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Follow-Up Support for Effective type 1 Diabetes self-management (The FUSED Model): A systematic review and meta-ethnography of the barriers, facilitators and recommendations for sustaining self-management skills after attending a structured education programme
- Source :
- BMC Health Services Research, Vol 18, Iss 1, Pp 1-24 (2018), BMC Health Services Research, Campbell, F, Lawton, J, Rankin, D, Clowes, M, Coates, E, Heller, S, de Zoysa, N, Elliott, J & Breckenridge, J P 2018, ' Follow-Up Support for Effective type 1 Diabetes self-management (The FUSED Model) : A systematic review and meta-ethnography of the barriers, facilitators and recommendations for sustaining self-management skills after attending a structured education programme ', BMC Health Services Research, vol. 18, no. 1, pp. 898 . https://doi.org/10.1186/s12913-018-3655-z
- Publication Year :
- 2018
- Publisher :
- BMC, 2018.
-
Abstract
- Background People with type 1 diabetes who attend structured education training in self-management using flexible intensive therapy achieve improved blood glucose control and experience fewer episodes of severe hypoglycaemia. However, many struggle to sustain these improvements over time. To inform the design of more effective follow-up support we undertook a review of qualitative studies which have identified factors that influence and inform participants’ self-management behaviours after attending structured education and their need for support to sustain improvements in glycaemic control. Methods We undertook a meta-ethnography of relevant qualitative studies, identified using systematic search methods. Studies were included which focused on participants’ experiences of self-managing type 1 diabetes after attending structured education which incorporated training in flexible intensive insulin therapy. A line of argument approach was used to synthesise the findings. Results The search identified 18 papers from six studies. The studies included were judged to be of high methodological quality. The line of argument synthesis developed the Follow-Up Support for Effective type 1 Diabetes self-management (FUSED) model. This model outlines the challenges participants encounter in maintaining diabetes self-management practices after attending structured education, and describes how participants try to address these barriers by adapting, simplifying or personalising the self-management approaches they have learned. To help participants maintain the skills taught during courses, the FUSED model presents ten recommendations abstracted from the included papers to provide a logic model for a programme of individualised and responsive follow-up support. Conclusions This meta-ethnography highlights how providing skills training using structured education to people with type 1 diabetes does not necessarily result in participants adopting and sustaining recommended changes in behaviour. To help people sustain diabetes self-management skills after attending structured education, it is recommended that support be provided over the longer-term by appropriately trained healthcare professionals which is responsive to individuals’ needs. Although developed to inform support for people with type 1 diabetes, the FUSED model provides a framework that could also be applied to support individuals with other long term conditions which require complex self-management skills to be learned and sustained over time. Trial registration PROSPERO registration: CRD42017067961. Electronic supplementary material The online version of this article (10.1186/s12913-018-3655-z) contains supplementary material, which is available to authorized users.
- Subjects :
- Adult
Blood Glucose
Male
medicine.medical_specialty
Health Personnel
030209 endocrinology & metabolism
Health informatics
Health administration
03 medical and health sciences
0302 clinical medicine
Patient Education as Topic
Argument
Self-management
Medicine
Humans
Hypoglycemic Agents
Insulin
030212 general & internal medicine
Anthropology, Cultural
Qualitative Research
Medical education
Qualitative evidence synthesis
business.industry
Health Policy
Nursing research
Public health
lcsh:Public aspects of medicine
Meta-ethnography
lcsh:RA1-1270
FUSED
Hypoglycemia
Structured education
Diabetes Mellitus, Type 1
Type 1 diabetes
DAFNE
Female
business
Qualitative research
Follow-Up Studies
Research Article
Subjects
Details
- Language :
- English
- ISSN :
- 14726963
- Volume :
- 18
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- BMC Health Services Research
- Accession number :
- edsair.doi.dedup.....af6e574606c706796db4e44d2fe96d96