Development and validity testing of the revised diabetes self-care inventory for children and adolescents

Managing the unmanageable through interdependence in adolescents living with type 1 diabetes and their parents: A constructivist grounded theory

BACKGROUND

Management of T1D is complex and requires continuous care and monitoring that place many demands on adolescents with T1D and their parents. The purpose of this study was to explore the nature of interdependence with T1D management with adolescents and their parents.

METHODS

Using a constructivist grounded theory methodology, 32 open-ended interviews were conducted, transcribed, and analyzed from 11 adolescents aged 10-18 years with T1D and eight parents.

FINDINGS

The data were coded using three coding phases: initial, focused, and theroetical and this process continued until theroetical saturation was reached. The substantive theory that emerged from the data describing parents' and adolescents' main concern of Maintaining Optimal Glycemic Control was Managing the Unmanageable through Interdependence. Four related subprocesses were found: Completing T1D Tasks, Attaining Support, Balancing Independence, and Reconciling Reality. These subprocesses occurred within the context of the ever-changing, Nature of the Illness.

DISCUSSION

There is a dynamic relationship associated with interdependence between adolescents with T1D and their parents that varied situationally and by age. Participants also indicated interdependence occurs or they would like it to occur, with others beyond themselves and the health-care team to others willing to be involved.

APPLICATION TO PRACTICE

Interdependence is a dynamic process and requires ongoing evaluation by health-care professionals of its function in the daily management of T1D by parents and adolescents. Additional research into of the roles of health professionals and others in promoting interdependence is needed.

A systematic review of self-care measures for adolescents with health needs

PURPOSE

The current study sought to review instruments measuring self-care for adolescents with health needs to provide a summary of the tools available for conducting self-care research in this population.

METHOD

Studies were mainly identified through searches in three electronic bibliographic databases (i.e., PsycINFO, CINAHL, and PubMed) and additional sources to retrieve relevant articles. Studies were included if they focused on self-care measures, included samples of adolescents (ages 10-19), were published in English peer-reviewed journals, dissertations, and from the years 1980 through 2020. The COnsensus-based Standards for the selection of health status Measurement Instruments (COSMIN) was used to assess the methodological quality of each study and evaluate the measurement quality based on available studies.

RESULTS

A total of ten scales from 12 papers were identified to meet the search criteria and designed for adolescent patients with three types of health needs, including diabetes, cystic fibrosis, and others (female care and nutrition). There is a lack of a clear and comprehensive definition of self-care for different health needs. The dominant focus of the scales was the behavioral aspect of self-care (e.g., adherence to medication regimen), with only a few scales (e.g., female care) assessing the psychological aspect of self-care. The quality of the psychometric properties of the scales varied greatly.

CONCLUSIONS

Results highlighted the need for more research on developing and validating self-care measures for adolescents with health needs. The unique developmental characteristics of adolescents should be adequately considered, and the psychological aspect of self-care should be incorporated in measurement development.