What nursing interventions and healthcare practices facilitate type 1 diabetes self-management in young adults? An integrative review

Abstract
This integrative review aimed to explore how current nursing and healthcare practices can be designed to facilitate effective type 1 diabetes (T1D) self-management in young adults aged 16-25 years. The review explored relevant quantitative and qualitative literature published between 2017 and 2021. Five electronic databases were searched: CINAHL, Medline, Scopus, PubMed and PsycINFO. PRISMA reporting was used to show the flow of information through the different phases of the review. Articles that met the inclusion/exclusion criteria were critically appraised using the Mixed Methods Appraisal Tool. Four main themes emerged through thematic analysis: digital information systems; glucose monitoring and insulin devices; group and peer education and peer support; and diabetes care delivery style. Findings from the review identified that 1) platforms for text messaging, social media, email, and smartphone apps were innovative communication strategies that worked for this age group; 2) the use of continuous glucose monitoring and insulin devices were found to improve self-management routines and psychological well-being of young adults; 3) health service support and education needs to be flexible, dynamic and young adults want to be treated as partners in their own care; and, 4) young adults prefer to be socially engaged, interacting either in group educational settings or with peers through social media. This integrative review highlights the importance of adopting age-appropriate interventions to improve young adults’ engagement in T1D self-management, requiring nurses and healthcare practitioners need to keep up to date with the rapid changes in digital technology and diabetes-related device technology. However, relational engagement remains an essential component integral to nurses supporting young adults living with T1D.

Ngā ariā matua
Ko te whāinga o tēnei arotake tuitui he tūhura me pēhea te hoahoa i ngā tikanga mahi tapuhi, taurima hauora hoki hei whakangāwari i te whakahaere whaihua a te pakeke taiohi i waenga i te 16-25 tau, i tōna anō mate huka momo 1 (T1D). I tūhuratia e te arotake ngā tuhinga ā-inerahi, ā-kounga hāngai i whakaputaina i waenga i te tau 2017 me 2021. E rima ngā pātengi raraunga matihiko i hāhauria. Ko CINAHL, ko Medline, ko Scopus, ko PubMed, ko PsycINFO hoki. I whakamahia ngā tikanga pūrongo PRISMA hei whakakite i te rerenga mōhiotanga, mā roto i ngā hipanga o te arotake. I arohaehaetia ngā tuhinga i eke ki ngā paearu tuku mai/aukati atu ki te Taputapu Arohaehae Tikanga Hanumi. E whā ngā tāhuhu matua i puta mai mā roto i te tātaritanga tāhuhu: ko ngā pūnaha mōhiotanga matihiko; ko te aroturuki huka toto, me ngā pūrere taiaki huka; te akoranga me te tautoko ā-rōpū, ā-hoa mahi hoki, me te āhua o te hora taurimatanga mate huka. I tautohutia e ngā kitenga o te arotake 1) he rautaki whakapā auaha te whakamahi pūhara mō te karere kuputuhi, pāpāho pāpori, me ngā taupānga waea atamai mō tēnei reanga; 2) nā te whakamahinga aroturuki huka toto, me ngā taputapu taiaki huka i piki ake ai ngā hātepe whakahaere a te pakeke taiohi i a ia anō, me tōna hauora ā-hinengaro anō hoki; 3) he mea hira kia kakama, kia hihiri ngā tautoko ratonga hauora, akoranga hoki, ā, e hiahia ana ngā pakeke taiohi kia kīa he hoa kōtui i roto i tō rātou taurimatanga; ā, 4) he mea pai kē atu ki te pakeke taiohi kia hono ā-pāpori ki ōna hoa, mā te kōrerorero i roto i ngā horopaki ako ā-rōpū, mā te kōrero rānei ki ngā hoa mā ngā pāpāho pāpori. Nā tēnei arotake tuitui kua whakaūngia te hira o te whakamahi i ngā ritenga āwhina tika ā-reanga hei whakapiki i te whakaurunga mai o te pakeke taiohi ki ngā whakahaere i a ia anō mō T1D, e tika ai kia ako haere tonu ngā tapuhi me ngā kaimahi taurima i ngā hangarau matihiko hou, me ngā hangarau e pā ana ki ngā pūrere mō te mate huka. Ahakoa tērā, he mea tino nui te whakatata atu mō ngā tapuhi tautoko i ngā pakeke taiohi e noho tahi ana me te mate huka T1D.

Keywords / Ngā kupu matua
adolescents / ngā taiohi; digital technology / hangarau matihiko; nursing / tapuhi; self-management / whakahaere i a ia anō; type 1 diabetes / mate huka momo 1; young adults / ngā pakeke taiohi