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Canadian Diabetes Association Grant Success…

CHEO Investigators Judy Rashotte, Christine Richardson, Margaret Lawson, Patricia Olivier, Meranda Nakhla and Dr. Frances Fothergill-Bourbonnais have received a one year CDA Operating Grant in the amount of $36, 68 for a project entitled:

Adolescents’ and Parents’ Experience of Living with REAL-Time Continuous Glucose Monitoring and Insulin Pump Therapy

Type 1 diabetes is a chronic disease that imposes a significant burden on the health and quality of life of children, adolescents and their families. New technological devices, such as continuous subcutaneous insulin infusion pumps (CSII) and REAL-Time continuous glucose monitors (RT CGM), offer assistance in meeting this goal. However, recent studies have been unable to demonstrate effectiveness of the use of sensor-augmented pump therapy, a combination of CSII and RT CGM, in the pediatric age group even when it is introduced in experienced pump users; children and adolescents appear to be unable to use these technologies in a sustained fashion. Adolescents are a salient group in this respect as they often struggle to achieve good diabetes control. We know very little about the reasons why adolescents engage (or not) in diabetes self-care practices, let alone why they sustain (or not) therapies such technologies as CSII and RT CGM. This study will explore the parents’ and adolescents’ experience of living with sensor-augmented pump therapy in order to enhance our understanding of the personal experiences of using this technology. Health care professionals can then share this information with parents and adolescents to help them make the decision whether or not to initiate sensor augmented pump therapy and/or to decide when and how best to use these combined technologies.

A multi-sited nursing research study entitled Adolescent-Friendly Health Services: What Can Perinatal Nurses and Hospitals Provide? is currently underway in CHEO’s NICU, the purpose of which is to examine how individual nurse and organizational factors influence the provision of adolescent-friendly perinatal nursing care. Funding for this project was received from the Association of Women’s Health, Obstetric and Neonatal Nursing (Canada), the Canadian Nurses Foundation, and the Ontario Premier’s Research Excellence Award. The research team (see picture above) is lead by Dr. Wendy Peterson, U of O. Dr. Judy Rashotte is a co-investigator on the project.

In Canada, approximately 14,000 infants are born to adolescents (< 19 of age) annually. The challenges of pregnancy and parenthood during adolescence combined with the adverse life circumstances of many adolescent mothers (e.g., prior life events, poverty, poor family support) likely contribute to their under-use of preventive services. While many community-based agencies have begun to engage adolescents by adapting their pre- and post-natal services to be more adolescent-friendly, little is known about initiatives that successfully promote adolescent-friendly hospital care for this population. Adolescent-friendly inpatient perinatal nursing care is important because it provides an opportunity for nurses to 1) assess and respond to the learning needs of young mothers and 2) ensure the provision of appropriate supports. However, studies have found that adolescents describe the quality of their inpatient nursing care as highly variable depending on the relationship-building skills of nurses and the degree of adolescent-friendliness of hospitals. Therefore, the findings from this study will inform our understanding of how to provide adolescent-friendly inpatient nursing care during the perinatal period and contribute to the development of individual nurse and organizational-level interventions to improve adolescent-mother and baby care.

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