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Habenicht A, Ahern E, Cody D, McDarby V, Houghton S. 'It's life threatening, it's not life limiting but it's life threatening' - Dyadic framework analysis of adolescent and parent adjustment to a type 1 diabetes diagnosis. J Health Psychol 2024; 29:905-917. [PMID: 38158848 PMCID: PMC11264551 DOI: 10.1177/13591053231216700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
Type 1 diabetes-management can be considered an adolescent-parent collaboration. Given particular adolescent adherence challenges, it is integral that adolescent-parent dyadic relationships are investigated. Therefore, this study aimed to explore dyads' adjustment to type 1 diabetes, while examining the congruence/dissimilarity within these dyads. Semi-structured interviews were conducted with 10 dyads (20 individuals) separately. Interviews were transcribed verbatim and analysed with thematic analysis using a dyadic framework method. Findings suggested complex experiences of adjustment among parents and adolescents which reflect two main themes - Never-Ending Abyss of Management and Diabetes Integration, with three subthemes - A Life of Food Restrictions, Evolving Familial Bonds and Technology as easing the burden of Diabetes. Dyadic analyses revealed dyadic congruence across most themes. This study adds to the adjustment literature by providing a systemic perspective rarely presented in prior paediatric research.
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Affiliation(s)
| | | | - Declan Cody
- Children’s Health Ireland at Crumlin, Ireland
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2
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Hussein S, Jespersen LN, Ingersgaard MV, Skovby P, Grabowski D. Trying to be like everybody else: A qualitative study revealing the importance of social contexts and illness representations among adolescents with type 1 diabetes and their parents. Chronic Illn 2024; 20:37-48. [PMID: 36760087 DOI: 10.1177/17423953231155287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
OBJECTIVE Type 1 diabetes is one of the most common chronic conditions in young children and adolescents. During the period of adolescence, young people with diabetes often struggle with self-management and have compromised health-related quality of life. This often leads to familial conflicts affecting all family members negatively. The aim of this study is to provide qualitative insight into the everyday life of families with adolescents with type 1 diabetes. METHODS The data consisted of participatory family workshops conducted using interactive dialogue tools. The total number of participants was 33 (adolescents n = 13, parents n = 20). The adolescents were between 15 and 17 years. The data were analyzed using systematic text condensation. RESULTS The results showed two main themes. The first theme, Diabetes-friendly and unfriendly social contexts, highlighted how the (dis)comfortability of disclosing diabetes was a significant factor in achieving optimal metabolic control. For parents, it affected their perception of social support. The second theme, incongruent illness representations among family members, dealt with the extended family conflict during the period of adolescence. DISCUSSION Insights from our study could help healthcare professionals apply a family-centered approach minimizing family conflict and supporting metabolic control when consulting families with adolescents with type 1 diabetes.
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Affiliation(s)
- Sana Hussein
- Department of Health Promotion Research, Copenhagen University Hospital, Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Louise Norman Jespersen
- Department of Health Promotion Research, Copenhagen University Hospital, Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Marianne Vie Ingersgaard
- Department of Health Promotion Research, Copenhagen University Hospital, Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Pernille Skovby
- Herning Hospital, Region of Central Jutland, Herning, Denmark
| | - Dan Grabowski
- Department of Health Promotion Research, Copenhagen University Hospital, Steno Diabetes Center Copenhagen, Herlev, Denmark
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3
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Marshall M, Waring G. Youth Work in the Hospital Setting: A Narrative Review of the Literature. Compr Child Adolesc Nurs 2023; 46:240-257. [PMID: 34166168 DOI: 10.1080/24694193.2021.1936294] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 05/18/2021] [Indexed: 10/21/2022]
Abstract
This paper presents a narrative literature review on the evidence relating to the youth worker role with young people in the hospital setting, within which the research gaps and inconsistencies within the body of knowledge available are highlighted. Medline, CINAHL, PsycINFO, AMED and British Nursing Index databases were searched and screened for papers which involved the youth worker role with young people in a hospital setting. Data relating to the youth workers who worked with young people in the hospital setting were extracted by two independent reviewers. A total of 11 papers were identified dating from 1971 to 2018, from a range of countries. In order to present the available body of knowledge, this narrative synthesis of the literature is presented under three headings: descriptive work, service evaluation and empirical research. The findings suggest that the youth worker role in the hospital setting has a positive impact upon the lives of young people and this was accomplished through the interventions the youth worker employed when working with young people. Equally, challenges were highlighted relating to the youth worker undertaking their role in the hospital setting. However, changes during this time period in attitudes towards adolescent health particularly within the United Kingdom, along with the loss of funding for youth work has had an impact on the research in this area of clinical practice. The number of descriptive papers in this review, highlights the necessity for empirical evidence in both quantitative and qualitative research in order to gain a greater understanding of what the youth worker role in the hospital provides to young people and the impact of their interventions from the perspectives of young people, parents, youth workers and members of the multi-disciplinary team.
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Affiliation(s)
- Marie Marshall
- Manchester Academic Health Science Centre, Manchester NHS Foundation Trust, The University of Manchester, Manchester, UK
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4
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Jaensch L, Goddard G, Oxlad M, Franke E. Health Professionals' Experiences Supporting People With Type 1 Diabetes Mellitus Who Deliberately Restrict and/or Omit Insulin for Weight, Shape, and/or Appearance: A Meta-synthesis. Can J Diabetes 2023; 47:532-542. [PMID: 36990273 DOI: 10.1016/j.jcjd.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 03/17/2023] [Accepted: 03/19/2023] [Indexed: 03/30/2023]
Abstract
OBJECTIVES It has been reported that health professionals currently lack the required empathy, understanding, and knowledge about the deliberate restriction and/or omission of insulin to influence weight and/or shape, which may impact the quality of care provided. We sought to synthesize existing qualitative research pertaining to health professionals' experiences supporting individuals within this unique population. METHODS We conducted a meta-synthesis using a meta-aggregative approach. We searched 5 electronic databases. Eligible articles were qualitative or mixed-methods empirical studies with primary data reporting health professionals' experiences supporting people with type 1 diabetes restricting and/or omitting insulin for weight and/or shape control, written in English, from database inception to March 2022. RESULTS A final sample of 4 primary studies were included. The analysis indicated that in the absence of standardized screening and diagnostic tools, health professionals found it challenging to decide when behaviour became clinically significant. Health professionals were also challenged by complex perceptions and behaviours relating to their illness management and features of broader health-care systems and organizational factors. CONCLUSIONS Our findings have widespread multidisciplinary implications for health professionals and the broader health-care systems in which they work. We provide evidence-based clinical recommendations and suggestions for vital future research.
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Affiliation(s)
- Lauren Jaensch
- School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
| | - Georgia Goddard
- School of Psychology, University of Adelaide, Adelaide, South Australia, Australia; Freemason's Centre for Men's Health and Wellbeing, Adelaide, South Australia, Australia.
| | - Melissa Oxlad
- School of Psychology, University of Adelaide, Adelaide, South Australia, Australia; Freemason's Centre for Men's Health and Wellbeing, Adelaide, South Australia, Australia
| | - Elisabeth Franke
- School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
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5
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Lassen RB, Abild CB, Kristensen K, Kristensen LJ, Jensen AL. Patient-reported outcome instruments for assessing the involvement of children and adolescents with type 1 diabetes in their treatment: a scoping review protocol. JBI Evid Synth 2023; 21:609-616. [PMID: 36170118 DOI: 10.11124/jbies-22-00105] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of this review is to identify available patient-reported outcome instruments used to assess the involvement of children and adolescents with type 1 diabetes in their treatment. Specifically, this review will examine the content, structure, and application of these instruments. INTRODUCTION It is considered meaningful to involve children and adolescents living with a chronic health condition, such as type 1 diabetes, in their own treatment. Despite a growing interest in patient involvement within pediatric health care, including the use of patient-reported outcomes, only a few patient-reported outcome instruments have been developed and are used to evaluate the experiences of children and adolescents with type 1 diabetes of being involved in their own treatment. INCLUSION CRITERIA This scoping review will examine patient-reported outcome instruments used to assess the experiences of children and adolescents (11 to 18 years of age) with type 1 diabetes of being involved in their own care. Patient-reported outcome instruments measuring parents' or clinicians' experiences of involvement will be excluded. METHODS The proposed review will follow JBI guidelines and all stages will involve 2 or more reviewers. PubMed, Embase, CINAHL, PsycINFO, JSTOR, and MedNar will be searched without limitations on the year or language of publication. Literature that is not written in English will be translated. Data extraction, charting, and analysis will be guided by a template developed for this review that focuses on the content, structure, and application of the patient-reported outcome instruments. Any modifications to the extraction template will be detailed in the review, and data will be presented in a descriptive format.
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Affiliation(s)
| | - Caroline Bruun Abild
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Kurt Kristensen
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | | | - Annesofie Lunde Jensen
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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6
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Holmström Rising M, Söderberg S. Experiences of transitions in daily life for parents of children with type 1 diabetes: An interpretive description. Res Nurs Health 2023; 46:313-322. [PMID: 36815583 DOI: 10.1002/nur.22303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 02/03/2023] [Accepted: 02/11/2023] [Indexed: 02/24/2023]
Abstract
In this study, we aimed to explore and describe the experiences of parents whose children have been diagnosed with type 1 diabetes (T1D) and the transitions of daily life. T1D is a long-term illness, and parents of children with T1D often become informal caregivers and face many challenges in their daily lives. A qualitative study design, in line with interpretive description, was used, and a sample of 10 parents of children with T1D participated in individual interviews. The COnsolidated criteria for REporting Qualitative Research (COREQ) checklist was used. The interviews were analyzed using interpretive descriptions. The analysis resulted in one main theme: "The realization of having taken 'daily life' for granted and having to accept a new reality," with six themes showing different transitions in the parents' daily lives, including transitions in daily life patterns, parenthood, in relationships with family and friends, relationships with school personnel, relationships with healthcare personnel, and in knowledge and learning about the illness. Parents experienced multifaceted changes that affected their lives, as shown by the six identified transitions. Being the parent of a child with T1D implies a new reality with complex, irreversible life changes that may be unknown and unspoken to healthcare professionals and society. Healthcare systems, school personnel, and society at large need to improve their knowledge regarding parents' situations to better support them in embracing a new reality for themselves and their children long after the onset of T1D.
