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Aims: Children and young people with diabetes (CYPD) from socio‐economically deprived and/or ethnic minority groups tend to have poorer glucose control and greater risk of diabetes‐related complications. In this systematic review of qualitative evidence (qualitative evidence synthesis, QES), we aimed to explore the experiences and views of clinical encounters in diabetes care from the perspectives of CYPD and their family/carers from underserved communities and healthcare professionals in diabetes care. Methods: We searched 6 databases to March 2022 with extensive search terms, and used a thematic synthesis following methods of Thomas and Harden. Results: We identified 7 studies and described 11 descriptive themes based on primary and secondary constructs. From these, three "analytical themes" were developed. (1) "Alienation of CYPD" relates to their social identity and interaction with peers, family and health service practitioners in the context of diabetes self‐ and family/carer management and is impacted by communication in the clinical encounter. (2) "Empowerment of CYPD and family/carers" explores families' understanding of risks and consequences of diabetes and taking responsibility for self‐ and family/carer management in the context of their socio‐cultural background. (3) "Integration of diabetes (into self and family)" focuses on the ability to integrate diabetes self‐management into the daily lives of CYPD and family/carers beyond the clinical consultation. Conclusions: The analytical themes are interdependent and provide a conceptual framework from which to explore and strengthen the therapeutic alliance in clinical encounters and to foster greater concordance with treatment plans. Communicating the biomedical aspects of managing diabetes in the clinical encounter is important, but should be balanced with addressing socio‐emotional factors important to CYPD and family/carers. [ABSTRACT FROM AUTHOR]

Background: Diet is a common concern among people with an ileostomy as it can be associated with serious and burdensome complications, for example, dehydration and obstruction, and dietary advice is often unsatisfactory. In this study, we explored healthcare professionals' (HCPs) perspectives on dietary advice for ileostomy management. Methods: Semi‐structured interviews were conducted with HCPs, from multiple professions, who provide dietary advice to patients with an ileostomy. A framework approach to thematic analysis was used to understand and compare HCPs' experiences, beliefs and attitudes that influence how dietary advice is provided and the effectiveness of dietary management. Results: Findings from interviews with 21 HCPs, across 3 hospitals, related to 7 key themes: tailoring of dietary advice to the patient, patient autonomy and communication, HCP knowledge and understanding, patient pathway, mixed messages, access to formal and social support and patient understanding and relationship with dietary advice. Profession was a strong determinator of what and how dietary advice is provided; however, closer team working increased consistency in dietary advice. Lack of scientific research and consensus contributes to mixed messages and reduced confidence in dietary advice for people with an ileostomy. Due to individual differences between patients, experiential learning with diet is key to self‐management and is encouraged in a controlled way by HCPs; however, a lack of 'one‐size‐fits‐all' guidance can be difficult for some. Conclusion: The study findings should inform HCPs caring for patients with an ileostomy, and researchers designing and evaluating interventions, to improve how patients receive dietary advice for ileostomy management. Key points: Semi‐structured interviews were conducted with 21 healthcare professionals (HCP) to explore their perspectives on dietary advice for people with an ileostomy.A lack of research and expert consensus contributes to mixed messages and reduced confidence in dietary advice for people with an ileostomy.Greater interdisciplinary working increases consistency in dietary advice for ileostomy management.HCPs' role involves providing guidance and support to people with an ileostomy while they develop the ability to self‐manage their diet through experiential learning.This study provides a detailed picture of the provision of dietary advice to people with an ileostomy, within the NHS, which should encourage HCPs to reflect on potential pitfalls as well as components of good practice, to improve how patients receive dietary advice for ileostomy management. [ABSTRACT FROM AUTHOR]

