title: What makes for a 'good' or 'bad' paediatric diabetes service from the viewpoint of children, young people, carers and clinicians? A synthesis of qualitative findings.
abstract: BACKGROUND
  There is mounting evidence that experience of care is a crucial part of the pathway for successful management of long-term conditions.
  
  
  OBJECTIVE
  To carry out (1) a systematic mapping of qualitative evidence to inform selection of studies for the second stage of the review; and (2) a narrative synthesis addressing the question, What makes for a 'good' or a 'bad' paediatric diabetes service from the viewpoint of children, young people, carers and clinicians?
  
  
  RESULTS
  The initial mapping identified 38 papers. From these, the findings of 20 diabetes-focused papers on the views on care of ≥650 children, parents and clinicians were synthesised. Only five studies included children under 11 years. Children and young people across all age groups valued positive, non-judgemental and relationship-based care that engaged with their social, as well as physical, health. Parents valued provision responsive to the circumstances of family life and coordinated across services. Clinicians wanting to engage with families beyond a child's immediate physical health described finding this hard to achieve in practice.
  
  
  CONCLUSIONS
  Socioeconomic status and ethnicity were poorly reported in the included studies.
  
  
  CONCLUSIONS
  In dealing with diabetes, and engaging with social health in a way valued by children, parents and clinicians, not only structural change, such as more time for consultation, but new skills for reworking relations in the consultation may be required.
authors: School of Health Sciences, City University London, London, UK.
authors: Katherine
authors: K
authors: Curtis-Tyler
authors: School of Health and Social Care, Teesside University, Middlesbrough, UK.
authors: Lisa
authors: L
authors: Arai
authors: UCL Institute of Child Health, London, UK.
authors: Terence
authors: T
authors: Stephenson
authors: UCL Institute of Child Health, London, UK.
authors: Helen
authors: H
authors: Roberts
mesh_terms: D001291:Attitude of Health Personnel; D001294:Attitude to Health; D017028:Caregivers / Q000523:psychology; D002648:Child; D002662:Child Health Services / Q000592:standards*; D003922:Diabetes Mellitus, Type 1 / Q000628:therapy*; D019317:Evidence-Based Medicine / Q000379:methods; D005190:Family / Q000523:psychology; D006801:Humans; D036301:Qualitative Research; D019984:Quality Indicators, Health Care
keywords: Adolescent Health; Diabetes; Health services research; Paediatric Practice; Qualitative research