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Affiliation(s)
| | - Siv Söderberg
- Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden
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7
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Lewis LF, Brower PM, Narkewicz S. "We Operate as an Organ": Parent Experiences of Having a Child With Type 1 Diabetes in a Rural Area. Sci Diabetes Self Manag Care 2023; 49:35-45. [PMID: 36594452 DOI: 10.1177/26350106221144962] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
PURPOSE The purpose of this study is to explore the experiences of parents of children with type 1 diabetes mellitus (T1DM) who are living in rural areas. Individuals living in rural areas face barriers to accessing health care that lead to significant health disparities with increased morbidity and mortality. There is a need to understand the unique experiences of those living in rural communities to support their health needs. METHODS In this qualitative study, a convenience sample of 11 parents of children who were diagnosed with T1DM in the last 10 years living in Vermont were recruited through connections with local health professionals and family support networks and interviewed about their experiences. Interviews were transcribed verbatim and analyzed using Braun and Clarke's 6-step approach to reflexive thematic analysis. RESULTS Five themes were identified to capture the experience of parenting a child with T1DM in a rural community, including enduring emotional traumas, living life on call, adapting to everyday challenges, lacking a safety net for support, and finding a rhythm. CONCLUSIONS Although findings echo many themes found in previous studies on experiences of parents of children with T1DM, participants also identified unique barriers such as physical distance from formal and informal support systems, unreliable and/or insufficient technological resources, and lack of understanding of T1DM by their communities, including among child care and schools. Diabetes care and education specialists working with families living in rural areas must explore ways to educate key supports to these families to minimize isolation, stigma, and burnout among parents.
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Affiliation(s)
| | | | - Sarah Narkewicz
- Department of Nursing, University of Vermont, Burlington, Vermont
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8
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Group Psychotherapy for Parents of Youth with Pediatric Acute-Onset Neuropsychiatric Syndrome. J Clin Psychol Med Settings 2022:10.1007/s10880-022-09926-0. [PMID: 36480109 DOI: 10.1007/s10880-022-09926-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2022] [Indexed: 12/13/2022]
Abstract
Parents of children with diagnoses of Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) and Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections (PANDAS) may experience significant psychological distress related to their child's severe and relapsing illness and challenges with the traumatic nature of its treatment. No manualized or studied psychological interventions specifically for parents of youth with PANS have existed prior to this study. In this pilot study, we assessed the feasibility, satisfaction, and treatment fidelity of a brief 9-session group therapy intervention for parents based on principles of trauma-focused cognitive behavior therapy (CBT). We hypothesized that, if initially elevated, symptoms of depression, anxiety, and trauma would decrease and participants' utilization of positive coping mechanisms would increase post-intervention. We adapted an existing evidence-based group intervention developed for parents of children with premature infants to target sources of stress and coping in parents of children with PANS. Ten parents participated in the study. The 9-session intervention used a combination of techniques that included cognitive restructuring, coping skills, self-care, and a trauma narrative to address psychological stress, trust, grief, and unwanted emotions. Outcome measures included parental symptoms of anxiety, depression, and posttraumatic stress disorder (PTSD), as well as rating of parental satisfaction with the intervention. The treatment was feasible and deliverable with high fidelity. The intervention was rated as useful and satisfactory by parents (overall average usefulness of 4.54 and satisfaction of 4.71 out of 5.0). Elevated symptoms of PTSD and depression decreased with large effect sizes (Cohen's d = 1.42 and Cohen's d = 1.38, respectively). Participating parents demonstrated significantly more active coping and acceptance behaviors and stances. A brief 9-session group therapy intervention based on principles of trauma-focused CBT was found to be effective in reducing symptoms of psychological distress in parents of children with PANS.
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9
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Nsamba J, Nabirye G, Hense S, Drenos F, Mathews E. Lived Experiences of Newly Diagnosed Type 1 Diabetes Mellitus Children and Adolescents in Uganda. J Multidiscip Healthc 2022; 15:2647-2665. [DOI: 10.2147/jmdh.s389265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 11/03/2022] [Indexed: 11/18/2022] Open
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10
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Neyra Marklund I, Rullander AC, Lindberg K, Ringnér A. Initial Education for Families with Children Diagnosed with Type 1 Diabetes: Consensus from Experts in a Delphi Study. Compr Child Adolesc Nurs 2022. [DOI: 10.1080/24694193.2022.2033351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Affiliation(s)
- Isabel Neyra Marklund
- Department of Nursing and Clinical Department of Paediatrics, Umeå University, Umeå, Sweden
| | - Anna-Clara Rullander
- Department of Nursing and Clinical Department of Paediatrics, Umeå University, Umeå, Sweden
| | - Karolina Lindberg
- Department of Nursing and Clinical Department of Paediatrics, Umeå University, Umeå, Sweden
| | - Anders Ringnér
- Department of Nursing and Clinical Department of Paediatrics, Umeå University, Umeå, Sweden
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11
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O’Donnell NR, Satherley RM, John M, Cooke D, Hale LS, Stewart R, Jones CJ. Development and Theoretical Underpinnings of the PRIORITY Intervention: A Parenting Intervention to Prevent Disordered Eating in Children and Young People With Type 1 Diabetes. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2022; 3:822233. [PMID: 36992722 PMCID: PMC10012129 DOI: 10.3389/fcdhc.2022.822233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 01/21/2022] [Indexed: 11/13/2022]
Abstract
Children and young people (CYP) with type 1 diabetes (T1D) are twice as likely to develop disordered eating (T1DE) and clinical eating disorders than those without. This has significant implications for physical and mental health, with some eating disorders associated with repeated diabetic ketoacidosis and higher HbA1c levels, both of which are life threatening. There is currently limited psychological support for CYP and families with T1D but increasingly, policy and practice are suggesting disordered eating in T1D may be effectively prevented through psychological intervention. We describe the development and theoretical underpinnings of a preventative psychological intervention for parents of CYP aged 11-14, with T1D. The intervention was informed by psychological theory, notably the Information Motivation Behaviour Skills model and Behaviour Change Technique Taxonomy. The intervention was co-developed with an expert advisory group of clinicians, and families with T1D. The manualised intervention includes two online group workshops, and supplementary online materials. The intervention continues to evolve, and feasibility findings will inform how best to align the intervention with routine care in NHS diabetes teams. Early detection and intervention are crucial in preventing T1DE, and it is hoped that the current intervention can contribute to improving the psychological and physical wellbeing of young people and families managing T1D.
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Affiliation(s)
| | | | - Mary John
- School of Psychology, University of Surrey, Guildford, United Kingdom
- Research and Development Department, Sussex Education Centre, Sussex Partnership NHS Foundation Trust, Brighton & Hove, United Kingdom
| | - Debbie Cooke
- School of Health Sciences, University of Surrey, Guildford, United Kingdom
| | - Lucy S. Hale
- School of Psychology, University of Surrey, Guildford, United Kingdom
| | - Rose Stewart
- Wrexham Maelor Hospital, Betsi Cadwaladr University Health Board, Wrexham, United Kingdom
| | - Christina J. Jones
- School of Psychology, University of Surrey, Guildford, United Kingdom
- *Correspondence: Christina J. Jones,
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12
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Kakkar R, Fung A, Barker C, Foster A, Hursh BE. The Experience of a Gluten-free Diet in Children with Type 1 Diabetes and Celiac Disease. J Can Assoc Gastroenterol 2022; 5:25-31. [PMID: 35118224 PMCID: PMC8806040 DOI: 10.1093/jcag/gwab013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 05/24/2021] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE This study examined overall self-reported adherence to gluten-free diet (GFD) in children with type 1 diabetes and celiac disease (T1DCD) compared to children with celiac disease (CD). Secondary objectives included gaining insight into self-reported symptoms, barriers to adherence, and experience of a GFD between groups. METHODS Children <18 years old who had been seen at BC Children's Hospital for T1DCD or CD were invited to participate in a web-based questionnaire and medical record review. RESULTS A total of 26 children with T1DCD and 46 children with CD participated in the study. The groups' demographics and symptoms of CD were similar; however, a greater proportion of those with T1DCD were asymptomatic at diagnosis (T1DCD 27%; CD 7%; P = 0.016). Overall adherence to a GFD was high in both groups (T1DCD 92%; CD 100%; P = 0.38) but those with T1DCD reported a significantly less positive effect on their health (P = 0.006) and a significantly greater negative effect on activities from a GFD (P = 0.03). Children with T1DCD reported more significant barriers to eating gluten-free at home and at restaurants, specifically with social pressure, cost and taste compared to those with CD only. CONCLUSION Children with T1DCD face specific barriers in adherence that are more impactful compared with children living with CD. These children are more often asymptomatic at diagnosis, and they go on to experience different impacts of a GFD spanning across home and social settings. Given the complexity of having a dual diagnosis, CD care should be tailored specifically to children living with T1DCD.
