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Experiences and decision making during paediatric transitions to continuous sub-cutaneous insulin infusion (CSII): A

Erika Altmann1, Christine Stirling2, Liz Broad3

  • 1School of Social Sciences, University of Tasmania, Hobart, Australia.

Digital Health
|October 27, 2018
PubMed

Insights

A new decision aid (DA) empowers families of children with diabetes to confidently choose continuous subcutaneous insulin infusion (CSII). The DA improved knowledge and reduced decisional conflict, leading all participants to prefer CSII.

Area of Science:

  • Pediatric Endocrinology
  • Diabetes Management Technology
  • Health Decision Science

Background:

  • Continuous subcutaneous insulin infusion (CSII) is an advanced treatment option for pediatric diabetes management.
  • Families face complex decisions when considering CSII for their children.
  • Access to relevant information and peer experiences can significantly influence treatment choices.

Purpose of the Study:

  • To enhance decision quality and outcomes for families of children with diabetes considering CSII.
  • To develop and evaluate a decision aid (DA) tailored for CSII adoption.
  • To assess the impact of the DA on knowledge and decisional conflict.

Main Methods:

  • A mixed-methods approach incorporating three focus groups (youth, parents, clinicians).
  • Development of a decision aid (DA) informed by focus group data.
  • Pre-test/post-test evaluation of the DA with five families considering CSII.

Main Results:

  • Focus groups revealed CSII adoption was empowering, with adolescents adapting quickly to the technology.
  • Experiential information from peers was highly valued by families.
  • DA use led to increased participant knowledge and decreased decisional conflict.
  • All participants' preferred option shifted to CSII after using the DA.

Conclusions:

  • A DA can effectively assist pediatric and adolescent patients and their caregivers in transitioning to CSII.
  • The PANDANI DA empowered participants to make informed decisions regarding CSII.
  • Further research, such as a randomized controlled trial, is recommended to validate these findings due to the pilot study's limitations.
Abstract

Keywords:
CSIIInsulin pump therapydecision aidnurse educatorspaediatrictype 1 diabetes

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