JMIR Publications

ABSTRACT

Background:

The period of transition of patients with type 1 diabetes from pediatric to adult-oriented health care is very vulnerable time, as it is associated with poorer glycemic control and less frequent clinic attendance. Fears and anxiety about the unknown, differences in the approach to care in adult settings, and sadness about leaving the pediatric provider all contribute to a patient’s reluctance to transition.

Objective:

The purpose of this study was to evaluate psychological parameters of transitioning young patients with type 1 diabetes during the 1st visit in adult outpatient clinic.

Methods:

We examined 50 consecutive patients (56% females) transitioning from 02.03.2021 - 21.11.2022 into adult care (3 diabetes centers from 3 regions in southern Poland (A=16; B=21; C= 13)) and their basic demographic information. All patients fulfilled the following psychological questionnaires: State-Trait Anxiety Inventory (STAI), Generalized Self-Efficacy Scale (GSES), Perceived Stress Scale (PSS-10), Satisfaction with Life Scale (SWLS), Acceptance of Illness Scale (AIS), Multidimensional Health Locus of Control Scale Form C (MHLC) and Courtauld Emotional Control Scale (CECS). Furthermore, we made comparison of data obtained in the study with data for general healthy population and general population with persons with diabetes available from Polish Test Laboratory during validation studies.

Results:

During the first adult outpatients visit patients mean age was 19.2±1.4 yrs. with 9.8±4.3 yrs. of diabetes duration and BMI 23.5±3.1 kg/m2. Participants came from diverse socioeconomic backgrounds: 36% live in village, 26% live in town up to 100,000 inhabitants and 38% live in bigger cities. Considering the therapy type: 67% of patients were treated with insulin pump therapy while 33% with multiple daily injections. Patients from center A had mean HbA1c 7.5±1.2. There was no difference regarding the level of life satisfaction, perceived level of stress and state anxiety between studied population and general/diabetes population. Studied patients had similar locus of health control and negative emotions control in comparison to general population of diabetes. Patients had higher level of suppression of negative emotions: anger, depression, and anxiety than age matched general population. In addition, our population was characterized by higher acceptance of illness and higher level of self-efficacy compared to general/diabetes population. According to the results 64% of our patients had high level of self-efficacy and 26% high level of life satisfaction.

Conclusions:

This study indicated that good psychological resources and coping mechanisms of young patients transitioning to adult outpatient clinic might result in adequate adaptation and adult life satisfaction including future metabolic control. Those result also prove wrong the stereotypes that young person with chronic disease has worse life perspective entering adulthood.