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Affiliation(s)
- Rohan Kakkar
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alex Fung
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Collin Barker
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
- Division of Gastroenterology, Hepatology and Nutrition, BC Children’s Hospital, Vancouver, British Columbia, Canada
| | - Alice Foster
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
- Division of Gastroenterology, Hepatology and Nutrition, BC Children’s Hospital, Vancouver, British Columbia, Canada
| | - Brenden E Hursh
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
- Endocrinology and Diabetes Unit, BC Children’s Hospital, Vancouver, British Columbia, Canada
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13
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Kang W. Investigating the association between diabetes and mental health: A train-and-test approach. Front Psychiatry 2022; 13:1044714. [PMID: 36601525 PMCID: PMC9806163 DOI: 10.3389/fpsyt.2022.1044714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 11/24/2022] [Indexed: 12/23/2022] Open
Abstract
Diabetes is a chronic health condition that affects how the body turns food into energy. Research has demonstrated a relationship between diabetes and various mental health issues, which include psychiatric disorders and other problems that are specific for people living with diabetes. Although previous studies have shed light on the associations between diabetes and various types of mental health issues with a focus on depression and anxiety, much less is known about how diabetes is associated with other dimensions of mental health such as social dysfunction and anhedonia and loss of confidence in a large nationally representative survey from the United Kingdom. The aim of the current study is to replicate the factor structure of the GHQ-12 and investigate how diabetes is related to general mental health and dimensions of mental health. By adopting a train-and-test approach to data from the UKHLS including 2,255 diabetes patients and 14,585 age and sex-matched participants who indicated that they were not clinically diagnosed with diabetes, the current study found that hypotheses are well-supported by the results.
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Affiliation(s)
- Weixi Kang
- Department of Brain Sciences, Imperial College London, London, United Kingdom
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14
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Palmer T, Waliaula C, Shannon G, Salustri F, Grewal G, Chelagat W, Jennings HM, Skordis J. Understanding the Lived Experience of Children With Type 1 Diabetes in Kenya: Daily Routines and Adaptation Over Time. QUALITATIVE HEALTH RESEARCH 2022; 32:145-158. [PMID: 34841984 PMCID: PMC8721679 DOI: 10.1177/10497323211049775] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Focusing only on biomedical targets neglects the important role that psychosocial factors play in effective diabetes self-management. This study aims to understand the lived experiences of children with Type 1 Diabetes (T1DM) in Kenya. Children (n = 15) participated in focus group discussions and photo diary data collection. Focus group discussions and semi-structured interviews were also conducted with caregivers (n = 14). We describe an adaptation to diabetes over time, identifying four overarching themes: knowledge and awareness, economic exclusion, the importance of social support, and striving for normality. Photo diaries are then categorized to explore daily realities of diabetes management. Children with T1DM in Kenya face varied barriers to care but can lead a "normal" and fulfilling life, provided adequate support is in place. To improve the lives of children with diabetes in this context and others like it, stakeholders must take note of children's experiences and recognize their multidimensional needs.
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Affiliation(s)
- Tom Palmer
- Institute for Global Health, 4919University College London, London, UK
| | - Cynthia Waliaula
- Institute for Global Health, 4919University College London, London, UK
| | - Geordan Shannon
- Institute for Global Health, 4919University College London, London, UK
| | | | | | | | | | - Jolene Skordis
- Institute for Global Health, 4919University College London, London, UK
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15
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Kimbell B, Lawton J, Boughton C, Hovorka R, Rankin D. Parents' experiences of caring for a young child with type 1 diabetes: a systematic review and synthesis of qualitative evidence. BMC Pediatr 2021; 21:160. [PMID: 33814007 PMCID: PMC8019496 DOI: 10.1186/s12887-021-02569-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 02/24/2021] [Indexed: 01/16/2023] Open
Abstract
AIMS To synthesise the qualitative evidence on parents' experiences of caring for a child aged ≤8 years with type 1 diabetes to identify: the challenges they encounter; their views about support received; ways in which support could be improved; and, directions for future research. METHODS We searched Medline, EMBASE, CINAHL, PsycINFO and Web of Science databases to identify qualitative studies reporting parents' views and experiences of caring for a child with type 1 diabetes aged ≤8 years. Key analytical themes were identified using thematic synthesis. RESULTS Fourteen studies were included. The synthesis resulted in the generation of two overarching themes. Monopolisation of life describes the all-encompassing impact diabetes could have on parents due to the constant worry they experienced and the perceived need for vigilance. It describes how parents' caring responsibilities could affect their wellbeing, relationships and finances, and how a lack of trusted sources of childcare and a desire to enable a 'normal' childhood constrained personal choices and activities. However, use of diabetes technologies could lessen some of these burdens. Experiences of professional and informal support describes how encounters with healthcare professionals, while generally perceived as helpful, could lead to frustration and anxiety, and how connecting with other parents caring for a child with type 1 diabetes provided valued emotional and practical support. CONCLUSIONS This synthesis outlines the challenges parents encounter, their views about support received and ways in which support might be improved. It also highlights significant limitations in the current literature and points to important areas for future research, including how sociodemographic factors and use of newer diabetes technologies influence parents' diabetes management practices and experiences. PROSPERO: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019128710.
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Affiliation(s)
- B Kimbell
- Centre for Population Health Sciences, Usher Institute, University of Edinburgh, Edinburgh, UK.
| | - J Lawton
- Centre for Population Health Sciences, Usher Institute, University of Edinburgh, Edinburgh, UK
| | - C Boughton
- Wellcome Trust - MRC Medical Research Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - R Hovorka
- Wellcome Trust - MRC Medical Research Institute of Metabolic Science, University of Cambridge, Cambridge, UK.,Department of Paediatrics, University of Cambridge, Cambridge, UK
| | - D Rankin
- Centre for Population Health Sciences, Usher Institute, University of Edinburgh, Edinburgh, UK
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Lesage S, Deacon E, Van Rensburg E, Segal D. 'It kinda sucks': Illness perception of a group of South African adolescents with type 1 diabetes mellitus. Afr J Prim Health Care Fam Med 2021; 13:e1-e9. [PMID: 33764139 PMCID: PMC8007989 DOI: 10.4102/phcfm.v13i1.2782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 11/11/2020] [Accepted: 11/18/2020] [Indexed: 12/04/2022] Open
Abstract
Background Living with diabetes is challenging, especially for adolescents at risk of poor glycaemic control. Understanding the illness perceptions of this group is important to be able to develop interventions for this growing population in need. Aim This study explored the illness perception amongst adolescents living with type 1 diabetes (T1D) and how these perceptions interacted with the management of T1D. Setting This study was conducted at a medical centre providing care for adolescents living with T1D in Parktown, South Africa. Methods A qualitative, explorative design with semi-structured interviews was followed. A non-random purposive sampling method was utilised. The illness perception amongst eight adolescents, aged 12–18 years, at risk of poor glycaemic control, was analysed through thematic analysis. Results Two subthemes related to illness perception were generated, namely (1) illness perception of T1D is negative and (2) living with T1D leads to a sense of being different. Furthermore, two subthemes were generated in relation to how illness perceptions interacted with diabetes management, namely (3) management of T1D is challenging and (4) management of T1D is motivated by fear. Conclusion This group of adolescents with at-risk glycaemic control believed that T1D is difficult to manage, leading to a largely negative perception of the disease. This study contributes to the body of literature on adolescents where illness perception may play a role in adhering to diabetes care plans. This research may give additional insights into the awareness of illness perception in designing successful interventions.
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Affiliation(s)
- Schvaugn Lesage
- Optentia Research Focus Area, Faculty of Health Sciences, North West University, Potchefstroom.
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Abstract
BACKGROUND Type 1 diabetes mellitus is the most common endocrine disease during infancy and adolescence. Diabetes causes serious coping problems during adolescence because of the need for continuous observation and because of diabetes-related complications. Thus, adolescents must adapt to and effectively manage their diabetes. PURPOSE This study was designed to determine the perceived barriers to home care in adolescents with Type 1 diabetes using the Health Promotion Model. METHODS Eighteen adolescents were selected from the qualified patients who applied to a diabetes polyclinic at a training and research hospital in western Turkey. Interview questions were created based on the Health Promotion Model. A phenomenological analysis of the data was conducted using the content analysis method. RESULTS The barriers that participants identified as negatively impacting their ability to manage their disease effectively were categorized into the three themes of "negative feelings about having diabetes," "personal barriers," and "environmental barriers." The barriers identified included school, friends, family, fear of complications, lack of information, and personal characteristics, among others. CONCLUSIONS/IMPLICATIONS FOR PRACTICE This qualitative study enables us to understand what patients feel because the participants explained their difficulties in managing their disease and in maintaining metabolic control. The findings provide an understanding of the subjective experiences of adolescent patients with diabetes. The findings of this study are intended to be helpful in restructuring training in clinics, raising diabetes awareness among teachers and students, socializing diabetic adolescents, and providing family-centered education.
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Pritlove C, Markowitz B, Mukerji G, Advani A, Parsons JA. Experiences and perspectives of the parents of emerging adults living with type 1 diabetes. BMJ Open Diabetes Res Care 2020; 8:8/1/e001125. [PMID: 33004400 PMCID: PMC7534673 DOI: 10.1136/bmjdrc-2019-001125] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 08/11/2020] [Accepted: 08/13/2020] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Whereas it is widely recognized that emerging adulthood can be a difficult time in the life of an individual living with type 1 diabetes, relatively little is known about the experiences of their parents or guardians. These individuals once shouldered much of the burden for their child's diabetes 'self'-management, yet their contribution is often overlooked by the adult healthcare system. Here, we set out to gain an understanding of the perspectives of parents of emerging adults living with type 1 diabetes. RESEARCH DESIGN AND METHODS Semi-structured interviews were performed with a purposeful sample of parents of emerging adults with type 1 diabetes recruited from two urban young adult diabetes clinics and through a national diabetes charity. Thematic coding was derived using a constant comparative approach. RESULTS Analysis of interviews with 16 parents of emerging adults with type 1 diabetes identified three themes: parental experiences of the transition to adult care; negotiating parent-child roles, responsibilities and relationships; and new and evolving fears. Parents spoke in detail about the time surrounding their child's diagnosis of type 1 diabetes to emphasize the complexity of diabetes care and the need to establish a 'new normal' for the family. In turn, adolescence and emerging adulthood required a renegotiation of roles and responsibilities, with many parents continuing to play a role in high-level diabetes management. Several parents of emerging adults with type 1 diabetes (particularly those of young men) vocalized worries about their child's readiness to assume responsibility for their self-care, and some expressed frustration with the apparent dichotomy in the role expectations of parents between the pediatric and adult care settings. CONCLUSIONS Adult healthcare providers should recognize both the ongoing involvement of parents in the 'self'-management of emerging adults with type 1 diabetes and the unique aspects of the caregiver burden that they experience.
