or ‘Low’ blood
sugarsParents
worry about complicatio
ns
Parents may accuse and
criticise
Kids feel discouraged and
blamed
Kids don’t check or find it hard to tell the
truth
Families feel frustrated and discouraged
Avoiding a Vicious Cycle
Helping families recognise and break this cycle!