Implementing psychological assessments required by the best practice tariff for paediatric diabetes
Despite advances in technologies, health outcomes for young people with diabetes remain suboptimal. The prevalence of psychosocial morbidity is alarmingly higher than in the general population with clinically elevated depression and anxiety symptoms present in 15-25% of adolescents with type 1 diabetes. Associated poor self-care, suboptimal glycaemic control and recurrent diabetic ketoacidosis are common. The aims of this article are to outline common psychological difficulties for young people, and the screening tools available, and to assess the potential impact of the best practice tariff for paediatric diabetes. Common psychological problems include depression, anxiety, disordered eating and burnout. Similarly to the multi-factorial aetiology of paediatric diabetes, there are multiple contributors to psychological functioning. There is no nationally recognised gold standard for psychological screening at present and provision is varied across the UK. Until standardised tools are developed and validated, it is likely that standards and screening methods will remain variable but will be clarified and nationally agreed as the tariff beds in and is more broadly attained in units across the country. National audit data highlight that enhanced care for young people as intended under the new best practice tariff is necessary. Service adjustment is likely to be challenging; however, the aim of better psychological coping annually assessed with access to appropriate psychology services is long overdue. Copyright © 2012 John Wiley & Sons.
Barnard, K; Davis, N; Taylor, C
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