Diabetes Transitions in Care: Pediatric Survey

Exit this survey

 

1. Does your clinic have a policy or standards of care around the area of transitioning from pediatric to adult diabetes care?

Does your clinic have a policy or standards of care around the area of transitioning from pediatric to adult diabetes care?   Yes No I Don't Know

2. If there is no current standard practice in your clinic, how important is it? 1 is not at all important, and 6 is very important

If there is no current standard practice in your clinic, how important is it? 1 is not at all important, and 6 is very important   1

2

3

4

5

6

3. Do you personally discuss anything related to transitioning with your pediatric patients prior to their graduation from high school?

Do you personally discuss anything related to transitioning with your pediatric patients prior to their graduation from high school?   Yes, 90-100 % of the time Yes, 50-90 % of the time Some 1-49% of the time None, 0 % of the time

4. Does your clinic have a policy of mandatory transitions at a certain age?

Does your clinic have a policy of mandatory transitions at a certain age?   yes no

5. If you do require transitioning to an adult practice, at what age?

If you do require transitioning to an adult practice, at what age?   18

19

20

21

22

other

6. If there is no explicit policy, at what age(s) do you prefer to transition your pediatric patients? Please check all that you consider appropriate.

If there is no explicit policy, at what age(s) do you prefer to transition your pediatric patients? Please check all that you consider appropriate.   <18

18

19

20

21

22

>22

7. Please list the factors you consider when deciding how and at what point to transition your pediatric patients.

Please list the factors you consider when deciding how and at what point to transition your pediatric patients.   1)
2)
3)
4)
5)

8. If you do discuss transitioning, what topics do you address with the teen? Which do you address with the parent/guardian? Please check all that apply.

	Discuss with Teen	Discuss with Parent/Guardian
Leaving Practice Issues (when, how, to where, linking to a new team)	*If you do discuss transitioning, what topics do you address with the teen? Which do you address with the parent/guardian? Please check all that apply. Leaving Practice Issues (when, how, to where, linking to a new team) Discuss with Teen	Leaving Practice Issues (when, how, to where, linking to a new team) Discuss with Parent/Guardian
Safety Issues (college life, alcohol use, drug use, living alone)	Safety Issues (college life, alcohol use, drug use, living alone) Discuss with Teen	Safety Issues (college life, alcohol use, drug use, living alone) Discuss with Parent/Guardian
Communication Issues (discussing with roommates, professors, bosses)	Communication Issues (discussing with roommates, professors, bosses) Discuss with Teen	Communication Issues (discussing with roommates, professors, bosses) Discuss with Parent/Guardian
Dating Issues (diabetes and relationships, sex, birth control)	Dating Issues (diabetes and relationships, sex, birth control) Discuss with Teen	Dating Issues (diabetes and relationships, sex, birth control) Discuss with Parent/Guardian
Legal Issues (driving, health care, discrimination)	Legal Issues (driving, health care, discrimination) Discuss with Teen	Legal Issues (driving, health care, discrimination) Discuss with Parent/Guardian
Health Insurance (insulin, medications, supplies)	Health Insurance (insulin, medications, supplies) Discuss with Teen	Health Insurance (insulin, medications, supplies) Discuss with Parent/Guardian
Planning for Diabetes Emergencies	Planning for Diabetes Emergencies Discuss with Teen	Planning for Diabetes Emergencies Discuss with Parent/Guardian
Health Worries	Health Worries Discuss with Teen	Health Worries Discuss with Parent/Guardian
Mental Health	Mental Health Discuss with Teen	Mental Health Discuss with Parent/Guardian
Other Issues	Other Issues Discuss with Teen	Other Issues Discuss with Parent/Guardian

9. How often do you address psycho-social issues related to diabetes in your clinic visits or appointments? (ie: depression, anxiety, social issues, diabetes burnout, health worries)

How often do you address psycho-social issues related to diabetes in your clinic visits or appointments? (ie: depression, anxiety, social issues, diabetes burnout, health worries)   90-100% of the time 50-89% of the time 1-49 % of the time Never

10. Does your clinic use any paper and pencil measures for transitioning patients?

Does your clinic use any paper and pencil measures for transitioning patients?   Yes No I'm not sure

11. If your clinic does use any paper and pencil measures for transitioning patients, which ones?

If your clinic does use any paper and pencil measures for transitioning patients, which ones?   Barriers to Adherence Scale CDC-Depression - Youth Diabetes Knowledge Test Diabetes Self-Management Profile Diabetes Quality of Life for Youth scale Diabetes Health Profile

Diabetes Family Behavior Scale Diabetes Care Profile Eating Disorder Inventory-3 Pediatric Quality of Life Inventory Self Care Inventory Helping for Health Inventory

Problem Areas In Diabetes (PAID) Diabetes Family Behavior Scale Diabetes Conflict Scale - Revised Other

12. Would you be interested in finding out which paper and pencil measures might help transitioning patients and parents?

	Patients/Teens	Parents/Guardians
Yes	*Would you be interested in finding out which paper and pencil measures might help transitioning patients and parents? Yes Patients/Teens	Yes Parents/Guardians
No	No Patients/Teens	No Parents/Guardians

13. How many patients are currently in your practice who have type 1 diabetes and are between the ages of 15-22 years?

How many patients are currently in your practice who have type 1 diabetes and are between the ages of 15-22 years?

14. How many patients are currently in your practice who have type 2 diabetes and are between the ages of 15-22?

How many patients are currently in your practice who have type 2 diabetes and are between the ages of 15-22?

15. How many of those "transition range" patients will either do not have insurance or will not have insurance after they turn 18?

How many of those "transition range" patients will either do not have insurance or will not have insurance after they turn 18?

16. What is your role in this clinic?
Which of these positions do you have located within your clinic?

	My role in this clinic	My clinic has these on staff here
CDE	*What is your role in this clinic? Which of these positions do you have located within your clinic? CDE My role in this clinic	CDE My clinic has these on staff here
Dietitian	Dietitian My role in this clinic	Dietitian My clinic has these on staff here
Nurse	Nurse My role in this clinic	Nurse My clinic has these on staff here
Physician	Physician My role in this clinic	Physician My clinic has these on staff here
Endocrinologist	Endocrinologist My role in this clinic	Endocrinologist My clinic has these on staff here
Nurse Practitioner	Nurse Practitioner My role in this clinic	Nurse Practitioner My clinic has these on staff here
Physician's Assistant	Physician's Assistant My role in this clinic	Physician's Assistant My clinic has these on staff here
Exercise Physiologist	Exercise Physiologist My role in this clinic	Exercise Physiologist My clinic has these on staff here
Social Worker	Social Worker My role in this clinic	Social Worker My clinic has these on staff here
Psychologist	Psychologist My role in this clinic	Psychologist My clinic has these on staff here
Counselor	Counselor My role in this clinic	Counselor My clinic has these on staff here
Medical Assistant	Medical Assistant My role in this clinic	Medical Assistant My clinic has these on staff here
Other	Other My role in this clinic	Other My clinic has these on staff here