Behind the scenes: the changing roles of parents in the transition from child to adult diabetes service

Allen, Davina; Channon, Susan Jane; Lowes, Lesley Madeline; Atwell, Christine; Lane, Claire

doi:10.1111/j.1464-5491.2011.03310.x

Cited by 60 publications

(81 citation statements)

References 17 publications

(18 reference statements)

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“…Depending on each family's cultural context and the relationship between the emerging adult and his or her parents, this transition may be a cause for significant stress and/or strife between family members as they work to renegotiate previously familiar boundaries. Mothers of children with diabetes, for example, have indicated feeling increased stress as their children transitioned from pediatric to adult care, particularly if they perceived that their children were not managing their health-care condition as well as they had been when it was previously under greater parent control (Allen et al 2011). Such stress might result in familial conflict and dysfunction which could subsequently interfere with the emerging adult's willingness or ability to adequately access services.…”

Section: Services and Supportsmentioning

confidence: 99%

Emerging Adulthood as a Critical Stage in the Life Course

Wood

Crapnell

Lau

et al. 2017

Handbook of Life Course Health Development

337

276

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Emerging adulthood, viewed through the lens of life course health development, has the potential to be a very positive developmental stage with postindustrial societies giving adolescents and emerging adults a greater opportunity for choice and exploration but also greater challenges with greater educational and social role requirements. The loss of supports and structures offered by schools, families, and child- and family-oriented health and social services means that the emerging adult must rely more on his/her own resources in a less structured environment. This increased agency in the context of less structure is occurring as the human brain is still developing higher-level capacities such as executive functioning. The person-context interactions during EA are many and complex, leading to multiple different pathways through emerging adulthood. Those with sufficient economic and adult supports as well as personal resources and maturity will be more likely to choose well and embark on a positive trajectory during EA. Those lacking these resources, or those with physical and mental health or intellectual disabilities, may struggle during this period and experience a negative trajectory in the spheres of education, vocation, relationships, and health status. The life course health science of EA requires more detailed and deeper analysis of the relationship between family, peers, and societal supports and personal internal resources in order to help promote successful developmental trajectories during EA.

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Section: Services and Supportsmentioning

confidence: 99%

Emerging Adulthood as a Critical Stage in the Life Course

Wood

Crapnell

Lau

et al. 2017

Handbook of Life Course Health Development

337

276

View full text Add to dashboard Cite

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“…It is important that providers working with young adults recognize this support role. Families prefer to participate in medical appointments for longer than some clinics mandate [55], and parents tend to be more active support providers when young adults remain in pediatric care rather than transitioning to adult care [46]. Ritholz and colleagues’ qualitative findings with young adults with type 1 diabetes support this research, as young adults encouraged providers to foster autonomy while also recognizing the continued role of parental support – even in early adulthood [56].…”

Section: Transition To Adult Health Carementioning

confidence: 95%

Type 1 Diabetes in Young Adulthood

Monaghan

Helgeson²,

Wiebe³

2015

CDR

152

125

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Type 1 diabetes has traditionally been studied as a chronic illness of childhood. However, young adulthood is a critical time for the development and integration of lifelong diabetes management skills, and research is starting to identify unique challenges faced by youth with diabetes as they age into adulthood. Most young adults experience multiple transitions during this unstable developmental period, including changes in lifestyle (e.g., education, occupation, living situation), changes in health care, and shifting relationships with family members, friends, and intimate others. Young adults with type 1 diabetes must navigate these transitions while also assuming increasing responsibility for their diabetes care and overall health. Despite these critical health and psychosocial concerns, there is a notable lack of evidence-based clinical services and supports for young adults with type 1 diabetes. We review relevant evolving concerns for young adults with type 1 diabetes, including lifestyle considerations, health care transitions, psychosocial needs, and changes in supportive networks, and how type 1 diabetes impacts and is impacted by these key developmental considerations. Specific avenues for intervention and future research are offered.

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“…Working in partnership with parents, as well as young people, will likely lead to a smoother and more effective transition for all. However, despite acknowledgement of the need for parent-targeted transition support [10,55,62] Allen et al [28] highlight that provision for parents is withdrawn at the time they need it most. Intervention studies remain limited.…”

Section: Discussionmentioning

confidence: 99%

“…(Mellin, 2002) Parents' experiences of their child's transition Whilst most parents valued independence and believed that letting go was the right thing to do, many described this as a difficult process, particularly if they perceived that their child was not managing their condition as well as they had been when it was under greater parental control. (Allen, 2011) Mothers described being anxious and uncertain about how much responsibility to give their children… They experienced a sense of risk in letting the child act independently. (Buford, 2004) (Akre, 2014) …”

Section: Providing Effective Transitional Carementioning

confidence: 99%

Parenting a child with chronic illness as they transition into adulthood: A systematic review and thematic synthesis of parents’ experiences

Heath

Farré

Shaw

2017

Patient Education and Counseling

163

116

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Highlights Parents view young person progression to self-care as an incremental process.  Parent perceptions of child readiness and wellness impact on healthcare autonomy.  Parents are concerned about a lack of transitional healthcare.  Parents can adjust their behaviour to support their child's independence.  Healthcare professionals can support parents to facilitate adolescent autonomy. AbstractObjective: To understand how parents view and experience their role as their child with a long-term physical health condition transitions to adulthood and adult healthcare services. Methods: Five databases were systematically searched for qualitative articles examining parents' views and experiences of their child's healthcare transition. Papers were quality assessed and thematically synthesised. Results: Thirty-two papers from six countries, spanning a 17-year period were included. Long-term conditions were diverse. Findings indicated that parents view their child's progression toward self-care as an incremental process which they seek to facilitate through up-skilling them in self-management practices. Parental perceptions of their child's readiness, wellness, competence and long-term condition impacted on the child's progression to healthcare autonomy. A lack of transitional healthcare and differences between paediatric and adult services served as barriers to effective transition. Parents were required to adjust their role, responsibilities and behaviour to support their child's growing independence. Conclusion: Parents can be key facilitators of their child's healthcare transition, supporting them to become experts in their own condition and care. To do so, they require clarification on their role and support from service providers. Practice

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Behind the scenes: the changing roles of parents in the transition from child to adult diabetes service

Abstract: There is a clear need to develop service structures that recognize the continuing role played by mothers in the diabetes care of young adults.

Cited by 60 publications

References 17 publications

Emerging Adulthood as a Critical Stage in the Life Course

Emerging Adulthood as a Critical Stage in the Life Course

Type 1 Diabetes in Young Adulthood

Parenting a child with chronic illness as they transition into adulthood: A systematic review and thematic synthesis of parents’ experiences

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