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Affiliation(s)
- Cheryl Pritlove
- Applied Health Research Centre, Li ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - Benjamin Markowitz
- Applied Health Research Centre, Li ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
| | - Geetha Mukerji
- Division of Endocrinology, Women's College Hospital, Toronto, Ontario, Canada
- WCH Institute for Health System Solutions and Virtual Care, Toronto, Ontario, Canada
| | - Andrew Advani
- Keenan Research Centre for Biomedical Science and Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
| | - Janet A Parsons
- Applied Health Research Centre, Li ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
- Department of Physical Therapy and Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
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Overgaard M, Lundby-Christensen L, Grabowski D. Disruption, worries and autonomy in the everyday lives of adolescents with type 1 diabetes and their family members: A qualitative study of intrafamilial challenges. J Clin Nurs 2020; 29:4633-4644. [PMID: 32964576 DOI: 10.1111/jocn.15500] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 08/19/2020] [Accepted: 09/06/2020] [Indexed: 11/27/2022]
Abstract
AIM To explore daily life with type 1 diabetes in families with an adolescent with type 1 diabetes. BACKGROUND Management of adolescent type 1 diabetes is carried out in the context of everyday life, thus involving and affecting the entire family. Type 1 diabetes causes disruption of family life, but the specific experiences and challenges of adolescents with type 1 diabetes, siblings and parents are not well-explored. Specifically, research is lacking on the siblings' experience of adolescents with type 1 diabetes. DESIGN A qualitative design using participatory workshops. METHODS A sample of 21 families comprising adolescents with type 1 diabetes (aged 8-18) (N = 20), their parents (N = 29) and siblings (N = 10) participated in four workshops exploring everyday life in families with adolescent diabetes from the perspective of all family members. Data were analysed using systematic text condensation. The COREQ checklist was used preparing the manuscript. RESULTS Family life with type 1 diabetes was characterised by three overarching themes: (a) the perpetual challenges and disruptive nature of life with diabetes, (b) different ways of worrying about diabetes and (c) diabetes autonomy and emancipation from parents. All family members' lives were marked by these aspects, however in different ways and to varying degrees. CONCLUSIONS Our findings emphasise that type 1 diabetes is indeed a family illness affecting all family members. The study provides insight into the unique experiences of adolescents with diabetes, their parents and siblings, all of whom encounter diabetes-related challenges in their daily lives. RELEVANCE TO CLINICAL PRACTICE The findings call for the inclusion of all family members of adolescents with type 1 diabetes in both research and healthcare practice. Family-oriented approaches targeting adolescents with diabetes as well as their parents and siblings will enable provision of nursing care that can meet the needs of the entire family.
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Arabiat D, Al Jabery M, Whitehead L. A concept analysis of psychological distress in parents related to diabetes management in children and adolescents. J SPEC PEDIATR NURS 2020; 25:e12287. [PMID: 31971657 DOI: 10.1111/jspn.12287] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 01/09/2020] [Accepted: 01/10/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE To report a concept analysis of parents' psychological distress in the context of diabetes management among children and adolescents. A clear understanding of the possible impact of diabetes management on parents will help to inform how nurses can work with parents to support glycaemic control in children and adolescents. DESIGN AND METHOD Concept analysis using Walker and Avant's eight-stage approach was used as a guiding framework. PubMed, OVID (CINAHL, Medline, PsychInfo), the Cochrane library and the Joanna Briggs library were searched for the past 50 years. RESULTS Thirty-three studies provided data for the concept analysis. Attributes included difficulty coping, changes in emotional status and manifestations of mental health problems. PRACTICE IMPLICATION Based on the literature synthesis, we suggest all facets of distress related to diabetes can in principle be inferred through the proposed relationship between distress and other interactions of individual coping, caring burden and family relational functioning. The proposed conceptual model linking antecedents' factors and individual characteristics of parents to the concepts of psychological distress may assist researchers to design interventions for supporting diabetes management in children and adolescents.
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Affiliation(s)
- Diana Arabiat
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, western Australia, Australia.,Faculty of Nursing, Maternal and Child Nursing Department, The University of Jordan, Amman, Jordan
| | - Mohammad Al Jabery
- Faculty of Education, Department of Special Education, The University of Jordan, Amman, Jordan
| | - Lisa Whitehead
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, western Australia, Australia.,Postgraduate Centre for Nursing Studies, University of Otago, Christchursch, New Zealand
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Abstract
BackgroundAlthough many studies explore the experiences of persons with type 1 diabetes, most examine the experience of children, adolescents, or persons in transition to adulthood. Few studies focus on the person living long term with type 1 diabetes.PurposeThe purpose of this study was to explore the facilitators and barriers for people living well with type 1 diabetes over the long term.MethodsAn inductive interpretive description approach was used to explore living with type 1 diabetes for a duration of 40 years or more. Qualitative semistructured interviews with a convenience sample (n = 8) were conducted.ResultsFour dialectic themes were identified: accommodating and battling the disease, convenience and constraint of technology and treatment, self-reliance and reliance on others, and external and personal knowledge.ConclusionsRecommendations for the health-care team emphasize person-centered care with acknowledgment of the person as expert and as more than their condition. Further research with this population would strengthen the implications for practice. Specifically, research is needed on diabetes distress, losses experienced due to diabetes, how to meet their educational needs, and how to tap into their expertise for the benefit of those with type 1 following them.
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Affiliation(s)
- Donna Epp
- Faculty of Health Studies, Brandon University, Brandon, Manitoba, Canada
| | - Sonya Grypma
- School of Nursing, Trinity Western University, Langley, British Columbia, Canada
| | - Barbara Astle
- School of Nursing, Trinity Western University, Langley, British Columbia, Canada
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Abstract
Objective To determine the challenges, coping strategies and needs of urban and rural Jamaican caregivers of adolescents with diabetes, and suggest ways to assist coping. Methods This qualitative study comprised four focus groups (two urban and two rural) with a total of nineteen caregivers of adolescents with diabetes. Thematic analysis was conducted on the data. Results The main challenges caregivers faced were keeping their children healthy, managing conflict with their children, and financial concerns. They met these challenges with problem-focused and emotion-focused coping strategies. Caregivers used the problem-focused strategies of vigilance, advocacy, minimising their children’s negative emotions, coercion, education, and seeking support, and the emotion-focused strategies of relying on their identity as parents and turning to their faith. Caregivers wanted assistance acquiring medication and equipment, increased diabetes education, and support groups. Discussion More resources should be channelled toward provision of diabetes supplies. Diabetes education is necessary in schools and for the general public. Healthcare practitioners should explore issues beyond diabetes management, such as caregivers’ coping and the caregiver-child relationship. Support groups are needed to facilitate learning. Special attention must be paid to rural areas: rural residents appeared to be in greater need than their urban counterparts.
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Affiliation(s)
- M Anderson
- 1 Department of Sociology, Psychology and Social Work, University of the West Indies, Jamaica
| | - M K Tulloch-Reid
- 2 Caribbean Institute for Health Research, University of the West Indies, Jamaica
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Bekker CI, Deacon E, Segal D. Meaning in life experienced by parents of children living with diabetes. Health Psychol Open 2019; 6:2055102919832221. [PMID: 30858981 PMCID: PMC6402055 DOI: 10.1177/2055102919832221] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
In this study, nine parents of children living with well-controlled diabetes participated in semi-structured interviews to explore how they make meaning of living with a child with diabetes. Creating a state of normalcy that incorporates the diabetes care plan, empowering their children to successful transition to independent care, positive relationships with their medical team as well as acquiring and sharing diabetes-related knowledge and skills add to the meaning in life of these parents. Health practitioners should facilitate conversations with parents to help them realise their motivation for adhering to the diabetes care plan.
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Rossiter RC, Cooper JL, Marjei SI, Brownie S. Case-Based Insights: Arab Muslim Mothers' Experiences of Managing a Child Newly Diagnosed With Type 1 Diabetes Mellitus. SAGE Open Nurs 2019; 5:2377960819870979. [PMID: 33415251 PMCID: PMC7774390 DOI: 10.1177/2377960819870979] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 07/04/2019] [Accepted: 07/28/2019] [Indexed: 12/04/2022] Open
Abstract
Mothers frequently fulfill the role of primary caregiver for children diagnosed with type 1 diabetes mellitus (T1DM). A T1DM diagnosis has a significant impact on the child and the wider family unit. The objective is to develop understanding of mothers' experiences caring for children diagnosed with T1DM in the cultural context of the Middle East to facilitate enhanced health service provision and support. This study used a qualitative design. Data were collected in individual semistructured interviews. Participants were mothers of Arabic descent and Muslim belief who had a child diagnosed with T1DM within the last 12 months. All mothers were registered at the health service where this research was conducted and resident in the United Arab Emirates at the time of this study. COREQ guidelines informed reporting of the research and findings. Participating mothers described initial reactions of shock and disbelief, followed by transition to near ordinary and near normal (85% normal) family functioning. Family, culture, and faith emerged as critical supports in the whirlwind daily challenge of balancing the multiple demands and competing needs of the newly diagnosed child and the broader family. This study is the first of its kind from countries comprising the Gulf Cooperation Council. The findings provide insight into the challenges and support needs of mothers caring for children newly diagnosed with T1DM in an Arab Muslim context. The findings also provide a basis for enhancing health service support and suggest themes to inform further research.
