Sixteen to twenty-five year-old patients with type 1 diabetes face multiple shifts in their career and development, and is one of the periods when they are confronted with the greatest life pressure. Moreover, the control of disease has been getting worse, which can lead to early occurrence of complications and an increase in the frequency of disease-related hospitalization, as well as negatively affect their quality of life. Providing interventions to meet their healthcare needs can reduce the impact during the transition period.
Purpose:
The purpose of this meta-synthesis was to understand the transitional healthcare needs of patients with type 1 diabetes in age 16-25 years old.
Method:
Meta-synthesis was employed. The manuscripts written in Chinese or English and published before August 2017 in MEDLINE, CINAHL, PsycINFO, PubMed, Cochrance library and Pro Quest Health and Medical, and the Chinese Electronic thesis and dissertation system were systematically retrieved. Search terms were combined with the following: type 1 diabetes or T1D, youth or adolescent or young adult, transition or from adolescent to young adult, healthcare needs or life experiences, and qualitative research or phenomenological research or grounded theory. Two researchers independently assessed each article for research quality, and using the Joanna Briggs Institute Critical Appraisal Tools as the main quality assessment tool. Any disagreements in the two researchers’ assessment results were discussed with a third researcher to resolve the conflict.
Results:
A total of 11 papers were included in the study. The results showed that in age 16-25 years old is the critical period when patients with type 1 diabetes transform themselves from attachment to de-attachment. After their healthcare needs were met, they eventually intend to become the chief executive officer of their own disease. The 5 themes of healthcare needs are: (1) health: patients need medical team to provide them with individualized disease self-management information in order to properly control their blood sugar and reduce any discomfort caused by the disease; (2) autonomy: patients need the skill to communicate with their caregiver to grasp the gaps between dependence and independence, and to bear their own responsibility of disease care; (3) interpersonal interaction: patients desire to fostering a friendly and empathetic environment to reduce the occurrence of interpersonal frustrations; (4) society: patients need to develop support networks of social resources and patient groups to increase their confidence in becoming independent; (5) spirituality: patients need to find faith and acquire spiritual comfort when faced with the disease’s unpredictability.
Conclusion: There presently is a lack of studies in the literature investigating the consistency and importance of healthcare needs during the transition period from the diversified perspectives of patients, parents, and medical personnel, as well as studies conducted in Asian countries. Future studies may perform in-depth investigations on these two dimensions. Moreover, the results of this study may be used as clinical care guidelines for patients with type 1 diabetes in age 16-25 years old and provide a reference for developing transitional intervention strategies. Attention should naturally be paid to cultural differences.
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