Using Person-Reported Outcomes (PROs) to Motivate Young People with Diabetes
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PSYCHOSOCIAL ASPECTS (SS JASER, SECTION EDITOR)
Using Person-Reported Outcomes (PROs) to Motivate Young People with Diabetes Maartje de Wit 1
&
Judith Versloot 2 & Ian Zenlea 2,3 & Eveline R. Goethals 4,5
# The Author(s) 2020
Abstract Purpose of Review This manuscript describes how person-reported outcomes (PROs) can be utilized in care for young people with diabetes in the context of motivation. Recent Findings The use of person-reported outcome measures (PROMS) in clinical care is feasible and acceptable, and helps focus the clinical encounter on life domains important to the person with diabetes. Results with regard to impact on selfmanagement and glycemic outcomes are limited. Motivation is an important factor for self-management. Based on selfdetermination theory, autonomy-supportive, person-centered, and collaborative communication by diabetes care providers is associated with better outcomes. PROMs can facilitate this conversation. Summary Understanding of youth motivation for maintaining or improving self-management behaviors requires a personcentered approach. PROMs can be used to facilitate an autonomy-supportive and person-centered conversation in clinical care. Training diabetes care providers in autonomy-supportive, person-centered conversation skills to discuss PROs might help to tap into youth’s motivation, but further research is needed. Keywords PROs . PROMs . Person-reported outcomes . Motivation . Young people . Type 1 diabetes
Introduction It has well been established that type 1 diabetes (T1D) is a challenging chronic illness requiring intensive daily selfmanagement behaviors. Maintaining or improving selfmanagement behaviors and feeling motivated to do so represent a struggle for many. Adolescents and young adults are at high risk for self-management difficulties [1]. Analyses of registry data from the US-based T1D Exchange Study [2],
This article is part of the Topical Collection on Psychosocial Aspects * Maartje de Wit [email protected] 1
Medical Psychology, Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
2
Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada
3
Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
4
Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA
5
KU Leuven, Leuven, Belgium
European-based Diabetes-Patienten-Verlaufsdokumentation (DPV) Study in Europe [3], and a recent study in Canada [4] revealed suboptimal HbA1c values in this specific vulnerable age group. From a developmental viewpoint, adolescents and young adults living with T1D find themselves in a “perfect storm” of coinciding normative developmental (e.g., going to college, seeking employment, establishing romantic relationships) and illness-related challenges. Young people and their families in this transitional phase of life need to find a new balance, as diabetes management evolves from parent-driven to youth-directed diabetes care, compounded by the need for transition from pedi
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