Follow-up results on monitoring and discussing health-related quality of life in adolescent diabetes care: benefits do not sustain in routine practice

被引:46
作者
de Wit, Maartje [1 ,2 ]
Delemarre-van de Waal, Henriette A. [3 ]
Bokma, Jan Alle [4 ]
Haasnoot, Krijn [5 ]
Houdijk, Mieke C. [6 ]
Gemke, Reinoud J. [7 ]
Snoek, Frank J. [1 ,2 ]
机构
[1] Vrije Univ Amsterdam Med Ctr, Dept Med Psychol, NL-1007 MB Amsterdam, Netherlands
[2] Vrije Univ Amsterdam Med Ctr, EMGO Inst, NL-1007 MB Amsterdam, Netherlands
[3] Leiden Univ, Med Ctr, Dept Pediat, NL-2300 RC Leiden, Netherlands
[4] Spaarne Ziekenhuis, Dept Pediat, NL-2130 AT Hoofddorp, Netherlands
[5] Med Ctr Alkmaar, Dept Pediat, NL-1800 AM Alkmaar, Netherlands
[6] Juliana Kinderziekenhuis, Dept Pediat, NL-2566 MJ The Hague, Netherlands
[7] Vrije Univ Amsterdam Med Ctr, Dept Pediat, NL-1007 MB Amsterdam, Netherlands
关键词
adolescents; HbA1c; psychology; quality of life; RCT; RANDOMIZED CONTROLLED-TRIAL; CHRONIC ILLNESS; TYPE-1; CHILDREN; MANAGEMENT; DEPRESSION; YOUTH;
D O I
10.1111/j.1399-5448.2009.00543.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: We previously demonstrated that adding monitoring and discussion of health-related quality of life (HRQoL) of adolescents with type 1 diabetes to routine periodic consultations positively impacts psychosocial well-being and satisfaction with care. The current study examines whether these positive effects are maintained 1 year after the intervention was terminated and patients received regular care again, with no formal HRQoL assessment. Patients and methods: Forty-one adolescents with type 1 diabetes were followed for 1 year after the initial HRQoL intervention, in which their HRQoL had been assessed and discussed as part of period consultations using the PedsQL. Changes in physical and psychosocial well-being [Child Health Questionnaire-Child Form 87 (CHQ-CF87), diabetes family conflict scale (DFCS), Center for Epidemiological Studies scale for Depression (CES-D)], satisfaction with care [Patients' Evaluation of the Quality of Diabetes (PEQ-D) care], and glycemic control (HbA(1c)) were determined 12 months after the HRQoL intervention had ended. Results: One year after the HRQoL intervention, mean scores on CHQ subscales: behavior (p = 0.001), mental health (p = 0.004), and self-esteem (p < 0.001) had decreased, whereas the family activities subscale remained stable. Adolescents were less satisfied with their care (p = 0.012), and HbA(1c) values had increased significantly 12 months postintervention (p = 0.002). Conclusions: The beneficial effects of an office-based HRQoL intervention in adolescents with diabetes largely disappear 1 year after withdrawing the HRQoL assessment procedure. This finding underscores the importance of integrating standardized evaluation and discussion of HRQoL in routine care for adolescents with diabetes.
引用
收藏
页码:175 / 181
页数:7
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