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Type 1 Diabetes Management and Health Care Experiences Across Rural Nebraska

Published:September 02, 2022DOI:https://doi.org/10.1016/j.pedhc.2022.07.005

      Highlights

      • Families living in rural Nebraska experienced decreased health care access.
      • Geographic and social isolation cause dramatic lifestyle changes after a child's T1D diagnosis.
      • Technology improved diabetes management and access to care.
      • Interprofessional teams may provide novel health care delivery systems to increase access and decrease health care disparities.

      Abstract

      Introduction

      This study aimed to explore the unique health care needs of rural Nebraska families with a child with type 1 diabetes mellitus (T1DM).

      Method

      Using a phenomenological approach, the researchers conducted four focus groups across Nebraska. The focus groups gathered input from children, caregivers, and health care providers (n = 23). The researchers coded data and generated themes. Member checking, researcher triangulation, reflexivity, a thick description of the process, and an audit trail established trustworthiness.

      Results

      Four themes emerged: dramatic family and lifestyle changes following diagnosis, lack of access to specialized care resulting in complications, isolation improved health management resourcefulness, and technology improved health management and flexibility.

      Discussion

      Lifestyle changes persist after a child's diagnosis with T1DM. Rural families reported unpredictable health status of their child, reduced health care services, and limited information access. Conversely, limited specialty health care access, resources, and community support led to creative self-education, advocacy, and health care management strategies. Diabetes technology offered opportunities for improved provider-patient communication and continuous glucose monitoring.

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