title: Working with young adults with Type 1 diabetes: views of a multidisciplinary care team and implications for service delivery.
abstract: OBJECTIVE
  Young adults with Type 1 diabetes experience difficulties achieving glucose targets. Clinic attendance can be poor, although health and self-care tend to be better among those who attend regularly. Our aims were to describe staff views about challenges working with this age-group (16-21 years).
  
  
  METHODS
  Semistructured interviews were conducted with 14 staff from Sheffield Teaching Hospitals diabetes care team. Interviews were audio-recorded, transcribed and analysed using thematic analysis.
  
  
  RESULTS
  Three main themes emerged. Unique challenges working with young adults included staff emotional burden, the low priority given to self-care by young adults and the complexity of the diabetes regimen. Working in a multidisciplinary team was complicated by differences in consultation styles, poor team cohesion and communication. An ideal service should include psychological support for the professional team, identification of key workers, and development of individualized care plans.
  
  
  CONCLUSIONS
  Staff differed in their views about how to achieve optimal management for young adults, but emphasized the need for greater patient-centred care and a range of interventions appropriate for individual levels of need. They also wanted to increase their own skills and confidence working with this age-group. While these results reflect the views of staff working in only one diabetes centre, they are likely to reflect the views of professionals delivering care to individuals of this age; replication is needed to determine their generalizability.
authors.affiliation: Department of Psychology Department of Human Metabolism, University of Sheffield, Sheffield NIHR CLAHRC for South Yorkshire, UK. s.brierley@sheffield.ac.uk
authors.forename: S
authors.initials: S
authors.lastname: Brierley
authors.forename: C
authors.initials: C
authors.lastname: Eiser
authors.forename: B
authors.initials: B
authors.lastname: Johnson
authors.forename: V
authors.initials: V
authors.lastname: Young
authors.forename: S
authors.initials: S
authors.lastname: Heller
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D000328:Adult; D003142:Communication; D003695:Delivery of Health Care / Q000592:standards*; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D010348:Patient Care Team / Q000592:standards*; D018802:Patient-Centered Care / Q000592:standards* / Q000639:trends; D010817:Physician-Patient Relations; D011788:Quality of Life; D012648:Self Care / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult