Résumé
Purpose: We aimed to evaluate patient self-management activities, patient perceptions of the therapeutic relationship
and satisfaction with nurse-led consultations as part of a structured, pilot program transitioning
young adults with type 1 diabetes (T1DM) to adult-oriented community-based practices.
Design and Methods: A descriptive, cross-sectional study of patients receiving nurse-led consultations. Patients
provided sociodemographic/health information, glycated hemoglobin (HbA1c) measures and completed
questionnaires assessing self-management (Revised Self-Care Inventory) and the therapeutic relationship
(Caring Nurse-Patient Interaction – short scale). HbA1c values were compared to guideline recommendations.
Results: Twenty patients participated. HbA1c was ≤7.5% in 3/14 (21%) and 5/14 (36%) exhibited poor glycemic
control (≥9.5%). The greatest concordance for self-care was in relation to insulin therapy (4.5 ± 0.5) while patients
reported the lowest adherence to diet recommendations (2.9 ± 0.8). Overall satisfaction with nurse-led
consultations was high (4 ± 0.5 out of 5). Patients considered diabetes knowledge and technical competence
as very important and were most pleased with the humanistic aspects of nursing care. Respect for privacy was
deemed the most important (and most frequently observed) nursing attitude/behavior during consultations.
Conclusions: Young adults found the nurse-led consultations with therapeutic education to develop T1DM selfcare
skills are an important complement to medical management during transition.
Practice Implications: Patient autonomy and privacy should be respected during this developmental period.
Nurses taking a humanistic approach towards accompanying and supporting the patient can enhance the therapeutic
relationship during transition and promote continuity of care. Transition nurses can use technical competence
and therapeutic education to empower patients for self-management.