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Affiliation(s)
| | | | | | - Sharon Brownie
- School of Nursing and Midwifery, Aga Khan University, Nairobi, Kenya
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Rankin D, Harden J, Barnard K, Bath L, Noyes K, Stephen J, Lawton J. Barriers and facilitators to taking on diabetes self-management tasks in pre-adolescent children with type 1 diabetes: a qualitative study. BMC Endocr Disord 2018; 18:71. [PMID: 30316299 PMCID: PMC6186043 DOI: 10.1186/s12902-018-0302-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 10/03/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND When children with type 1 diabetes approach adolescence, they are encouraged to become more involved in diabetes self-management. This study explored the challenges pre-adolescent children encounter when self-managing diabetes and the factors which motivate and enable them to take on new diabetes-related tasks. A key objective was to inform the support offered to pre-adolescent children. METHODS In-depth interviews using age-appropriate questioning with 24 children (aged 9-12 years) with type 1 diabetes. Data were analysed using an inductive, thematic approach. RESULTS Children reported several barriers to taking on self-management tasks. As well as seeking respite from managing diabetes, children described relying on their parents to: perform the complex maths involved in working out carbohydrate content in food; calculate insulin doses if they did not use a bolus advisor; and administer injections or insert a cannula in hard-to-reach locations. Children described being motivated to take on diabetes tasks in order to: minimise the pain experienced when others administered injections; alleviate the burden on their parents; and participate independently in activities with their peers. Several also discussed being motivated to take on diabetes-management responsibilities when they started secondary school. Children described being enabled to take on new responsibilities by using strategies which limited the need to perform complex maths. These included using labels on food packaging to determine carbohydrate contents, or choosing foods with carbohydrate values they could remember. Many children discussed using bolus advisors with pre-programmed ratios and entering carbohydrate on food labels or values provided by their parents to calculate insulin doses. Several also described using mobile phones to seek advice about carbohydrate contents in food. CONCLUSIONS Our findings highlight several barriers which deter children from taking on diabetes self-management tasks, motivators which encourage them to take on new responsibilities, and strategies and technologies which enable them to become more autonomous. To limit the need to perform complex maths, children may benefit from using bolus advisors provided they receive regular review from healthcare professionals to determine and adjust pre-programmed insulin-to-carbohydrate ratios. Education and support should be age-specific to reflect children's changing involvement in self-managing diabetes.
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Affiliation(s)
- David Rankin
- The Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, EH8 9AG UK
| | - Jeni Harden
- The Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, EH8 9AG UK
| | - Katharine Barnard
- BHR Ltd, 42 Kilmiston Drive, Portchester, Fareham, Hants, PO16 8EG and Faculty of Health & Social Science, Bournemouth University, Royal London House, Bournemouth, BH1 3LT UK
| | - Louise Bath
- Royal Hospital for Sick Children, Sciennes Road, Edinburgh, EH9 1LF UK
| | - Kathryn Noyes
- Royal Hospital for Sick Children, Sciennes Road, Edinburgh, EH9 1LF UK
| | - John Stephen
- Child Health Department, Borders General Hospital, Melrose, TD6 9BS UK
| | - Julia Lawton
- The Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, EH8 9AG UK
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Stefanowicz A, Stefanowicz J. The Role of a School Nurse in the Care of a Child with Diabetes Mellitus Type 1 - The Perspectives of Patients and their Parents: Literature Review. Zdr Varst 2018; 57:166-174. [PMID: 29983783 PMCID: PMC6032180 DOI: 10.2478/sjph-2018-0021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Accepted: 05/16/2018] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION The aim of this literature review was to explore the views of parents and children with type 1 diabetes mellitus regarding having a school nurse. METHODS Six databases were selected for the analysis. The research strategy was based on the PICO model. The research participants were children with type 1 diabetes mellitus and/or their parents. RESULTS The present review of research papers includes 12 publications. The majority of works deal with the perspectives of children with type 1 diabetes and their parents on various aspects related to the role of a school nurse in the care of a child with type 1 diabetes:the presence of a school nurse;the role of a school nurse in the prevention and treatment of hypoglycaemia, in performing the measurements of blood glucose, and in insulin therapy;the role of a nurse in improving metabolic control of children with type 1 diabetes;a nurse as an educator for children with type 1 diabetes, classmates, teachers, teacher's assistants, principals, administrators, cafeteria workers, coaches, gym teachers, bus drivers, and school office staff;a nurse as an organiser of the care for children with type 1 diabetes. CONCLUSIONS According to parents and children with type 1 diabetes mellitus, various forms of school nurse support (i.e., checking blood glucose, giving insulin, giving glucagon, treating low and high blood glucose levels, carbohydrate counting) are consistently effective and should have an impact on the condition, improvement of metabolic control, school activity and safety at school.
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Affiliation(s)
- Anna Stefanowicz
- Medical University of Gdansk, Faculty of Health Sciences with Subfaculty of Nursing and Institute of Maritime and Tropical Medicine, Subfaculty of Nursing, Department of Nursing, Department of General Nursing, Pediatric Nursing Workshop, Debinki 7, 80-211Gdansk, Poland
| | - Joanna Stefanowicz
- Medical University of Gdansk, Faculty of Medicine, Department of Paediatrics, Haemathology & Oncology, Debinki 7, 80-211Gdansk, Poland
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Lauder B, Sinclair PM, Maguire J. Mothers' experience of caring for a child with early onset scoliosis: A qualitative descriptive study. J Clin Nurs 2018; 27:e1549-e1560. [PMID: 29399910 DOI: 10.1111/jocn.14301] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2018] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES This study aimed to identify and describe the experience of parents of children diagnosed with early onset scoliosis living in Australia. BACKGROUND Chronic childhood disease has a major impact on health-related quality of life. Caring for a child with a chronic illness is well documented but the specific experiences of parents who care for children with early onset scoliosis, a rare but devastating illness, has not been explored. Numerous studies have described the interrelated psychological, financial, social, physical and logistical factors that impact the experience of the caregiver role with various diseases, but in the case of early onset scoliosis, limited studies have been conducted about the parental experience. METHODS A qualitative descriptive design was used. A snowball sampling technique assisted in the recruitment. Parents invited to the study included mothers, fathers and guardians. Data were collected through semistructured interviews and transcribed verbatim. Transcripts were analysed thematically. Data collection complied with the Consolidated criteria for reporting qualitative research guidelines. FINDINGS Twelve mothers of children with early onset scoliosis were interviewed, as only mothers consented to participate. Four major themes emerged: emotional rollercoaster ride, a lack of resources, money talks and pervasive burden. Factors that impacted on the participants' ability to confront, manage and endure caring for a child with early onset scoliosis emerged from the data. CONCLUSION The findings suggest there are multiple factors that influence the experience of mothers' caring for a child with early onset scoliosis. The recognition and appropriate management of these factors by healthcare professionals have the potential to improve the quality of life of parents who care for a child with early onset scoliosis. RELEVANCE TO CLINICAL PRACTICE Healthcare professionals have first-line contact with parents of children with early onset scoliosis and are well placed to provide parents with evidence-based education and increased support.
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Affiliation(s)
- Bonnie Lauder
- Faculty of Health and Medicine, School of Nursing and Midwifery, The University of Newcastle, Callaghan, Australia
| | - Peter M Sinclair
- Faculty of Health and Medicine, School of Nursing and Midwifery, The University of Newcastle, Callaghan, Australia
| | - Jane Maguire
- Faculty of Health, School of Nursing, The University of Technology, Sydney, Australia
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Lendahls L, Edvardsson I. The Health and Well-Being among Children with Diabetes and Low HbA1c—A Qualitative Study in Sweden. Health (London) 2018. [DOI: 10.4236/health.2018.105044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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"They called me a terrorist": Social and Internalized Stigma in Latino Youth with Type 1 Diabetes. HEALTH PSYCHOLOGY REPORT 2018; 6:307-320. [PMID: 31032396 DOI: 10.5114/hpr.2018.80004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background Diabetes-related stigma (DRS) globally affects patients' lives. Over a third of adolescents with type 1 diabetes (T1D) in Puerto Rico reported concerns of others knowing about their diabetes and about being different. Participants and Procedures We examined DRS among 65 T1D Latino youth (aged 12-17). During a depression-treatment study screening, they answered open-ended questions about diabetes-related concerns/difficulties and issues bothering them while interacting with peers, family, and healthcare professionals because of T1D. Using content analysis, we classified responses into Social Stigma (SS), Internalized Stigma (IS), and No Stigma. Four SS and IS sub-categories were developed. Results After coding, inter-rater reliability (Cohen's kappa) ranged from .73 to .1.00 (p≤.001). Forty-four youth (67.69%) reported at least one DRS verbalization, and 25 reported more than one. Both SS and IS were identified in 32 (49.23%) adolescents. Among SS experiences were: "they call me a junkie [because of insulin shots]"; "they call me a terrorist [because of insulin pump]". IS verbalizations included: "I've never wanted to accept that I have T1D, so I don't practice good self-care"; "at times I do not feel the same as others". We found more stigma-related verbalizations among those from urban zones or larger families. DRS was related to increased depressive symptoms and risk of a depressive disorder. Peers were the main source of SS. Conclusion DRS was common, pervasive, and linked to depression. This study innovatively examines DRS in an exclusively T1D Latino and adolescent sample. Understanding its extent and nature is essential for developing interventions to address DRS.
