Introduction and Objective: Older adults with type 1 diabetes face age-related changes. Dyadic coping, where care partners (CPs) and people with diabetes (PWD) collaboratively manage diabetes, can improve outcomes but is hindered by misaligned illness appraisals (viewing diabetes as individual vs. shared responsibility) and communication difficulties. This study describes experiences of older PWD/CP dyads in the Share plus intervention, which facilitates dyadic coping and sharing CGM data.Methods: Fifteen intervention dyads (PWD aged ≥60 years with T1D, A1c ≤11%, using CGM; CPs aged ≥18) participated in three 90-minute telehealth sessions at weeks 2, 4, and 8, addressing illness appraisal, communication, problem-solving, and glucose pattern management. Sessions were audio-recorded and transcribed (n=45). Thematic analysis was used to analyze the data. Two dyads (6 transcripts) were coded jointly by the research team to develop the codebook; remaining transcripts were independently coded and reviewed in regular meetings. Codes were organized into themes.Results: Results showed that diabetes appraisal varied, with CPs generally endorsing greater shared appraisal compared to PWDs. Over time, some dyads increased shared appraisal while others did not. Dyads were overall accepting of Share plus, particularly valuing sharing hypoglycemia data. However, some PWDs and CPs indicated resistance to dyadic coping for hyperglycemia and reported concerns around burdening CPs. Collaborative strategies implemented by dyads ranged from basic to complex problem-solving and dyadic negotiation of appropriate CP support strategies. Intervention experiences and behavioral strategies were influenced by baseline appraisal patterns.Conclusion: CGM data-sharing interventions should assess dyadic appraisal at baseline and provide tailored approaches to address resistance areas. Future iterations may benefit from early attention to CP burden concerns and behavior-specific problem-solving strategies.
N.A. Allen: Research Support; Current; Dexcom, Inc. F. Horner: Employee; Ended; Dexcom, Inc. Research Support; Ended; Dexcom, Inc. B. Gonzales: None. C.A. Berg: None. A. Pickford: None. H. Naidu: None. C. Buena: None. M. Litchman: Research Support; Current; National Institutes of Health, American Diabetes Association, Dexcom, Inc.
National Institutes of Health (R01DK133270-01)
Source link
Leave a Reply