Kan een interventie met Q-zorgprofielen helpen in de spreekkamer om in gesprek te komen met adolescenten met Diabetes Mellitus type I?: Exploratief pilot-onderzoek

Abstract

Will an intervention with Q-care profiles improve the quality of the dialogue during outpatient center visits with adolescents with Diabetes Mellitus type I; A explorative Pilot study Jacobien Wagemakera,b,c, Susan Jedelood,e, Anneloes van Staad,e aUtrecht University - Master of Nursing Science – The Netherlands bDiakonessen hospital Utrecht-Zeist-Doorn – The Netherlands cUniversity Medical Center – Wilhelmina Children’s Hospital, Utrecht, The Netherlands dRotterdam University, Expertise Center Transition of Care, Rotterdam, The Netherlands eErasmus University – Institute of Health Policy & Management, Rotterdam, The Netherlands

Abstract Background: Pediatric nurses specialized in diabetes care often struggle in how to communicate with the adolescent with Diabetes Mellitus type I during outpatient visits. Adolescents are experiencing the same difficulties to communicate and don’t feel triggered or challenged. There is no communication tool available that might help. An intervention is developed with use of Q-care profiles for adolescents with chronic conditions. The intervention is not yet tested in applicability and practicality. Objectives: To uncover insight information about the applicability and practicality of the intervention which could be used for further development. Design and method: A explorative pilot study has been conducted with a mixed method design. Data were obtained by field observation and semi-structured interviews with pediatric nurses specialized in diabetes care at an university and regular hospital in the centre of The Netherlands. Demographic and disease specific characteristics of the population were collected to compare the populations. Fifty scores of the Q-care profiles, between adolescents and pediatric nurses specialized in diabetes care, were checked with the Cohen´s Kappa, on the interrater agreement. Applicability and practicality were checked by profit, complexity, triability, consistence and visibility. Results: Population of both hospitals were comparable except for the significant difference in sexe in de research group (p0,024). A total of four field observations and three semi-structured interviews were obtained. The intervention was perceived as complex and difficult to use in daily practice. There was a different view about the scores of the Q-care profiles between adolescents and the pediatric nurse specialist in diabetes care. There was a significant, but weak, interrater agreement of ,266 (p0,001) on the C-profile. Triability was good. There was an observable positive effect in the communication that led to discuss the different views. Conclusion: Applicability of the intervention is not yet proven in this research. There is some proof of practicality of the intervention when used by pediatric nurses specialized in diabetes care; the difference in views is subject for dialogue. The intervention needs further development. Further research in other populations is advised.