Question Title

* 1. What is your gender?

Question Title

* 2. What is your age?

Question Title

* 3. Where do you predominantly practice?

Question Title

* 4. How many adult diabetologists are working in your hospital?

Question Title

* 5. How many patients with diabetes (T1&T2) do you follow?

Question Title

* 6. What proportion of your patient population are patients with type 1 DM?

Question Title

* 7. Are you working in the context of a RIZIV convention for diabetes?

Question Title

* 8. Does your hospital have a pediatric diabetes convention?

Question Title

* 9. How many pediatric diabetologists are working in your hospital?

Question Title

* 10. Your multidisciplinary diabetic team consists of (please choose all that apply)

Question Title

* 11. Are there adult diabetologists who serve as a contact point for young adults in your center and are therefore responsible for the care of new young adult in your clinic?

Question Title

* 12. Do you have a transition coordinator?

Question Title

* 13. The transition coordinator is

Question Title

* 14. What are the responsibilities of the transition coordinator? (please choose all that apply)

Question Title

* 15. What is to your opinion the ideal age range for transition?

Question Title

* 16. At what age does the actual transfer from pediatrics to adult endocrinology take place in your center?

Question Title

* 17. Do you use a written structured transition program?

Question Title

* 18. What do you think is important for the adolescent in transition? (please choose all that apply)

Question Title

* 19. What do you think is the best measure of a successful transition?

Question Title

* 20. What do you think are the barriers for a successful transition?

  Strongly disagree Disagree Undecided Agree Strongly agree
Lack of time and resources for organising transition care
Less frequent consultations in adult-oriented care
Less support in-between appointments in adult-oriented care
Different approach by adult endocrinologist
Lack of understanding of the vulnerability of the young adult patient.
Lack of transition protocols
Patient related factors (lack of interest, motivation,…)

Question Title

* 21. During the transition period the adolescent is seen (please choose all that apply):

Question Title

* 22. How often do you see adolescents with type 1 diabetes type?

Question Title

* 23. Did you have a special training in transition care?

Question Title

* 24. When/how did you receive this training?

Question Title

* 25. How do most referred patients get to your clinic?

Question Title

* 26. When welcoming a young adult with type 1 diabetes transitioning to your care from pediatric care, you are

Question Title

* 27. What information would you like to receive from the pediatric team about a patient that is transferred to your care? (please choose all that apply)

Question Title

* 28. What information do you receive from the pediatric team about a patient that is transferred to your care?

  Rarely-never Sometimes Most of the time
A referral addressed to you specifically
A written medical summary
A written psychosocial summary
A transition readiness assessment checklist
A phone communication
A joint consultation
No communication

Question Title

* 29. How satisfied are you with the communication with the pediatric team?

Very unhappy Neutral Couldn't be better
Clear
i We adjusted the number you entered based on the slider’s scale.

Question Title

* 30. In your opinion, how much room is there for improvement in this communication?

It's perfect Neutral Everything has to change
Clear
i We adjusted the number you entered based on the slider’s scale.

Question Title

* 31. What are the positive aspects of pediatric diabetes clinics in general according to your perception?

  Strongly disagree Disagree Undecided Agree Strongly agree
Longterm comfortable relationship with pediatric health care provider
Holistic approach, multidisciplinary and focused on family involvement
Receiving a lot of support and guidance

Question Title

* 32. What are the negative aspects or points of improvement of pediatric diabetes clinics according to your perception?

  Strongly disagree Disagree Undecided Agree Strongly agree
To liberal use of exchange values
Continued use of snacks
To little focus on the concept of healthy food
Continued involvement of parents

Question Title

* 33. Do you give written feedback to the pediatric provider after the transferred care?

Question Title

* 34. Do you follow a fixed protocol when seeing a young adult with type 1 diabetes for the first time?

Question Title

* 35. What items do you discuss with the patient during the transition period? (please choose all that apply)

Question Title

* 36. Indicate your interest in using the following transition-specific staff and / or resources for your practice

  Already in use Would use if available Would not use Need to know more about this tool before using it
Information brochure explaining your approach to diabetes care and transition, services offered in your practice and contact information
Transition care coordinator / dedicated transition nurse
A person dedicated to booking and confirming appointments
A self-care management checklist that assesses patient’s knowledge, skills and experiences in diabetes self-care
A health care passport which includes a written medical summary and emergency care plan to share with the patient that is updated and printed in a portable format
A tool to monitor progress of each patient during the transition process
A registry to track attendance and loss to follow-up
Feedback survey for young adults to complete about their experience with the new adult care team
0 of 36 answered
 

T