Yours, Mine, and Ours: A Qualitative Analysis of the Impact of Type 1 Diabetes Management in Older Adult Married Couples

Litchman, Michelle L.; Wawrzynski, Sarah E; Allen, Nancy A.; Tracy, Eunjin Lee; Kelly, Caitlin S.; Helgeson, Vicki S.; Berg, Cynthia A.

doi:10.2337/ds18-0057

Cited by 13 publications

(39 citation statements)

References 39 publications

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“…One way to augment DSMES would be to include caregivers (eg, parents) and care partners (eg, spouses, family, friends). 59 In a systematic review by Baig and colleagues, 60 family involvement was found to have positive impact on other outcomes including improved self-care, self-efficacy, knowledge, and perceived social support. Furthermore, among adults newly diagnosed with T2DM, family involvement in diabetes education was shown to be beneficial for glucose levels, knowledge and attitudes, and quality-of-life outcomes.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…The systematic review by Baig et al 60 of family interventions to improve general outcomes in adults with T2DM provided no reports on hypoglycemia-related outcomes; however, a recent study of older adults indicated that care partners can be heavily involved in hypoglycemia mitigation, and targeted interventions may further support hypoglycemia prevention. 59 Only 2 of the studies specifically targeted ethnically diverse groups, 52,53 and none specifically focused on black or African American individuals. This is particularly significant because hospitalization rates of black patients for acute diabetes complications, including hyperglycemia and hypoglycemia, are 4 times higher than those of the general population of PWD.…”

Section: Discussionmentioning

confidence: 99%

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Diabetes Education Impact on Hypoglycemia Outcomes: A Systematic Review of Evidence and Gaps in the Literature

et al. 2019

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Purpose The primary purpose of this study is to report a systematic review of evidence and gaps in the literature among well-conducted studies assessing the impact of diabetes education on hypoglycemia outcomes and secondarily reporting the impact on other included target outcomes. Methods The authors used a modified Cochrane method to systematically search and review English-language titles, abstracts, and full-text articles published in the United States between January 2001 and December 2017, with diabetes education specified as an intervention and a directly measurable outcome for hypoglycemia risk or events included. Results Fourteen quasi-experimental, experimental, and case-control studies met the inclusion criteria, with 8 articles reporting a positive impact of diabetes self-management education and support (DSMES) on hypoglycemia outcomes; 2 of the 8 reported decreased hypoglycemia events, and 1 reported decreased events in both the intervention and control groups. In addition, 5 studies targeted change in reported hypoglycemia symptoms, with all 5 reporting a significant decrease. DSMES also demonstrated an impact on intermediate (knowledge gain, behavior change) and long-term (humanistic and economic/utilization) outcomes. An absence of common hypoglycemia measures and terminology and suboptimal descriptions of DSMES programs for content, delivery, duration, practitioner types, and participants were identified as gaps in the literature. Conclusions Most retained studies reported that diabetes education positively affected varied measures of hypoglycemia outcomes (number of events, reported symptoms) as well as other targeted outcomes. Diabetes education is an important intervention for reducing hypoglycemia events and/or symptoms and should be included as a component of future hypoglycemia risk mitigation studies.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Diabetes Education Impact on Hypoglycemia Outcomes: A Systematic Review of Evidence and Gaps in the Literature

et al. 2019

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“…The experience of being a partner or family member of someone with Type 1 diabetes has also been extensively explored [10,11]. Recent qualitative work with couples living with Type 1 disease has compared perspectives of what constitutes diabetes support, revealing some distinctions between how people with Type 1 diabetes and their partners make sense of adequate self-care [12]. The study also suggested that people with Type 1 diabetes are not always aware of the extent to which diabetes affects their partner; however, the extent to which partners are aware of the emotional struggles experienced by people with Type 2 diabetes is less understood.…”