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Stjerna ML, Worth A, Harden J, Olin Lauritzen S. Risk as a relational phenomenon: a cross-cultural analysis of parents’ understandings of child food allergy and risk management. HEALTH RISK & SOCIETY 2017. [DOI: 10.1080/13698575.2017.1409887] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | - Allison Worth
- Edinburgh Clinical Research Facility, University of Edinburgh, Edinburgh, UK
| | - Jeni Harden
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
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Carter B, Ford K, Bray L, Water T, Arnott J, Tichanow C, Dickinson A. "It's not who I am": Children's experiences of growing up with a long-term condition in England, Australia, and New Zealand. J SPEC PEDIATR NURS 2017; 22. [PMID: 28950047 DOI: 10.1111/jspn.12197] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 07/06/2017] [Accepted: 08/27/2017] [Indexed: 11/26/2022]
Abstract
PURPOSE Most studies of growing up with a long-term condition focus on older children and adolescents and are condition-specific. Relatively few studies address the experiences of children in middle childhood or consider their experience across a range of conditions, countries, and health settings. This study aimed to explore children's perceptions and understandings of how their lives are shaped (or not) by a long-term condition and its associated management. DESIGN AND METHODS A qualitative, participatory methodology using autodriven photoelicitation interviews (PEIs) with 45 purposively recruited children (6-12 years) with long-term conditions (e.g., hemophilia, arthritis, Crohn's disease), from England, New Zealand, and Australia was utilized. PEI facilitated the construction of inductively derived understandings of the children's experiences as the children had control over creating and then selecting which photographs to discuss with the researcher. RESULTS Interpretive thematic analysis of the interviews and content analysis of the photographs resulted in an overarching theme, "It's not who I am …" but it is part of me, and three subthemes: getting on with my life; the special value of family, friendship, support, and comfort; and things that get in the way of getting on. Across all ages and the three countries, the children actively projected their self-concept as "well" children and they strove, through their photographs and their accompanying explanations of their lives, to emphasize that they were "normal" children. They were active social agents who demonstrated their capacity to shape parts of their lives interdependently with their parents and the requirements of their condition. PRACTICE IMPLICATIONS Pediatric nurses should be aware of the importance that children with long-term conditions place on projecting and protecting their sense of being normal and ensure that when they engage with children that they take account of the children's understandings and efforts to live a life constrained but not limited by the condition.
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Affiliation(s)
- Bernie Carter
- Faculty of Health and Social Care, Edge Hill University, Ormskirk, UK
| | - Karen Ford
- Centre for Education and Research, Royal Hobart Hospital, Hobart, Australia
| | - Lucy Bray
- Faculty of Health and Social Care, Edge Hill University, Ormskirk, UK
| | - Tineke Water
- Auckland University of Technology, Auckland, New Zealand
| | - Janine Arnott
- School of Health, University of Central Lancashire, Preston, UK
| | - Cassandra Tichanow
- Paediatric Outpatient Clinic, Royal Hobart Hospital, Hobart, Tasmania, Australia
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Rankin D, Harden J, Jepson R, Lawton J. Children's experiences of managing Type 1 diabetes in everyday life: a thematic synthesis of qualitative studies. Diabet Med 2017; 34:1050-1060. [PMID: 28391607 DOI: 10.1111/dme.13362] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/05/2017] [Indexed: 12/18/2022]
Abstract
AIMS To explore the everyday experiences of children (aged ≤ 12 years) with Type 1 diabetes to identify factors that help or hinder diabetes self-management practices. METHODS Eight databases (Embase, Medline, CINAHL, Web of Science, PsychInfo, ASSIA, ERIC and ProQuest Dissertations) were searched in 2016 to identify qualitative studies exploring children's views about self-managing diabetes. Data were extracted, coded and analysed using thematic synthesis. RESULTS Eighteen studies from five countries were included in the review. Synthesis of studies' findings resulted in the identification of three overarching analytical themes. The first theme, 'Understandings of diabetes and involvement in self-management', outlines ways in which children understand diabetes and develop self-management responsibilities. The second theme, 'Disruption to life and getting on with it', reports children's frustrations at disruptions to everyday life when managing diabetes, and how attempts to appear normal to family and friends affect self-management practices. The third theme, 'Friends' support', describes how friends' reactions and responses to diabetes affect children's ability to appear normal and willingness to disclose information about diabetes, and support provided by 'informed friends', or peers with diabetes. CONCLUSIONS Although the synthesis has identified how children's everyday life experiences inform ways in which they undertake diabetes self-management, it was not possible to determine new ways to provide support. To help children optimise their glycaemic control, further work should be undertaken to identify their need for support and which takes into account the potential ways in which parents, friends and peers can offer assistance.
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Affiliation(s)
- D Rankin
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | - J Harden
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | - R Jepson
- The Scottish Collaboration for Public Health Research and Policy, University of Edinburgh, Edinburgh, UK
| | - J Lawton
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
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Abstract
Adults who have lived much of their life with type 1 diabetes have learned lessons that can benefit health care providers (HCPs), families, and young people who live with the condition. This study was undertaken to gain a better understanding of the challenges of growing up and living with type 1 diabetes from adults who have experienced those challenges and to recommend strategies for parents, caregivers, and HCPs who work with children or adolescents with type 1 diabetes. Thirty-five adults with type 1 diabetes participated in this qualitative study consisting of two in-depth interviews with each participant. Six themes emerged: 1) It's not who you are. 2) Don't let it limit you. 3) Get involved in diabetes support groups. 4) It's going to be OK. 5) Teach them; don't scare them. 6) Don't single kids out. Through hindsight and the more mature perspective of adulthood, study participants were able to share valuable insights that could inform the efforts of those who work with or care for younger people with type 1 diabetes.
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Affiliation(s)
| | - Tina Dyches
- Department of Counseling Psychology and Special Education, Brigham Young University, Provo, UT
| | - Susanne Olsen Roper
- College of Family, Home, and Social Sciences, Brigham Young University, Provo, UT
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Haugvik S, Beran D, Klassen P, Hussain A, Haaland A. "My heart burns" - A qualitative study of perceptions and experiences of type 1 diabetes among children and youths in Tajikistan. Chronic Illn 2017; 13:128-139. [PMID: 27614907 DOI: 10.1177/1742395316668566] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims To explore and describe perceptions and experiences of living with type 1 Diabetes Mellitus among children/youths in Tajikistan. Methods Qualitative methods were employed. Participants were recruited through purposive and snowball samplings. Data were collected using a semi-structured interview guide with children/youths having diabetes, their parents as well as health professionals. Data were analyzed according to Malterud's systematic text condensation. Results Children/youths with diabetes (n = 18), their parents (n = 19) and endocrinologists (n = 4) were interviewed. Families described unique stories in which "emotional stress" and a spiritual "evil eye" were perceived as possible causes of diabetes. Life-threatening complications and maltreatment preceding diagnosis of diabetes were frequent. From manifestation of diabetes onwards, families struggled with systemic and cultural obstacles, causing stigma, discrimination, high school-drop-out rates, diabetic coma, chronic complications or death of the child/youth with diabetes. Conclusions Results of this qualitative study highlight the severity and complexity of challenges families living with a child/youth having diabetes in this low-income country face. Efforts to improve life expectancy and life quality are strongly needed and require addressing both systemic and cultural factors in order to accomplish sustainable impact.
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Affiliation(s)
- Severina Haugvik
- 1 Department of Community Medicine and Global Health, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - David Beran
- 2 Division of Tropical and Humanitarian Medicine, Faculty of Medicine, University of Geneva and University of Geneva Hospitals, Geneva, Switzerland
| | | | - Akhtar Hussain
- 1 Department of Community Medicine and Global Health, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Ane Haaland
- 1 Department of Community Medicine and Global Health, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
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Elissa K, Bratt EL, Axelsson ÅB, Khatib S, Sparud-Lundin C. Societal Norms and Conditions and Their Influence on Daily Life in Children With Type 1 Diabetes in the West Bank in Palestine. J Pediatr Nurs 2017; 33:16-22. [PMID: 27979497 DOI: 10.1016/j.pedn.2016.12.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 12/01/2016] [Accepted: 12/03/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE To explore the experiences of daily life in children with type 1 diabetes (T1D) and their parents living in the West Bank in Palestine. DESIGN AND METHODS A qualitative study using thematic interviews was performed with 10 children with T1D and their parents (n=10). Content analysis was performed with the assistance of NVIVO 10. RESULTS The overall theme was facing the social reality of diabetes. This was underpinned by two themes: stigmatization and social constraints. Facing the social reality of diabetes described children and their parents' everyday life attempts to place themselves within the context of the disease and social context. Children and their parents described how stigmatization and social constraints impacted their daily life as a result of fear of disclosing the disease, which could affect their social status. CONCLUSION These findings highlighted how daily life in children with T1D and their parents was highly affected by cultural impacts, especially as stigma related to the illness affected social interactions of female and male children/adolescents. Lack of knowledge and misunderstandings about T1D in society lead to negative consequences like poorer management of diabetes, and this becomes mediated by gender. PRACTICAL IMPLICATIONS The findings suggest health care providers need to be aware of the cultural and social impact of T1D on children's and parents' daily life in order to meet their needs and challenges by providing appropriate interventions, strategies and support.
