Trust, targets and teenagers : the negative impact of the audit culture combined with the medicalisation of adolescence on young people with diabetes

McKiernan, Peter and Greene, A. and Greene, S. (2007) Trust, targets and teenagers : the negative impact of the audit culture combined with the medicalisation of adolescence on young people with diabetes. Preprint / Working Paper. University of Strathclyde, Glasgow. (Unpublished)

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Abstract

Objective: To examine the value of ‘trust’ in the delivery of patient centred care for young people with Type 1 diabetes. Design: A longitudinal, quantitative study using semi-structured interviews and observation of consultations using the constant comparative method. Setting: Seven clinical centres in three Health Boards in Scotland. Participants: Nineteen health care professionals and 65 young people. Results: Conclusions: Two distinct barriers (the audit culture and medicalisation) interfere with the establishment of long-term reciprocity between health care professionals and young people with diabetes, which diminishes the development of trust based relationships. To improve the reciprocity necessary for maintaining these long-term relationships requires both an appreciation of these barriers and a change in management strategy to nullify their impact.

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