Behandlungsverhalten und Wünsche an die Therapie aus Sicht von jungen Erwachsenen mit Diabetes mellitus Typ 1

Zusammenfassung

Hintergrund Bei Jugendlichen und jungen Erwachsenen (JujE) mit Diabetes mellitus Typ 1 (DMT1) werden gehäuft Behandlungsverhaltensweisen beobachtet, die mit ungünstigen Gesundheitsoutcomes assoziiert sind. Darüber hinaus verläuft der in diesem Alter erforderliche Transitionsprozess oft problematisch. Insgesamt ist diese Altersspanne mit einem erhöhten Risiko für akute Komplikationen und langfristige Folgeschäden assoziiert. Ziel der Studie ist es, Gründe für Therapieunzufriedenheit und ungünstiges Behandlungsverhalten aus Sicht der JujE zu explorieren und den Bedarf sowie konkrete Empfehlungen für ein zusätzliches psychologisches Coaching abzuleiten.

Methode Insgesamt wurden 15 qualitative Interviews mit JujE (Alter M=20.2; SD=3.1 Jahre; 53.3% weiblich) geführt. Zudem wurden die Soziodemographie und depressive Symptomatik (PHQ-9; Patient Health Questionnaire) erhoben.

Ergebnisse Die Ergebnisse deuten darauf hin, dass Behandlungsunzufriedenheit und ungünstiges Behandlungsverhalten mit direktiven Kommunikationsmustern sowie einer fehlenden persönlichen Bindung zu den Behandler:innen assoziiert sind. Zudem werden psychische Belastungen aus Sicht der Befragten unzureichend thematisiert. Die JujE wünschten sich insbesondere Kontinuität im Behandlungsteam sowie einen empathischen Umgang. Die Idee eines zusätzlichen Coachings wurde positiv aufgenommen. Hierbei besteht der Wunsch nach bedürfnisorientierter Ausgestaltung.

Diskussion Mögliche Barrieren von Adhärenz und psychische Belastungen sollten offen erfragt und thematisiert werden. Insbesondere bei psychisch belasteten JujE könnte das Behandlungsverhalten möglicherweise durch zusätzliche niederschwellige Coachingangebote verbessert werden. Eine randomisiert-kontrollierte Studie ist noch ausstehend.

Abstract

Background Adolescents and young adults (AYA) with type 1 diabetes (T1D) have an increased risk for treatment behaviors that are associated with adverse long-term health outcomes. In addition, the transition process often causes manifest difficulties. Overall, this age is associated with an increased risk for acute complications and long-term health consequences. The aim of the study is to explore reasons for treatment dissatisfaction and unfavorable treatment behavior from perspective of AYA as well as the need and concrete recommendations for an additional psychological coaching approach.

Methods A total of 15 qualitative interviews were conducted with AYA (age M=20.2; SD=3.1 years; 53.3% female). In addition, sociodemographics and depressive symptoms (PHQ-9; Patient Health Questionnaire) were assessed.

Results The findings indicate that treatment dissatisfaction and unfavorable treatment behavior are associated with paternalistic communication patterns as well as a lack of personal attachment to treatment providers. In addition, psychological problems are insufficiently addressed. AYA expressed the wish of continuity in the treatment team and an empathetic communication style during treatment. The idea of additional coaching was positively perceived. There is a desire for needs-oriented design.

Discussion Potential barriers of adherence and psychological distress should be openly addressed in the treatment. Especially for AYA with psychological distress, treatment behavior could possibly be improved by additional low-threshold coaching approaches. A randomized controlled trial is still pending.

Schlüsselwörter

Diabetes mellitus Typ 1 - Therapieadhärenz - Therapieunzufriedenheit - telemedizinisches Coaching - Motivational Interviewing

Keywords

diabetes mellitus type 1 - treatment adherence - treatment dissatisfaction - telemedical coaching - motivational interviewing

Publication History

Received: 24 February 2022

Accepted after revision: 17 June 2022

Article published online:
11 August 2022

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