Abstract: Background The poor control of type 1 diabetes in Chinese adolescents has brought a heavy burden to families and society. Diabetes education in China is mainly aimed at patients with type 2 diabetes, and there is a lack of self-management support programs for adolescents with type 1 diabetes.Objective To develop a resilience-oriented structured treatment and educational program for type 1 diabetic adolescents, and to verify its applicability and feasibility among Chinese adolescents with type 1 diabetes.Methods This study was conducted during January to May 2020. Guided by the diabetes resilience model, the analysis of needs of adolescents with type 1 diabetes through literature analysis and interviews, and references obtained from the available structured educational model for type 1 diabetes, a draft resilience-oriented structured treatment and educational program for adolescents with type 1 diabetes was developed, then was revised and improved according to the results of the expert consultation. After wards, potential participants were recruited by posters posted in the outpatient department and telephone to attend a trial test conducted in the First Affiliated Hospital with Nanjing Medical University to evaluate the feasibility of the program from three aspects: recruitment response rate, authenticity and acceptability.Results The final program covers 43 teaching objectives in 3 fields, including 12 in the field of perceptions, 14 in the behavioral field and 17 in the emotional field. The program adopts group teaching method, with 5-8 patients, 1 doctor and 1 nurse in each group. There were 6 classes in a course cycle. A total of 8 adolescents were recruited in the feasibility analysis, of whom 6 adolescents completed all courses. Patients said that the course content was close to life and the class atmosphere was relaxed, and their levels of self-management ability, acceptance of diabetes and emotion regulation ability were all improved after learning the program.Conclusion The resilience-oriented structured treatment and educational program has systematic contents, standardized implementation process and high feasibility, which is worthy of further clinical verification.

Key words: Diabetes mellitus, type 1, Adolescents, Resilience, Structured education, Curriculum, Feasibility

摘要： 背景 我国青少年1型糖尿病患者疾病控制不佳，给家庭和社会带来沉重负担。目前国内糖尿病教育主要面向2型糖尿病患者，缺乏针对青少年1型糖尿病患者的自我管理支持项目。目的 开发心理韧性导向的青少年1型糖尿病患者结构化治疗与教育课程，并验证其在我国青少年1型糖尿病群体中的适用性和可行性。方法 2020年1—5月，以心理韧性模型为切入点，通过文献分析和访谈对青少年1型糖尿病患者进行需求分析，借鉴现有1型糖尿病结构化教育模式，开发心理韧性导向的结构化治疗与教育课程，并通过专家会议进一步修订和完善心理韧性导向的青少年1型糖尿病患者结构化治疗与教育课程。采用门诊张贴海报和打电话的方式招募潜在参与者，在南京医科大学第一附属医院进行预试验，从招募应答率、真实性和可接受性3个方面评价课程可行性。结果 心理韧性导向的青少年1型糖尿病患者结构化治疗与教育课程终稿涵盖认知、动作技能和情感3个领域，12项认知领域目标、14项动作技能领域目标及17项情感领域目标，共43项教学目标。课程采用小组式教学法，每组5~8名患者，1名医生和1名护士，6次课为1个课程周期。共招募8例1型糖尿病患者进行心理韧性导向的青少年1型糖尿病患者结构化治疗与教育课程的可行性评价，其中6例患者完成了所有课程。患者表示该课程内容全面、贴近生活、氛围轻松，参与后自我管理能力增强、对疾病接受度提高、情绪调节能力改善。结论 心理韧性导向的青少年1型糖尿病患者结构化治疗与教育课程内容系统可行性高，值得进一步临床验证。

关键词: 糖尿病, 1型, 青少年, 心理韧性, 结构化教育, 课程, 可行性分析