The 3i Conceptual Framework for Recognizing Patient Perspectives of Type 1 Diabetes During Emerging Adulthood

Abstract

Key Points Question How do individuals narrate their experiences of living with type 1 diabetes during early emerging adulthood (the developmental life stage roughly spanning between the ages of 18 and 24 years)? Findings This qualitative study involved in-depth interviews with 33 emerging adults with type 1 diabetes. Narrative analysis identified 3 distinct story types encompassing differing perceptions of living with type 1 diabetes (3i), termed ingrained (characterized by actively integrating diabetes within one’s life), intrusive (characterized by struggles to accept diabetes and a sense of striving for control), and inconspicuous (characterized by attempts to minimize attention toward diabetes to protect one’s sense of normalcy). Meaning The 3i conceptual framework provides a means by which differing emerging adult perceptions of type 1 diabetes can be recognized and articulated, which may help health care professionals better individualize their approaches to self-management support during the transitioning years.

The four I's of adolescent transition in type 1 diabetes care: A qualitative study

“…Questions in the focus group guide (see Table 1) were developed from prior literature (e.g. [13][14][15][16]. Participants were explicitly encouraged to share their thoughts, even if they disagreed with another participant, in order to promote a wide range of responses.…”

“…6 A qualitative study on emerging adults with type 1 diabetes described three lenses through which one might view their diabetes (ingrained, intrusive and inconspicuous) and discussed how practitioners should consider the highly individualized psychosocial context when caring for them. 16 One reason that previous interventions may not have been able to satisfactorily improve diabetes outcomes in this population is that one intervention may not be able to address the heterogeneous problems that a diverse population of adolescents may face; there is no one-size-fits-all solution to the problem. Rather, individualization of transition preparation, transition programming and transition timing may be more effective than a single intervention such as an appointment manager or transition coordinator.…”

Aus Sicht der Diabetespraxis: erwachsen werden mit Typ-1-Diabetes

“…Trotz engagierter Initiativen zur Unterstützung der Transition [ 2 , 22 ] gibt es erhebliche Unterschiede, wann, auf welchem Weg und in welcher somatischen und psychischen Verfassung junge Erwachsene zum ersten Mal eine internistisch geleitete Diabetesschwerpunktpraxis aufsuchen.…”

“…Eine Optimierung der Stoffwechselsituation setzt in solchen Fällen eine multiprofessionelle Betreuung voraus, bei welcher nicht nur die Glukosewerte beachtet werden, sondern auch die Stabilisierung der Lebenssituation angestrebt werden muss. Zunächst aber geht es darum, eine tragfähige und vertrauensvolle therapeutische Beziehung aufzubauen und aufrechtzuerhalten, die nicht nur auf Defizite fokussiert, sondern auch die Stärken und Chancen dieser jungen Menschen mit T1D adressiert [ 22 ].…”

Competing Demands of Young Adulthood and Diabetes: A Discussion of Major Life Changes and Strategies for Health Care Providers to Promote Successful Balance

“…Although social support has a positive effect on general well-being, it can be challenging to find when managing multiple new social contexts and people. For example, social engagement with friends has the potential to detract from diabetes care if management is viewed as socially differentiating (31,32). Likewise, a fear of stigma can make it challenging to seek peer support or increase the difficulty of completing daily diabetes management tasks (6).…”