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Affiliation(s)
- Kawther Elissa
- Institutes of Health and Care Science, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden; Department of Nursing, Faculty of Health Profession, Alquds University, Abu-Deis, Palestine.
| | - Ewa-Lena Bratt
- Institutes of Health and Care Science, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden; Department of Pediatric Cardiology, The Queen Silvia Children's Hospital, Gothenburg, Sweden.
| | - Åsa B Axelsson
- Institutes of Health and Care Science, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden; Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden.
| | - Salam Khatib
- Department of Nursing, Faculty of Health Profession, Alquds University, Abu-Deis, Palestine.
| | - Carina Sparud-Lundin
- Institutes of Health and Care Science, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
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Castensøe-Seidenfaden P, Teilmann G, Kensing F, Hommel E, Olsen BS, Husted GR. Isolated thoughts and feelings and unsolved concerns: adolescents' and parents' perspectives on living with type 1 diabetes - a qualitative study using visual storytelling. J Clin Nurs 2017; 26:3018-3030. [PMID: 27865017 DOI: 10.1111/jocn.13649] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2016] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To explore and describe the experiences of adolescents and their parents living with type 1 diabetes, to identify their needs for support to improve adolescents' self-management skills in the transition from child- to adulthood. BACKGROUND Adolescents with type 1 diabetes often experience deteriorating glycaemic control and distress. Parents are important in adolescents' ability to self-manage type 1 diabetes, but they report anxiety and frustrations. A better understanding of the challenges adolescents and parents face, in relation to the daily self-management of type 1 diabetes, is important to improve clinical practice. DESIGN A qualitative explorative study using visual storytelling as part of individual interviews. METHODS A purposive sample of nine adolescents and their parents (seven mothers, six fathers) took photographs illustrating their experiences living with type 1 diabetes. Subsequently, participants were interviewed individually guided by participants' photographs and a semistructured interview guide. Interviews were analysed using thematic analysis. RESULTS Four major themes were consistent across adolescents and their parents: (1) striving for safety, (2) striving for normality, (3) striving for independence and (4) worrying about future. Although adolescents and parents had same concerns and challenges living with type 1 diabetes, they were experienced differently. Their thoughts and feelings mostly remained isolated and their concerns and challenges unsolved. CONCLUSIONS The concerns and challenges adolescents and their parents face in the transition from child- to adulthood are still present despite new treatment modalities. Parents are fundamental in supporting the adolescents' self-management-work; however, the parties have unspoken concerns and challenges. RELEVANCE TO CLINICAL PRACTICE Healthcare providers should address the parties' challenges and concerns living with type 1 diabetes to diminish worries about future including fear of hypoglycaemia, the burden of type 1 diabetes and the feeling of being incompetent in diabetes self-management. It is important to focus on supporting both adolescents and their parents, and to provide a shared platform for communication.
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Affiliation(s)
| | - Grete Teilmann
- Pediatric and Adolescent Department, Nordsjaellands Hospital, Hillerød, Denmark
| | - Finn Kensing
- Department of Computer Science, University of Copenhagen, Copenhagen, Denmark
| | - Eva Hommel
- Steno Diabetes Center, Gentofte, Denmark
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Jönsson L, Lundqvist P, Hallström I. Parents HRQOL, Their Satisfaction with Care, and Children Over the Age of Eight’s Experiences of Family Support Two Years Subsequent to the Child’s Diagnosis with Type 1 Diabetes. Compr Child Adolesc Nurs 2016. [DOI: 10.1080/24694193.2016.1241837] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Lindberg B, Söderberg S. Standing on their own feet: Experiences of young people living with Type 1 diabetes when entering adulthood — A qualitative study. ACTA ACUST UNITED AC 2016. [DOI: 10.1080/20573316.2016.1170406] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Birgitta Lindberg
- Department of Health Science, Luleå University of Technology, Luleå, Sweden
| | - Siv Söderberg
- Department of Nursing Sciences, Mid Sweden University, Campus, Östersund, Sweden
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Coad J, Gibson F, Horstman M, Milnes L, Randall D, Carter B. Be my guest! Challenges and practical solutions of undertaking interviews with children in the home setting. J Child Health Care 2015; 19:432-43. [PMID: 24812062 DOI: 10.1177/1367493514527653] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This article aims to share critical debate on undertaking interviews with children in the home setting and draws on the authors' extensive research fieldwork. The article focuses on three key processes: planning entry to the child's home, conducting the interviews and exiting the field. In planning entry, we include children's engagement and issues of researcher gender. In conducting the interviews, we consider issues such as the balance of power, the importance of building a rapport, the voluntary nature of consent and the need for a flexible interview structure. Finally, we address exiting from the child's home with sensitivity at the end of the interview and/or research study. Undertaking research in the child's home provides a known and familiar territory for the child, but it means that the researcher faces a number of challenges that require solutions whilst they are a guest in a child's home.
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Affiliation(s)
| | - Faith Gibson
- Great Ormond Street Hospital for Children NHS Trust; London South Bank University, UK
| | | | | | | | - Bernie Carter
- University of Central Lancashire; Alder Hey Children's NHSFT, UK & University of Tasmania, Australia
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40
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Robinson E. Being diagnosed with type 1 diabetes during adolescence. How do young people develop a healthy understanding of diabetes? PRACTICAL DIABETES 2015. [DOI: 10.1002/pdi.1986] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Emily Robinson
- Medical Psychology, Leicestershire Partnership Trust; Leicester UK
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Rostami S, Parsa-Yekta Z, Najafi-Ghezeljeh T, Vanaki Z, Zarea K. Self-perception in Iranian adolescents with diabetes: a qualitative study. J Diabetes Metab Disord 2015; 14:36. [PMID: 26064863 PMCID: PMC4462089 DOI: 10.1186/s40200-015-0163-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 04/14/2015] [Indexed: 11/24/2022]
Abstract
Background It is obvious that self-perception can play an important role in the development of self-management behaviours among adolescents with diabetes to promote their health and quality of life. This study seeks to explain self-perception in adolescents with diabetes. Method This qualitative study, which is of “grounded theory” type, was performed in 2013 in Ahvaz, Iran, through semi-structured interviews with ten adolescents with type 1 diabetes, two parents and a nurse, who were chosen objectively. Data analysis was performed using Strauss and Corbin 1998 method. Results Four main theme was obtained from the analysis of data, and the consequence theme was inferred as follows: getting insight (knowledge acquisition and belief management), perceiving similarities with others (not hiding the disease, showing the illness is normal, and accepting an active role in the family), and self-care management (independent control of food and treatment regimen and understanding of capabilities to manage the future of life and manage the daily activities of life), and life satisfaction (perception of being healthy and having a normal life). Conclusion Getting insight into the disease is the most important part of perceiving similarities with others and offering self-care, which can provide a person’s positive perception of himself/herself and the illness, as well as life satisfaction for their adolescent over time. These results are an operational guide for personnel providing health care services, especially diabetes specialist nurses.
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Affiliation(s)
- Shahnaz Rostami
- Chronic Disease Care Research Centre, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Zahra Parsa-Yekta
- Nursing Care Research center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Tahereh Najafi-Ghezeljeh
- Nursing Care Research center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Zohreh Vanaki
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Kourosh Zarea
- Chronic Disease Care Research Centre, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Erickson K, Freeborn D, Roper SO, Mandleco B, Anderson A, Dyches T. Parent experiences raising young people with type 1 diabetes and celiac disease. J Pediatr Nurs 2015; 30:353-63. [PMID: 25305541 DOI: 10.1016/j.pedn.2014.09.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 09/24/2014] [Accepted: 09/26/2014] [Indexed: 12/14/2022]
Abstract
Authors of this qualitative descriptive study interviewed 30 parents concerning their experiences raising a child or adolescent with type 1 diabetes (T1D) and celiac disease (CD). Analysis revealed six themes: (a) health complications of T1D, (b) challenges of daily disease management, (c) financial concerns, (d) the young person's emotional/mental health, (e) experiences with healthcare providers, and (f) experiences with people outside the family and at school. Results suggest nurses need to be sensitive to challenges young people living with T1D and CD and their parents face, conduct ongoing assessments, and provide time during interactions to adequately address concerns.
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Affiliation(s)
- Kerri Erickson
- Family Nurse Practitioner, Intermountain Healthcare, Salt Lake City, UT
| | | | | | | | - Ashley Anderson
- University Medical Center at Texas Tech University, Lubbock, TX
| | - Tina Dyches
- McKay School of Education, Brigham Young University, Provo, UT
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Spirkova A, Dusatkova P, Peckova M, Kolouskova S, Snajderova M, Obermannova B, Stechova K, Hrachovinova T, Mares J, Cinek O, Lebl J, Sumnik Z, Pruhova S. Treated Autoimmune Thyroid Disease Is Associated with a Decreased Quality of Life among Young Persons with Type 1 Diabetes. Int J Endocrinol 2015; 2015:185859. [PMID: 26089877 PMCID: PMC4451782 DOI: 10.1155/2015/185859] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 11/28/2014] [Indexed: 12/25/2022] Open
Abstract
Type 1 diabetes (T1D) in children and adolescents is relatively often accompanied by other immunopathological diseases, autoimmune thyroid disease (AITD) or celiac disease (CD). Our aim was to assess whether these conditions are associated with changes in the health-related quality of life (HRQOL) in pediatric patients with T1D. In a cross-sectional study we identified eligible 332 patients with T1D aged 8-18 years, of whom 248 (75%) together with their parents responded to the PedsQL Generic and Diabetes Modules. Compared to 143 patients without thyroid autoantibodies, 40 patients with a thyroxine-treated AITD scored lower in the overall generic HRQOL (P = 0.014), as well as in the overall diabetes-specific HRQOL (P = 0.013). After adjustment for age, gender, duration of diabetes, type of diabetes treatment, and diabetes control, this association remained statistically significant for the generic HRQOL (P = 0.023). Celiac disease was not associated with a change in the generic or diabetes-specific HRQOL (P = 0.07 and P = 0.63, resp.). Parental scores showed no association with AITD or celiac disease, except a marginally significant decrease in the overall generic HRQOL (P = 0.039) in the T1D + AITD compared to T1D group. Our study indicates that, in pediatric patients with T1D, concomitant thyroxine-treated AITD is associated with lower quality of life.
