title: Attitudes and dilemmas of caregivers supporting people with intellectual disabilities who have diabetes.
abstract: OBJECTIVE
  To explore how professional caregivers in communal living arrangements support people with a mild or moderate intellectual disability (ID) who have diabetes.
  
  
  METHODS
  A qualitative study, 13 caregivers participated in semi-structured interviews.
  
  
  RESULTS
  Professional caregiver support in diabetes care is almost solely directed towards administering medication and controlling food intake. Caregivers want to provide person-centered care but are hindered by a conflict between protecting a client's health and at the same time respecting autonomy. None of the caregivers had received training in supporting self-management; their knowledge about diabetes is limited. The few that engaged their client in self-management stressed the importance of a positive and collaborative approach.
  
  
  CONCLUSIONS
  This study provides a first insight into the challenges that professional caregivers experience when a client with ID has diabetes. More education for caregivers seems needed. Self-management support is likely to benefit from consensus among caregivers about what comprises person-centered care and self-management in people with ID who have a chronic disease.
  
  
  CONCLUSIONS
  Increasing caregivers' awareness of the importance of supporting self-management in people with ID and a chronic disease is essential. Discussing practice examples in the light of existing knowledge about developing autonomy will contribute to their awareness.
authors.affiliation: NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands. m.cardol@nivel.nl
authors.forename: Mieke
authors.initials: M
authors.lastname: Cardol
authors.forename: Mieke
authors.initials: M
authors.lastname: Rijken
authors.forename: Henny
authors.initials: H
authors.lastname: van Schrojenstein Lantman-de Valk
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D017028:Caregivers / Q000523:psychology*; D003924:Diabetes Mellitus, Type 2 / Q000451:nursing / Q000523:psychology* / Q000628:therapy; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008607:Intellectual Disability / Q000451:nursing / Q000523:psychology*; D007407:Interviews as Topic; D008297:Male; D009426:Netherlands; D009732:Nursing Care; D011369:Professional-Patient Relations; D036301:Qualitative Research; D012648:Self Care / Q000523:psychology*; D012720:Severity of Illness Index; D012944:Social Support