In the early stages of the COVID-19 outbreak, people with type 2 diabetes accounted for nearly one-third of COVID-related deaths. 1 Type 2 diabetes is associated with increased severity of COVID-19 as the SARS-CoV-2 virus induces hyperglycaemia, which in turn leads to immune dysfunction, increased vulnerability to infections, and development of long-term
Background Children and young people (CYP) with complex neurodisability experience multiple physical, communication, educational and social challenges which require complex packages of multidisciplinary care. Cerebral palsy, an exemplar complex neurodisability condition, is the most common cause of serious physical disabilities among children globally. It is unclear the best way to meet the emotional, social, practical, and empowerment needs of CYP with complex neurodisability and their caregivers. The aim of this study was to determine the needs and priorities of those caring for CYP with complex neurodisability. This forms part of the feasibility phase of a wider study (ENCOMPASS) which aims to adapt the Baby Ubuntu intervention, a participatory caregiver programme for families of CYP with complex neurodisability, to an ethnically diverse urban UK context. Methods Two rounds of semi-structured interviews were conducted with 12 caregivers of CYP with complex neurodisability and six healthcare professionals from a variety of disciplines, recruited from a community child health service in London Borough of Newham, UK in 2020. The interviews included open-ended questions to explore caregiving trajectories, experiences of navigating health services and perceived service gaps. Transcripts were analysed using a data-driven inductive thematic analysis. Results Three themes were identified that related to the aim of understanding caregivers experiences and unmet needs relating to current service provision. These were (1) Caregiver Mental Health, (2) A Thirst for Knowledge and (3) The Need for Holistic Support. Mental health difficulties were reported, particularly around the period of diagnosis. Priority needs included the provision of clear information about the diagnosis and services offered, opportunities to forge peer support networks and for services across the community to collaborate. Conclusions The delivery of health services for CYP with neurodisability should encompass the broad needs of the family as well as meeting the clinical needs of the CYP.
Purpose Recent models of care incorporate service user involvement within the development and sustainability of a quality improvement project. The purpose of this paper is to demonstrate the significance of working with patients and members of the public for the integration of psychosocial care into long-term condition (LTC) management. Design/methodology/approach Research shows that mental health difficulties are more prevalent in people with LTC. The three Dimensions for Long-term Conditions (3DLC) is a patient-centred multidisciplinary service which integrates psychological and social care into the usual physical care. Thematic analysis was conducted on the discussions of the two patient and public involvement workshops that were facilitated by the service. The workshops included healthcare professionals, patients with LTC and their carers. Findings Several themes and subthemes emerged which highlighted the importance of discussing and treating mental health in a physical health setting, the challenges that both the patients and healthcare professionals encounter and the ways in which an integrated care service may address these barriers. The findings show that there was an emphasis on patient-centeredness, accessibility of services and the need for better communication. Practical implications People with LTC can be empowered to better self-manage their condition, whilst having access to all types of care, physical, social and psychological. By involving service users in the implementation process of the 3DLC service, the components of an effective integrated service are delineated. Originality/value The service users have identified barriers and facilitators of integrating a biopsychosocial model in care pathways. This has helped the 3DLC team to further develop the model to ensure improvements in condition-specific outcomes, quality of life and healthcare utilisation.
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