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Affiliation(s)
- Alena Spirkova
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital in Motol, V Uvalu 84, 15006 Prague, Czech Republic
- Department of Psychology, Faculty of Arts, Charles University in Prague, 11000 Prague, Czech Republic
| | - Petra Dusatkova
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital in Motol, V Uvalu 84, 15006 Prague, Czech Republic
- *Petra Dusatkova:
| | - Monika Peckova
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital in Motol, V Uvalu 84, 15006 Prague, Czech Republic
- Department of Probability and Mathematical Statistics, Faculty of Mathematics and Physics, Charles University in Prague, 11800 Prague, Czech Republic
| | - Stanislava Kolouskova
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital in Motol, V Uvalu 84, 15006 Prague, Czech Republic
| | - Marta Snajderova
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital in Motol, V Uvalu 84, 15006 Prague, Czech Republic
| | - Barbora Obermannova
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital in Motol, V Uvalu 84, 15006 Prague, Czech Republic
| | - Katerina Stechova
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital in Motol, V Uvalu 84, 15006 Prague, Czech Republic
| | - Tamara Hrachovinova
- Department of Psychology, Faculty of Arts, Charles University in Prague, 11000 Prague, Czech Republic
| | - Jiri Mares
- Department of Social Medicine, Faculty of Medicine in Hradec Kralove, Charles University, 50038 Hradec Kralove, Czech Republic
| | - Ondrej Cinek
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital in Motol, V Uvalu 84, 15006 Prague, Czech Republic
| | - Jan Lebl
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital in Motol, V Uvalu 84, 15006 Prague, Czech Republic
| | - Zdenek Sumnik
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital in Motol, V Uvalu 84, 15006 Prague, Czech Republic
| | - Stepanka Pruhova
- Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and University Hospital in Motol, V Uvalu 84, 15006 Prague, Czech Republic
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Rankin D, Harden J, Waugh N, Noyes K, Barnard KD, Lawton J. Parents' information and support needs when their child is diagnosed with type 1 diabetes: a qualitative study. Health Expect 2014; 19:580-91. [PMID: 25074412 PMCID: PMC5055234 DOI: 10.1111/hex.12244] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
AIM AND OBJECTIVE The aim of this study was to describe and explore parents' information and support needs when their child is diagnosed with type 1 diabetes, including their views about the timing and chronology of current support provision. Our objective was to identify ways in which parents could be better supported in the future. DESIGN AND PARTICIPANTS Semi-structured interviews were conducted with 54 parents of children with type 1 diabetes in four paediatric diabetes clinics in Scotland. Data were analysed using an inductive, thematic approach. FINDINGS Parents described needing more reassurance after their child was diagnosed before being given complex information about diabetes management, so they would be better placed psychologically and emotionally to absorb this information. Parents also highlighted a need for more emotional and practical support from health professionals when they first began to implement diabetes regimens at home, tailored to their personal and domestic circumstances. However, some felt unable to ask for help or believed that health professionals were unable to offer empathetic support. Whilst some parents highlighted a need for support delivered by peer parents, others who had received peer support conveyed ambivalent views about the input and advice they had received. CONCLUSIONS Our findings suggest that professionals should consider the timing and chronology of support provision to ensure that parents' emotional and informational needs are addressed when their child is diagnosed and that practical advice and further emotional support are provided thereafter, which takes account of their day-to-day experiences of caring for their child.
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Affiliation(s)
- David Rankin
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | - Jeni Harden
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | - Norman Waugh
- Warwick Medical School, University of Warwick, Coventry, UK
| | | | | | - Julia Lawton
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
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Hemingway S, Trotter F, Stephenson J, Holdich P. Diabetes: increasing the knowledge base of mental health nurses. ACTA ACUST UNITED AC 2014; 22:991-2, 994-6. [PMID: 24067307 DOI: 10.12968/bjon.2013.22.17.991] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Physical health assessment for people with a serious mental illness (SMI) has been a neglected issue, with all the evidence showing that mental health nurses (MHNs) and associated practitioners need to develop such skills. The University of Huddersfield and South West Yorkshire Partnership Foundation Trust collaborated in a Physical Skills Project with the aim of facilitating knowledge and skills for MHNs. The development of the education and training workshop is presented. The results of a pre- and post-test evaluation of diabetes, evaluation of the workshop and, finally, implications for practice with regard to transferable knowledge and skill, are discussed.
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Rintala TM, Paavilainen E, Åstedt-Kurki P. Everyday living with diabetes described by family members of adult people with type 1 diabetes. INTERNATIONAL JOURNAL OF FAMILY MEDICINE 2013; 2013:967872. [PMID: 24455251 PMCID: PMC3878394 DOI: 10.1155/2013/967872] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 11/17/2013] [Accepted: 11/21/2013] [Indexed: 06/02/2023]
Abstract
The aim of this study was to explore family members' experiences of everyday life in families with adult people living with type 1 diabetes. The grounded theory method was used to gather and analyse data from the interviews of nineteen family members. Six concepts describing the family members' views on everyday living with diabetes were generated on the basis of the data. Everyday life with diabetes is described as being intertwined with hypoglycemia. Becoming acquainted with diabetes takes place little by little. Being involved in the management and watching self-management from the sidelines are concepts describing family members' participation in the daily management of diabetes. The family members are also integrating diabetes into everyday life. Living on an emotional roller-coaster tells about the thoughts and feelings that family members experience. Family members of adult people with diabetes are involved in the management of the diabetes in many ways and experience many concerns. The family members' point of view is important to take into consideration when developing education for adults with diabetes.
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Affiliation(s)
- Tuula-Maria Rintala
- School of Health Sciences, Nursing Science, University of Tampere, Kuntokatu 4, 33520 Tampere, Finland
| | - Eija Paavilainen
- School of Health Sciences, Nursing Science, University of Tampere, Kuntokatu 4, 33520 Tampere, Finland
| | - Päivi Åstedt-Kurki
- School of Health Sciences, Nursing Science, University of Tampere, Kuntokatu 4, 33520 Tampere, Finland
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Abstract
Transition of care from a child-centered care environment to an adult-centered care environment for pediatric patients with diabetes is needed to ensure continued diabetes care. The transition process should start early and be tailored to the developmental stage of the patient. The typical challenges of adolescence and young adulthood including pubertal changes, parent-child conflict and the potential for high-risk behavior complicate the transition process. Methods of transfer of care are variable and less than optimal. Ongoing study and continued efforts are needed to improve the transition process so that young patients with diabetes receive high quality uninterrupted care.
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Oskouie F, Mehrdad N, Ebrahimi H. Mediating factors of coping process in parents of children with type 1 diabetes. J Diabetes Metab Disord 2013; 12:20. [PMID: 23673161 PMCID: PMC3662580 DOI: 10.1186/2251-6581-12-20] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Accepted: 05/08/2013] [Indexed: 11/10/2022]
Abstract
Background Type 1 diabetes is a lifelong condition for children and their parents, the management for which imposes a vast responsibility. This study explores the mediating factors that affect Iranian parents’ coping processes with their children’s type 1 diabetes. Methods Research was conducted using the grounded theory method. Participants were selected purposefully, and we continued with theoretical sampling. Constant comparative analysis was used to analyze the data. Results The mediating factors of the parental coping process with their child’s diabetes consist of the child’s cooperation, crises and experiences, economic challenges, and parental participation in care. Conclusion Findings highlight the necessity of well-informed nurses with insightful understanding of the mediating factors in parental coping with juvenile diabetes in order to meet the particular needs of this group.
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Affiliation(s)
- Fatemeh Oskouie
- School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran.
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Sparud-Lundin C, Hallström I, Erlandsson LK. Challenges, strategies, and gender relations among parents of children recently diagnosed with type 1 diabetes. JOURNAL OF FAMILY NURSING 2013; 19:249-273. [PMID: 23539561 DOI: 10.1177/1074840713484386] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This study explored (a) parents' process of changes and challenges in their patterns of daily activities after the onset of diabetes in their children; and (b) how personal gender relations can restrain or create functional strategies for managing the changes and challenges of illness. Interviews were conducted with 21 mothers and 15 fathers of 23 children with type 1 diabetes 8 to 10 months after onset. Using a constant comparative analysis method, the core category depicts how the illness forced parents to reconstruct their family project with respect to patterns of daily activities and gender structures. The emerging subcategories of reinforced mothering and adjusted fathering illustrate the parents' effort to handle contemporary and contradictory demands. With increased knowledge of the dynamics of gender relations of families in the context of a child's illness, health care professionals can assist in promoting well-being and functional strategies in families when a child is newly diagnosed with diabetes.
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Affiliation(s)
- Carina Sparud-Lundin
- Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
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Sharif MO, Callery P, Tierney S. The Perspectives of Children and Young People Living with Cleft Lip and Palate: A Review of Qualitative Literature. Cleft Palate Craniofac J 2013; 50:297-304. [DOI: 10.1597/12-054] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective To explore the experiences of children and young people with cleft lip and/or palate (CL/P) in relation to being treated for and living with this condition. Design A systematic review of qualitative research. Electronic databases and hand-searching were employed to identify relevant studies. The review centered on studies examining the views or experiences of young patients first-hand. Any study using a qualitative/mixed method design was eligible for inclusion. Results From 184 potential references, 38 papers were read in full, from which only two studies of young people met all the review's inclusion criteria. Common reasons for exclusion were not being a qualitative study, not focusing on CL/P, or data coming from parents only. A further two papers provided a retrospective account of childhood with CL/P from interviews with adults. Their suitability for the review's aims was limited, but they were discussed. Conclusions This review demonstrates that there is a paucity of evidence about the experiences of young people living with CL/P. No studies of children and only two studies of young people met all inclusion criteria. Identified papers implied that more attention is needed within families and services to help young people manage everyday difficulties such as bullying and self-consciousness due to facial difference.
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Affiliation(s)
- Mohammad Owaise Sharif
- National Institute for Health Academic, Orthodontics, School of Dentistry, the University of Manchester; Higher Cambridge Street, Manchester, U.K
| | - Peter Callery
- Children's Nursing, the School of Nursing, Midwifery and Social Work the University of Manchester, U.K.; Higher Cambridge Street, Manchester, U.K
| | - Stephanie Tierney
- The School of Nursing, Midwifery and Social Work, the University of Manchester; Higher Cambridge Street, Manchester
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