Psychosocial screening and management of young people aged 18-25 years with diabetes: psychosocial screening for diabetes

d'Emden, Helen, McDermott, Brett, D'Silva, Neisha, Dover, Tom, Ewais, Tatjana, Gibbons, Kristen and O'Moore-Sullivan, Trisha (2017) Psychosocial screening and management of young people aged 18-25 years with diabetes: psychosocial screening for diabetes. Internal Medicine Journal, 47 4: 415-423. doi:10.1111/imj.13375

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Author d'Emden, Helen
McDermott, Brett
D'Silva, Neisha
Dover, Tom
Ewais, Tatjana
Gibbons, Kristen
O'Moore-Sullivan, Trisha
Title Psychosocial screening and management of young people aged 18-25 years with diabetes: psychosocial screening for diabetes
Journal name Internal Medicine Journal   Check publisher's open access policy
ISSN 1444-0903
1445-5994
Publication date 2017-01-20
Sub-type Article (original research)
DOI 10.1111/imj.13375
Open Access Status File (Author Post-print)
Volume 47
Issue 4
Start page 415
End page 423
Total pages 20
Place of publication Richmond, VIC, Australia
Publisher Wiley-Blackwell
Language eng
Subject 2724 Internal Medicine
Abstract Background: Routine psychosocial screening and management of people with diabetes is recommended. Aims: To profile demographic, medical and psychosocial characteristics of young people with diabetes, and to develop a screening tool and care pathway for routine use. Methods: Indices of diabetes control and recorded diabetes complications were complimented by psychosocial screening tools assessing psychological, diabetes specific and perceived stress (Kessler 10, Problem Area in Diabetes, Perceived Stress Scale), well-being (World Health Organization Well Being Index-5), disordered eating (Eating Disorder Risk Inventory-3 Risk Composite), compensatory behaviour questionnaire, social support (Multidimensional Scale of Perceived Social Support), resilience (Connor Davidson Resilience Scale – 2 item) and financial concerns. Service provision and demographic data were also collected. Diabetes and mental health clinicians then identified a subset of measures to use for routine screening along with care pathways. Results: Psychosocial screening was well accepted. Participants (151) had suboptimal glycaemic control (glycated haemoglobin 8.0 interquartile range 1.8%/64 interquartile range 22 mmol/mol). Severe diabetes-related distress (Problem Area in Diabetes ≥40) was found in 19.4% and 26.0% reported difficulties managing healthcare costs. A mental health disorder was likely in 9.7%, whilst 23.4% had high Kessler 10 scores. Low World Health Organization Well Being Index-5 scores (≤13) were seen in 29.0%. Risk for an eating disorder (Eating Disorder Risk Inventory-3 Risk Composite) was 12.7%, whereas approximately 36.0% had disturbed eating behaviours. Conclusion: Psychosocial screening of young adults with diabetes identified complex needs. A brief psychosocial screening tool and associated care pathways were developed for routine use in a young adult tertiary referral diabetes clinic. The tool assesses constructs, such as diabetes distress, depression, anxiety, well-being, hypoglycaemia-unawareness, fear of hypoglycaemia, social support, weight, shape and eating concerns and financial concerns. This will provide a longitudinal data source for further research to inform clinical practice.
Formatted abstract
Background: Routine psychosocial screening and management of people with diabetes is recommended.

Aims: To profile demographic, medical and psychosocial characteristics of young people with diabetes, and to develop a screening tool and care pathway for routine use.

Methods: Indices of diabetes control and recorded diabetes complications were complimented by psychosocial screening tools assessing psychological, diabetes specific, and perceived stress (K10, PAID, PSS), well-being (WHO-5), disordered eating ((EDI-3RC), compensatory behaviour questionnaire, social support (MSPSS), resilience (CD-2) and financial concerns. Service provision and demographic data was also collected. Diabetes and mental health clinicians then identified a subset of measures to use for routine screening along with care- pathways.

Results: Psychosocial screening was well accepted. Participants (151) had suboptimal glycaemic control (HbA1c 8.0 IQR 1.8%/64 IQR 22 mmol/mol). Severe diabetes related distress (PAID≥40) was found in 19.4% and 26.0% reported difficulties managing health care costs. A mental health disorder was likely in 9.7%, whilst 23.4% had high K10 scores. Low WHO-5 scores (≤13) were seen in 29.0%. Risk for an eating disorder (EDI-3RC) was 12.7%, whereas approximately 36.0% had disturbed eating behaviours.

Conclusion: Psychosocial screening of young adults with diabetes identified complex needs. A brief psychosocial screening tool and associated care-pathways were developed for routine use in a young adult tertiary referral diabetes clinic. The tool assesses constructs such as diabetes distress, depression, anxiety, well-being, hypoglycaemia-unawareness, fear of hypoglycaemia, social support, weight, shape and eating concerns and financial concerns. This will provide a longitudinal data source for further research to inform clinical practice.
Keyword Diabetes Mellitus Type 1
Young Adults
Psychology
Evidenced-based Practice
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Mater Research Institute-UQ (MRI-UQ)
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Created: Sun, 12 Feb 2017, 21:52:48 EST by Tatiana Ewais on behalf of Mater Clinical Unit