Aims: Facilitated self‐management support programmes have become central to the treatment of chronic diseases including diabetes. For many children and young people with diabetes (CYPD), the impact on glycated haemoglobin (HbA1c) and a range of self‐management behaviours promised by these programmes remain unrealised. This warrants an appraisal of current thinking and the existing evidence to guide the development of programmes better targeted at this age group. Methods: Create a narrative review of systematic reviews produced in the last 3 years that have explored the impact on CYPD of the four key elements of self‐management support programmes: education, instruction and advice including peer support; psychological counselling via a range of therapies; self‐monitoring, including diaries and telemetric devices; and telecare, the technology‐enabled follow‐up and support by healthcare providers. Results: Games and gamification appear to offer a promising means of engaging and educating CYPD. Psychological interventions when delivered by trained practitioners, appear to improve HbA1c and quality of life although effect sizes were small. Technology‐enabled interactive diaries can increase the frequency of self‐monitoring and reduce levels of HbA1c. Telecare provided synchronously via telephone produced significant improvements in HbA1c. Conclusions: The cost‐effective flexibility of increasing the reliance on technology is an attractive proposition; however, there are resource implications for digital connectivity in underserved populations. The need remains to improve the understanding of which elements of each component are most effective in a particular context, and how to optimise the influence and input of families, caregivers and peers. [ABSTRACT FROM AUTHOR]

Background: Debate remains regarding whether to recommend a low iodine diet (LID) before radioactive‐iodine treatment and its duration and stringency. This mixed‐methods review aimed to determine if iodine status affects treatment success, the most effective diet to reduce iodine status, and how LID impacts wellbeing. Methods: Five electronic databases were searched until February 2021. An effectiveness synthesis (quantitative studies) and views synthesis (qualitative, survey, and experience‐based evidence) were conducted individually and then integrated. Quality assessment was undertaken. Results: Fifty‐six quantitative and three qualitative studies were identified. There was greater ablation success for those with an iodine status of <50 mcg/L (or mcg/gCr) compared with ≥250 (odds ratio [OR] = 2.63, 95% confidence interval [CI], 1.18–5.86, n = 283, GRADE certainty of evidence very low). One study compared <50 mcg/L (or mcg/gCr) to 100–199 and showed similar rates of ablation success (OR = 1.59, 95% CI, 0.48–6.15, n = 113; moderate risk of bias). People following a stricter LID before ablation had similar rates of success to a less‐strict diet (OR = 0.67, 95% CI, 0.26–1.73, n = 256, GRADE certainty of evidence very low). A stricter LID reduced iodine status more than a less strict (SMD = −0.40, 95% CI, −0.56 to −0.24, n = 816), and reduction was seen after 1 and 2 weeks. The main challenges were a negative impact on psychological health, over restriction, confusion, and difficulty for sub‐groups. Conclusions: Although a LID of 1–2 weeks reduces iodine status, it remains unclear whether iodine status affects treatment success as only a few low‐quality studies have examined this. LIDs are challenging for patients. Higher‐quality studies are needed to confirm whether a LID is necessary. [ABSTRACT FROM AUTHOR]

Objective. According to the common-sense model of illness behaviour, illness representations are directly related to coping and, via coping, to adaptive or maladaptive outcomes. However, it may be more appropriate to conceptualize coping by assessing what patients actually do - i.e., their coping behaviours - rather than what they say they do in coping scales - i.e., their coping cognitions. The aim of this study was to examine the relationships between illness representations and the relative importance of coping cognitions and coping behaviours in the context of the management of type 2 diabetes. Design. The relationship between illness representations and coping variables was explored within a prospective design. Methods. The illness representations of 134 patients were assessed with the IPQ-R (Moss-Morris et al., 2002) along with coping cognitions and coping behaviours (medication, physical activity, diet). Results. Illness representations predicted coping cognitions and coping behaviours but coping cognitions did not mediate the relationships between illness representations and coping behaviours. Conclusion. The results demonstrate that illness representations are direct predictors of both coping cognitions and coping behaviours in patients with type 2 diabetes. In addition, coping cognitions and coping behaviours appear to be distinct mechanisms that operate independently. The findings suggest that rather than manipulating patients' coping cognitions to improve patients' health behaviours it may be beneficial to focus on their beliefs about diabetes. [ABSTRACT FROM AUTHOR]

Presents a study that applied protection motivation theory (PMT) to the prediction of parental adherence to eye patching recommendations for children with amblyopia. Method of the study; Results and discussion; Conclusion.