Using Intervention Mapping to Develop a Child Diabetes Support Intervention

Caregivers of children with diabetes mellitus: challenges of caring for and perceptions of consultations in a South African public sector context

“…The researchers wanted (Aim 1a) to describe the experiences of caring for a child with DM and care consultations with the MDT from the caregivers' perspectives in the South African public health sector in order (Aim 1b) to confirm and provide a more detailed picture of previously published focus-group local needs assessment. 18 As reported in similar studies, the data could also (Aim 1c) help the MDT better understand the challenges faced by our caregivers and their children. This knowledge can (Aim 1d) inform clinical practice including communication with patients and caregivers, guide support systems, and contribute to HCPs' as well as community awareness and education concerning the experiences of living with DM in this treatment context.…”

“…This is an indication of a shared, almost universal experience with caring for this LTHC, irrespective of the context. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] The occurrence of general stress, diabetes distress, anxiety, fear, anger and even depressed mood among caregivers is evident around a diabetes diagnosis and ongoing practical day-to-day diabetes care tasks. Caregivers' experiences seem to be alike irrespective of the age of the child at diagnosis.…”

“…56,60,61 Similarities to sub-Saharan countries that were articulated by the caregivers included a lack of adequate expertise at all levels of care, poor access to consumables and medication at hospitals closer to home and costly, long-distance travel for tertiary consultations. 3,[18][19][20][21][30][31][32] In gauging QoC, in line with the six aims of improvement from among the perspectives of the caregivers, care consultations with the MDT were mainly perceived as patient-centred. However, they were not timely (long waiting times), or equitable (quality varied between the tertiary site and hospitals closer to home).…”

“…[7][8][9]13,14 Studies on caregivers' experiences in low-and middle-income countries (LMIC) have similar themes and also report experiences of shock, anxiety, depression, fear, guilt, shame, poor quality of life (QoL), psychological problems and inadequate care and support in schools. [15][16][17][18][19][20][21] The role of caregivers and their coping mechanisms are therefore essential aspects of MDT-based, patient-centred care for childhood DM. 18,[22][23][24][25] Successful communication, which starts with listening to and understanding the experiences of caregivers, can be important for improving patient outcomes such as metabolic control and QoL.…”

“…[15][16][17][18][19][20][21] The role of caregivers and their coping mechanisms are therefore essential aspects of MDT-based, patient-centred care for childhood DM. 18,[22][23][24][25] Successful communication, which starts with listening to and understanding the experiences of caregivers, can be important for improving patient outcomes such as metabolic control and QoL. The clinic consultation, a regular face-to-face care interaction with principal members of the MDT, serves as an extremely valuable opportunity to review care and to implement plans to achieve treatment goals.…”