Psychosocial aspects of continuous subcutaneous insulin infusion (CSII) therapy — ASN Events

Psychosocial aspects of continuous subcutaneous insulin infusion (CSII) therapy (#363)

Marlene Payk 1 , Tracy Robinson 2 , Marjorie Atchan 2 , Deborah Davis 2 , Kim Foster
  1. Westmead Hospital, Westmead, NSW, Australia
  2. University of Canberra, Canberra, ACT, Australia

Background
CSII therapy can be an effective treatment for type 1 diabetes though it is not acceptable to all patients. Given that CSII therapy has significant clinical benefits for people in terms of managing their diabetes, is imperative that potential psychosocial factors are identified. A number of studies focus on this element of the experience but none has drawn this information together in a review.

Purpose
The purpose of this integrative review was to synthesize the literature on the psychosocial aspects of CSII therapy among people with type 1 diabetes.

Methods
A systematic search of the electronic databases: CINAHL, Cochrane, Medline, PsycINFO and Scopus was conducted to identify published studies between 2005 and 2015. Studies reporting psychosocial aspects of CSII therapy were eligible for inclusion.

Results
Thirty-two potential articles were identified from titles and abstracts and the full texts were reviewed. Of these, 13 met the inclusion criteria. Studies included 6 papers on adults on CSII therapy and 7 in young people on CSII therapy. Psychosocial aspects associated to facilitators of CSII therapy included the flexibility and freedom it provided for living with diabetes, enhancing social situations and empowering daily management. In contrast barriers included the demands of CSII therapy, self-consciousness in wearing the pump and fear of hypoglycaemia and pump failure.

Conclusion
Evidence indicates that the psychosocial benefits of CSII therapy do not always correlate with HbA1c as a measure of diabetes control. The daily management of type 1 diabetes is largely improved on CSII therapy and enhances psychosocial well-being. Findings can be used by health professionals for people embarking on CSII therapy to inform and prepare them with regard to expectations of the treatment. The role of the diabetes health professional in providing psychosocial support to people with type 1 diabetes on CSII therapy warrants further investigation.

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