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.