Doctor of Philosophy
Jackson, Kimberley, T.
Although previous research has examined adolescents’ general experiences of living with type 1 diabetes (T1D), there is a paucity of research, especially in Canada, exploring perceived adolescent readiness to assume self-management responsibility from their parents. Utilizing Charmaz’s (2014) constructivist grounded theory methodology, this study aimed to: 1) explore, from the perspective of adolescents, parents, and diabetes nurse educators, the underlying processes in determining adolescent readiness to increase their independence and self-management responsibility of diabetes, and 2) gain a greater understanding of the barriers and facilitators associated with being ready to transfer diabetes management responsibility from the parent to the adolescent. Fifteen semi-structured interviews were completed with three diabetes nurse educators, seven parents of adolescents living with T1D, and five adolescents living with T1D. Five major categories emerged from the data, including: 1) aging through adolescence with diabetes, 2) ready or not here it comes, 3) letting go is a process, 4) encouraging optimal diabetes management, and 5) “it’s not easy having diabetes”.
This study provides new insight into the processes used to determine adolescent readiness, from the perspective of adolescents, parents, and diabetes nurse educators. Findings revealed that determining adolescent readiness for increasing their diabetes management responsibility is a complex and tedious process that requires active participation from adolescents, parents, and diabetes nurse educators. It highlights teamwork, communication, and collaboration between the adolescent and their parent(s) and between families and diabetes management teams as pivotal for success. This study emphasizes the need to support adolescents, encouraging them to be independent, building their confidence and growing their diabetes knowledge. With the results from this study, families and diabetes management teams can continue to improve the transfer of care process, including adolescents’ ability to independently manage their diabetes, which will help to successfully prepare teens for the critical transition from pediatric focused to adult oriented medical care.
Summary for Lay Audience
The purpose of this study was to explore the self-management experience in adolescents living with type 1 diabetes. Specifically, it investigated adolescent readiness to increase their self-management responsibility of diabetes. Adolescents, parents, and diabetes nurse educators were invited to complete an interview to discuss their experiences with transferring self-management responsibility from the parent to the adolescent, along with the barriers and facilitators associated with the transfer of care process. Major categories that emerged during this study were: 1) aging through adolescence with diabetes; 2) ready or not, here it comes; 3) letting go is a process; 4) encouraging optimal diabetes management; 5) “it’s not easy having diabetes”. The findings revealed that as teens age through adolescence their desire for independence increases, emphasizing the importance of regularly assessing their readiness to take on more diabetes management. This study uncovered the various challenges faced by adolescents, parents, and diabetes nurse educators when determining adolescent readiness levels and transferring diabetes responsibility form the parent to the adolescent. Specifically, it highlights the difficulties families experience when letting go of diabetes responsibilities and underscores the significance of the adolescent-parent relationship for successfully relinquishing diabetes responsibilities. Proposed strategies for overcoming the various challenges are provided along with recommendations for future research, policy, education, and practice to improve long-term health outcomes for adolescents living with type 1 diabetes. The results of this study add to a beginning foundation of knowledge regarding self-management readiness in adolescents living with type 1 diabetes. Understanding the processes involved with determining adolescent self-management readiness is essential for successfully preparing teens for the transition from pediatric-focused to adult-oriented medical care.
Kennedy, Kelly A., "Uncovering the Experience of Determining Readiness to Increase Self-Management Responsibility in Canadian Adolescents Living with Type 1 Diabetes" (2023). Electronic Thesis and Dissertation Repository. 9843.
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