A Tale of Two Diagnoses: An Interpretative Phenomenological Analysis of Healthcare Professionals Working with Children with Type 1 Diabetes and Coeliac Disease.

The psychosocial issues and challenges for young people with a dual diagnosis of type 1 diabetes and coeliac disease and their parents have been researched and uncertainties within screening and diagnostic processes are documented. However, the experiences of healthcare professionals working with this group have to date remained unexplored. A cross sectional design, using Interpretative Phenomenological Analysis, was used to understand the experiences of Health Care Professional’s who work with children with a dual diagnosis and the meanings they assign to their experiences. Twelve healthcare professionals (paediatricians, gastroenterologists, nurses, dieticians) from three paediatric healthcare teams were interviewed about their experiences to explore the challenges, rewards and concerns in the role. Three superordinate themes emerged: ‘connection and burden’; ‘diagnoses together, but separate and uneven’; and ‘sitting with certain uncertainty and complexity’. Themes represent participants’ connection to the experience of patients and increasing patient burden; a sense of disparity in managing the two conditions; uncertainty and complexity with the dual diagnosis, and a repertoire of coping strategies utilised. Interpretations of participants’ stories suggest that positive aspects of the role (i.e., making a difference, improving health and reducing risk) along with coping strategies serve to buffer the challenges of working with this client group. The study offers insight primarily into the challenges and coping responses of healthcare professionals working with the coeliac disease/ type 1 diabetes dual diagnoses. Recommendations include a dual review clinic (for type 1 diabetes and coeliac disease) and further support for staff. Additional research on psychosocial aspects of this dual diagnosis would support healthcare professionals in their role and service development.