Staff experiences of diabetes care in residential care facilities for people with severe disabilities in Denmark: a mixed-methods assessment of access to screening for diabetes complications

Objectives To identify the prevalence of diabetes among
adults (>18 years) living in residential care facilities in
Denmark and to identify the structural, practical, and
individual barriers and drivers related to their participation
in screening programmes.
Design
Setting The register-based study included all residents
living in residential care facilities in Denmark. The survey
and qualitative analysis were carried out exclusively in the
Capital Region of Denmark.
Participants For the register-based study, we identified
11 620 residents of care facilities in Denmark (>18
years) and identified the number of residents with
diagnosis codes of type 1 or type 2 diabetes or dispensed
prescriptions of blood glucose-lowering medication.
Staff from 102 psychiatric facilities housing adults with
severe psychiatric disabilities were invited to participate
in the survey. Of these, 56 facilities participated with one
responder each, of which n=16 also participated in followup qualitative interviews.
Results Register-based study: of the residents at the
facilities, 954 (8%) were diagnosed with diabetes.
Descriptive statistics of responses and results from
content analysis of interviews were summarised in five
themes that illuminated how a screening programme
could be tailored to the care facilities: (1) characteristics
of residents and care facilities, (2) the care needs of
residents, (3) the way care was organised, (4) the specific
barriers and drivers for participating in programmes, (5)
number of hours and settings for screening programmes.
Conclusion To increase the participation of people living
in psychiatric care facilities in screening programmes,
future programmes should be tailored to the identified
needs and barriers experienced by the residential care
staff.