Section: Introductionmentioning

confidence: 99%

Exploring the perceptions of emotional distress among couples living with Type 2 diabetes and among diabetes healthcare providers, and consideration of support needs

2019

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Aims To compare the emotional distress experienced by people with Type 2 diabetes with the perceptions of their partners, and to explore the perceptions of healthcare providers and how these differ from the perceptions and experiences of couples living with Type 2 diabetes regarding their support needs. Methods A purposive sample of people with Type 2 diabetes and their partners was recruited through Diabetes UK media outlets and support groups, while healthcare providers were recruited through hospital and diabetes education teams. Inductive thematic analysis was conducted. Results Seven people with Type 2 diabetes and six partners took part in separate semi‐structured interviews and seven healthcare providers took part in focus groups. Themes emerged regarding unique psychological struggles for people with Type 2 diabetes: ‘sense of restriction’; ‘disempowerment’; and ‘acceptance of diabetes’. For partners the themes of ‘feeling responsible’ and ‘need for greater involvement’ emerged. Common themes arising from people with Type 2 diabetes, partners and healthcare providers highlighted diabetes‐related stresses: ‘self‐care struggles’ and ‘perceived need for appropriate psychological support’. A key theme drawn from healthcare providers was ‘perceived professional barriers to psychological support’, which captures concerns related to providing emotional support in clinical practice. Conclusions People with Type 2 diabetes, partners, and healthcare providers share a common understanding of the emotional stresses of living with Type 2 diabetes, but also experience diabetes differently depending on their role and responsibilities. All face barriers that need to be considered to ensure that emotional support in diabetes is meaningful and feasible in routine practice.

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“…11 For example, there may be challenges due to discordant appraisal of diabetes responsibility, resulting in relationship tension among couples. 12 There are also instances when a fifth type of support, invisible, is offered and PWD are not aware that it is being offered. Family members and/or friends of PWD can benefit from training by diabetes care and education specialists and other HCPs on how they may optimally provide ongoing support.…”

Section: Types Of Diabetes Supportmentioning

confidence: 99%

The Role and Value of Ongoing and Peer Support in Diabetes Care and Education

et al. 2019

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Purpose Increasing attention is being given to the challenges and emotional toll of managing diabetes. This Perspectives in Practice details the specialty’s guiding documents for initial and ongoing support. It also defines various types of social support, including peer support, for optimal diabetes care. Focusing on peer support, this paper provides a review of the body of evidence demonstrating the value of peer support to improve clinical and behavioral outcomes. To achieve positive outcomes, it is optimal for people with diabetes to have access to ongoing support from their health care provider, including diabetes care and education specialists. They should also be made aware of, and given referral to options and opportunities for peer support. This Perspectives in Practice concludes with a call to action for diabetes care and education specialists to deliver to integrate and promote the value of peer support in the care they provide. Conclusion Managing diabetes during the stages and ages of life is chronically challenging and complex. Various types of support offered by health care providers, including diabetes care and education specialists and others in the person’s social support milieu, can positively affect emotional well-being. Health care providers should routinely assess their client’s social supports and refer the person with diabetes and/or their caregivers to evidence-based types of peer support mutually determined to be of most value. Diabetes care and education specialists should increase their awareness of opportunities to integrate the value of and referral to peer support in their counseling and to gain greater insight into the diabetes-lived experience.

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Yours, Mine, and Ours: A Qualitative Analysis of the Impact of Type 1 Diabetes Management in Older Adult Married Couples

Cited by 13 publications

References 39 publications

Diabetes Education Impact on Hypoglycemia Outcomes: A Systematic Review of Evidence and Gaps in the Literature

Diabetes Education Impact on Hypoglycemia Outcomes: A Systematic Review of Evidence and Gaps in the Literature

Exploring the perceptions of emotional distress among couples living with Type 2 diabetes and among diabetes healthcare providers, and consideration of support needs

The Role and Value of Ongoing and Peer Support in Diabetes Care and Education

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