Développement de l'hospitalisation à domicile (HAD) pédiatrique après diagnostic du diabète : évaluation des attentes et freins auprès des familles et médecins généralistes

Abstract : Aims: To evaluate whether hospital-based home care was desired by the parents of children diagnosed with type 1 diabetes under the age of five and their general practitioners, and to identify the main expectations and obstacles to its implementation. Methods: We led a descriptive two center study in France between November 2016 and November 2017. Data were collected by interviewing 57 families of children diagnosed with diabetes before the age of five years and the corresponding 30 general practitioners. The primary endpoint was families’ or general practitioners’ acceptance or refusal of home based care after diagnosis. Univariate and multivariate analyses were performed to identify factors associated with refusal of this care pathway. Results: Forty-nine of the 57 families (86%) and twenty eight of the 30 physicians (93%) wished home based care to be established. This care pathway was considered essential by 79% of families and 87% of physicians. Low income families were less likely to accept hospital based home care (p < 0.001). The expectations of families from this pathway were help with social care, management of emergencies, and return to school. The physicians’ main request was improved interprofessional collaboration, with the most popular suggested measure being shared computer files. Conclusion: Most of the families of children with diabetes and their general practitioners wanted changes in the care pathway with a transition toward hospital based home care after diagnosis. Multidisciplinary support, personalized social care and access to welfare benefits could improve acceptance rates, especially among low-income families.
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https://dumas.ccsd.cnrs.fr/dumas-01949522
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Submitted on : Monday, December 10, 2018 - 11:01:52 AM
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Juliette Moulin. Développement de l'hospitalisation à domicile (HAD) pédiatrique après diagnostic du diabète : évaluation des attentes et freins auprès des familles et médecins généralistes. Sciences du Vivant [q-bio]. 2018. ⟨dumas-01949522⟩

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