Structural model of patient-centered communication and diabetes management in early emerging adults at the transfer to adult care

ISPAD Clinical Practice Consensus Guidelines 2022: Psychological care of children, adolescents and young adults with diabetes

“…Pediatric diabetes care is characterized by a triadic relationship 163 . Youth, parents and pediatric care providers must sustain effective communication about the demands, expectations (“who does what”) and burden of diabetes management 164 as youth face many physical and psychosocial developmental changes from childhood to adolescence, as responsibility for diabetes management gradually shifts from parents to youth.…”

“…Pediatric diabetes care is characterized by a triadic relationship. 163 Youth, parents and pediatric care providers must sustain effective communication about the demands, expectations (“who does what”) and burden of diabetes management 164 as youth face many physical and psychosocial developmental changes from childhood to adolescence, as responsibility for diabetes management gradually shifts from parents to youth. Providers need to navigate this shift by being attuned to youth's evolving competencies and readiness for independent self‐care, 165 , 166 while also considering the need for parental and provider support and guidance.…”

“…Research has shown that responsive and supportive communication between youth with diabetes and their family, caregivers and the broader social environment (e.g., peers, school system, other relatives, sport coaches) is essential for youth well‐being, including better glycemic outcomes, self‐management, QoL, and satisfaction with care. 117 , 129 , 130 , 167 Person‐centered communication by providers, which is closely linked to autonomy‐supportive communication (i.e., explaining the personal relevance of treatment guidelines and offering choices), 130 , 163 , 168 puts the young person with diabetes and their family at the forefront by eliciting their perspectives on the proposed treatment recommendations, and by engaging in a shared‐decision making process. This communication style promotes openness and trust, and fosters dialog about the best way to optimize diabetes management and outcomes for each young person with diabetes and their family.…”

Using Person-Reported Outcomes (PROs) to Motivate Young People with Diabetes

“…Research is now beginning to demonstrate that youth and parent perceptions of autonomy-supportive, person-centered, and collaborative communication, and care by diabetes care providers are associated with more optimal outcomes such as higher levels of self-efficacy and treatment adherence [45,48,49]. Further, there is growing insight into the power and impact of the language providers use to motivate people [13,50].…”

“…MI is aimed at initiating and maintaining partnership between the person with diabetes and the diabetes care provider, while emphasizing a caring relationship in health care communication, and by forwarding the person's own ideas and reasons for change. Studies on MI and on person-centered communication in young people with T1D show promising results [49,[53][54][55][56], although the implementation of such provider-based interventions have proven to be difficult [21,30,57,58]. PROMs might facilitate maintaining these conversation skills as their use places the person's perspective at the center of the conversation.…”