BACKGROUND:Hypoglycemia is a frequent phenomenon in people being treated for diabetes mellitus, which can acutely disrupt driving performance. For the benefit of personal and public traffic safety, we decided to identify successful diabetes-related (SDR) behaviors to support safe driving for people with diabetes, from the perspective of experiential experts with diabetes mellitus. Experiential experts are people who can manage their own illness and conditions by developing expertise relevant to maintaining health and countering illness, and who are able to use this expertise to the benefit of peers. OBJECTIVE:The aim of our study was to objectify and systematize experiential expertise in terms of SDR behaviors, based on reports by experiential experts, to support safe driving for people with type 1 and type 2 diabetes mellitus. The emphasis was on preventing hypoglycemia as a short-term complication during driving. METHODS:We performed a mixed-methods study involving (i) semi-structured in-depth interviews with 33 experiential experts with diabetes mellitus from the Dutch Diabetes Association (DVN; Diabetesvereniging Nederland), in order to identify SDR behaviors regarding safe driving, and (ii) a validation study by means of a survey among a panel of 98 experiential experts (peers) from the DVN, to determine the extent to which they agreed with the communicability, importance, and feasibility of these behaviors for drivers with diabetes mellitus. RESULTS:We identified a comprehensive set of 11 SDR behaviors, differentiated into seven general and four specific behaviors, to support safe driving. The general behaviors concern the following topics: (i) acquiring knowledge and information; (ii) acquiring and using self-measuring of blood glucose (SMBG) equipment; (iii) knowing one's physical response pattern; (iv) obtaining knowledge about the medication used; (v) preventing long-term eye complications; (vi) influencing factors that can affect blood glucose; and (vii) renewal procedure for driving license. The four specific behaviors refer to the following topics: (i) measures to be taken before driving; (ii) responding effectively to hypoglycemia while driving; (iii) informing and instructing passengers; and (iv) preventing hypoglycemia in drivers with type 2 diabetes mellitus not using SMBG equipment. Key factors for safe driving proved to be the ability of drivers to anticipate and respond effectively to hypoglycemia while driving and to inform and instruct fellow passengers. Participants of the validation survey agreed to a considerable degree with the communicability, importance, and feasibility of these behaviors to support safe driving for people with diabetes mellitus. CONCLUSIONS:This study resulted in the identification and description of SDR behaviors to support safe driving. It proved possible to operationalize experiential expertise in terms of such behaviors. The next step is to have these behaviors validated by professional care providers in the field of diabetes, followed by translation into recommendations in self-management programs.

译文

背景:低血糖症在接受糖尿病治疗的人们中很常见,会严重破坏驾驶性能。为了个人和公共交通安全,我们决定从经验丰富的糖尿病专家的角度确定成功的糖尿病相关(SDR)行为,以支持糖尿病人安全驾驶。经验丰富的专家可以通过发展与维护健康和对抗疾病有关的专业知识来管理自己的疾病和状况,并能够利用这些专业知识来为同行谋福利。
目的:我们的研究目的是根据经验专家的报告,对SDR行为进行客观化和系统化的专门知识,以支持1型和2型糖尿病患者的安全驾驶。重点是预防驾驶过程中的短期并发症即低血糖症。
方法:我们进行了一项混合方法研究,涉及(i)对来自荷兰糖尿病协会(DVN; Diabetesvereniging Nederland)的33位糖尿病专家进行的半结构化深度访谈,以确定与安全驾驶有关的SDR行为, (ii)通过对来自DVN的98位经验丰富的专家(同行)进行的调查来进行验证研究,以确定他们在多大程度上同意这些行为对于糖尿病驾驶员的可传播性,重要性和可行性。
结果:我们确定了11种SDR行为的综合集合,分为7种一般行为和4种特定行为,以支持安全驾驶。一般行为涉及以下主题:(i)获取知识和信息; (ii)获取和使用自我测量的血糖仪(SMBG); (iii)了解一个人的身体反应方式; (iv)获得有关所用药物的知识; (v)预防眼部长期并发症; (vi)可能影响血糖的影响因素; (vii)驾驶执照的续签程序。四种具体行为涉及以下主题:(i)驾驶前应采取的措施; (ii)驾驶时有效应对低血糖; (iii)通知和指示乘客; (iv)预防不使用SMBG设备的2型糖尿病驾驶员的低血糖症。事实证明,安全驾驶的关键因素是驾驶员在驾驶时能够预见和有效应对低血糖以及告知和指导同伴的能力。验证调查的参与者在相当程度上同意这些行为的可传播性,重要性和可行性,以支持糖尿病人的安全驾驶。
结论:本研究确定并描述了支持安全驾驶的SDR行为。事实证明,可以根据这种行为来操作经验专业知识。下一步是使这些行为得到糖尿病领域专业护理人员的验证,然后转化为自我管理计划中的建议。

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