Although compliance with self-care amongst adolescents with diabetes is known to be problematic, this issue has rarely been examined from the perspective of young diabetics themselves. The purpose of the study was to explore how adolescents with diabetes perceived the actions of physicians, nurses, parents and friends in relation to compliance with self-care. Fifty-one young diabetics aged from 13 to 17 responded to a questionnaire concerning compliance and were interviewed on the topic of compliance. Interview data were analysed by content analysis. The categories obtained were quantified and the relationship between compliance and the actions of physicians, nurses, parents and friends analysed by cross-tabulation. Interviews with 51 adolescents showed that the actions of physicians, nurses and parents described as motivating were associated with better compliance. Good compliance was also more evident when parental actions were perceived as accepting. Young diabetics whose friends offered silent support, or who viewed friends as irrelevant, were more likely to report good compliance. In contrast, physicians' actions described as routine/negligent, disciplined control by parents, and domination by friends were linked with poor compliance.
A consideration of literature dealing with the principles of child interviewing shows that there is surprisingly little guidance available on conversational methods involving children. The empirical and conceptual foundation for child interviewing is not very clear. Novice researchers especially may need recommendations about how to conduct a qualitative child interview. The method must suit both the purpose and the context.
The placement of demented patients in long-term institutional care can be deferred with the support of a dementia family care coordinator. However, by the end of the 2-year intervention, the number of patients institutionalized was similar in the intervention and control group. It seems to be beneficial to direct this type of intensive support at severely demented patients and their caregivers. On the basis of our experiences, we suggest that intervention by a dementia family care coordinator should be targeted especially at patients with problems threatening the continuity of community care.
The aim of this study was to develop a model to clarify the existing knowledge concerning the self-care of home-dwelling elderly people. The data were collected in Oulu, a medium-sized city in northern Finland, by interviewing 40 home-dwelling elderly persons aged 75 or more. Data were analysed using the constant comparative method of the grounded theory approach. The model consists of four modes of self-care with different conditions for action and different meanings: responsible self-care consists of responsible activity by the elderly person based on a positive orientation towards the future and a positive experience of ageing. The meaning of responsible self-care is a desire to continue living as an active agent. Formally guided self-care consists of uncritical observance of instructions and routine performance of daily tasks. This approach is based on life experiences of taking care of others and realistic awareness of the effects of old age. The meaning of formally guided self-care is a tendency to accept life as it comes. Independent self-care is based on the person's desire to listen to his/her own internal voice. These persons aim to manage in life independently and deny the prospect of growing old. The meaning of independent self-care is an attempt to maintain the constancy of life. Abandoned self-care is characterized by helplessness and lack of responsibility. It involves bitterness and a negative attitude towards ageing. The meaning of abandonment is a desire to 'give up'. According to this study, self-care is not a separate part of old men's or women's lives, it is associated closely with their past life and with the future. As an activity, self-care is not just a rational way to maintain health. It also reflects the person's overall attitude towards health care, illnesses and manner of living.
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