Der Merkurstab | September/Oktober 2015 | 22,00 Euro (inkl. Mwst., zzgl. Versandkosten)
Artikel | Patient-centered diabetes care in children: an integrated, individualized, systems-oriented, and multidisciplinary approach |
Autoren | Gunver Sophia Kienle, Michael Meusers, Birgit Quecke, Dörte Hilgard |
Seiten | 339-345 |
Volume | 68 |
Zusammenfassung
Background: Type 1 diabetes mellitus in children is associated with
various medical, psychological, emotional, social, and organizational
hurdles. Patient-centered disease management should address all
patient-relevant issues in an individualized, systems-oriented, and
multidisciplinary approach.
Case: A 10-year-old girl with type 1 diabetes mellitus, a developmental
disorder with motor and sensory dysfunction and dyscalculia was cared
for full-time by her mother and an assistant nurse. Receiving standard
intensified insulin therapy, she still had poor glucose control with frequent
mild and severe hypoglycemic episodes. She was socially isolated
and not able to attend peer activities and was frustrated with her situation.
The mother was substantially stressed, and the child-mother relationship
was endangered. The girl and her family were referred to an
integrated, patient-centered, and highly individualized, multidisciplinary
diabetic care program that offered self-management education
courses and psychosomatic care. A core element was to switch the main
focus from technical management and laboratory data to the girl and
her specific problems, wishes, goals, needs, and conditions. The child
became an active partner in management and decisions. The program
offered age-appropriate activities. Consequently, the girl was able to
successively self-manage her disease, resulting in a substantial improvement
in glucose control, quality of life, satisfaction, and the relationship
between mother and daughter.
Conclusion: Increasing technical sophistication in diabetes management
tends to lay the focus on biomedical outcomes. Improved medical
and psychosocial results may be achieved when the patient and his or
her needs, hurdles, goals, and psychological and social issues are made
central to the care he or she receives.