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Articles by K. D. Barnard
Total Records ( 5 ) for K. D. Barnard
  K. D. Barnard , C. E. Lloyd and T. C. Skinner
 

Aim To review systematically the published literature addressing whether continuous subcutaneous insulin infusion (CSII) provides any quality of life benefits to people with Type 1 diabetes.

Methods Electronic databases and published references were searched and a consultation with two professional groups was undertaken to identify relevant studies published up to July 2005. A multistep selection process was then undertaken to identify those articles which met the specific selection criteria, which were then critically reviewed.

Results Eighty-four potential relevant articles were identified from examination of titles and abstracts published during the specified time frame. Of these, 28 articles were retrieved in full text, of which 17 fulfilled the specific criteria for inclusion. Mixed results emerged from existing literature. Of the five randomized controlled trials, three reported mixed results, with one study reporting quality of life benefits and one reporting no evidence of quality of life benefits.

Conclusions There is conflicting evidence reported in the various studies on the quality of life benefits of CSII in Type 1 diabetes. Existing research is flawed, making a judgement about the quality of life benefits of insulin pump use difficult. There is no strong evidence against quality of life benefits associated with CSII or otherwise, with poor methodology and inconsistent assessment of quality of life clouding the issue. The lack of reported benefit is probably a function of this rather than pump therapy not offering any quality of life benefits.

  J. Speight , M. D. Reaney and K. D. Barnard
  Aims  Quality of life (QoL) is recognized widely as an important health outcome in diabetes, where the burden of self-management places great demands on the individual. However, the concept of QoL remains ambiguous and poorly defined. The aim of our review is to clarify the measurement of QoL in terms of conceptualization, terminology and psychometric properties, to review the instruments that have been used most frequently to assess QoL in diabetes research and make recommendations for how to select measures appropriately.

Methods  A systematic literature search was conducted to identify the ten measures most frequently used to assess QoL in diabetes research (including clinical trials) from 1995 to March 2008.

Results  Six thousand and eight-five abstracts were identified and screened for instrument names. Of the ten instruments most frequently used to assess ‘QoL’, only three actually do so [i.e. the generic World Health Organization Quality of Life (WHOQOL) and the diabetes-specific Diabetes Quality of Life (DQOL) and Audit of Diabetes-Dependent Quality of Life (ADDQoL)]. Seven instruments more accurately measure health status [Short-Form 36 (SF-36), EuroQoL 5-Dimension (EQ-5D)], treatment satisfaction [Diabetes Treatment Satisfaction Questionnaire (DTSQ)] and psychological well-being [Beck Depression Inventory (BDI), Hospital Anxiety and Depression Scale (HADS), Well-Being Questionnaire (W-BQ), Problem Areas in Diabetes (PAID)].

Conclusions  No single measure can suit every purpose or application but, when measures are selected inappropriately and data misinterpreted, any conclusions drawn are fundamentally flawed. If we value QoL as a therapeutic goal, we must ensure that the instruments we use are both valid and reliable. QoL assessment has the proven potential to identify ways in which treatments can be tailored to reduce the burden of diabetes. With careful consideration, appropriate measures can be selected and truly robust assessments undertaken successfully.

  K. D. Barnard , M. Peyrot and R. I. G. Holt
  Not available
  K. D. Barnard , M. J. Campbell , C. Emery , A. J. Young and S. Heller
  Not available
  K. D. Barnard , C. E. Lloyd , P. A. Dyson , M. J. Davies , S. O`Neil , K. Naresh , J. Lawton , R. Ziegler and R. I. G. Holt
  National Audit Data highlight persistent sub-optimum control among increasing numbers of people living with diabetes, with severe consequences for the individual and the NHS. The aim of the present review was to introduce a new cohesive, holistic model of care, tailored to individual needs to support optimum diabetes outcomes. This model of diabetes is necessary in order to understand the driving forces behind behaviour and their impact on diabetes management. Feelings (an emotional state or reaction) and beliefs (an acceptance that something is true or real) are fundamental behavioural drivers and influence diabetes self-management choices. Individually, these explain some of the complexities of behaviour and, collectively, they impact on personal motivation (rationale/desire to act) to achieve a specific outcome. Inevitably, they independently affect diabetes self-management and the environment in which individuals live. A model of care that proposes the encompassing of environment, intrinsic thought and therapy regimens to provide tailored, personalized healthcare should support enhanced diabetes self-management and outcomes from diagnosis. The Kaleidoscope model of care could be deliverable in routine care, incorporating each of the influences on diabetes self-management, and should benefit both individuals with diabetes and healthcare professionals.
 
 
 
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