Discovering the hidden emotional burden: Systematic screening for diabetes distress in adults with type 1 diabetes in nurse-led routine diabetes care

Aim: To gain insights into the experience of adults with type 1 diabetes (T1D) using a systematic screening method to assess and address diabetes distress (DD) in nurse-led routine diabetes care.

Methods: DD screening in 30 consultations incorporated the Type 1 Diabetes Distress Scale-7 (T1-DDS-7), a short-form, validated instrument capturing the most common sources of DD, and a dialogue model to support diabetes specialist nurses (DSNs) in addressing DD. Semi-structured interviews were conducted with 30 adults with T1D who participated in DD screening. Interviews were analysed using thematic text condensation.

Results: Participant mean age and diabetes duration were 47 and 26 years, respectively. Sixteen participants reported moderate to high DD (total T1-DDS-7 score ≥14). Participants described positive experiences discussing DD with DSNs during annual consultations. Three themes emerged from interviews: (1) an eye-opener that enhanced emotional support in adults with T1D, (2) meaningful conversations and personalised diabetes care and (3) increased satisfaction and engagement with diabetes care in adults with T1D.

Conclusion: Systematically assessing and addressing DD in clinical consultations was both useful and acceptable. Participants reported high levels of satisfaction with the screening method, noting that DSNs used open-ended questions and active listening skills to support managing DD, reflecting good fidelity with the dialogue model. Future research should explore methods for implementing the screening tools to ensure consistent detection of DD in adults with T1D during consultations as well as timely referral to effective interventions.