The Clinical, Psychosocial, and Socioeconomic Concerns of Urban Youth Living With Diabetes

Gee, Leslie; Smith, Tracie L.; Solomon, Marla C.; Quinn, Michael T.; Lipton, Rebecca B.

doi:10.1111/j.1525-1446.2007.00640.x

Cited by 19 publications

(44 citation statements)

References 17 publications

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“…Indeed, themes related to social support were commonly voiced by both youth and their parents, similar to other qualitative findings (22). To explain this phenomenon, Allen and Gregory (5) discuss young adult independence as a myth: despite increasing self-management skills and a growing desire for autonomy, emerging adults often continue to rely on family and friends.…”

Section: Discussionsupporting

confidence: 85%

“…As in other samples of emerging adults with diabetes (22,25), the participants in this study emphasized the importance of a good fit with an adult care provider and expressed worries about having negative interactions. Despite these concerns, young adults in the Posttransition group largely reported positive experiences, suggesting that many adult care providers adequately address young adult issues in their practice.…”

Section: Discussionmentioning

confidence: 51%

“…Previous qualitative research has reported that many youth feel confused about how to establish an adult care provider (22) or face challenges with access (23). Some youth report positive, supportive interactions with adult care providers, and others feel put off by briefer visits, more directive communication styles, and a lack of consistency in providers or clinic staff (23).…”

Section: Introductionmentioning

confidence: 99%

“…Qualitative work has also emphasized the importance of social and family support. Although parents’ roles change continuously as youths become more independent, their support is frequently identified as an important component of successful diabetes management and control throughout emerging adulthood (22,23). However, some emerging adults also report wanting to establish independence, which can detract from parents’ ability to be supportive during the transition (23).…”

Section: Introductionmentioning

confidence: 99%

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Perspectives From Before and After the Pediatric to Adult Care Transition: A Mixed-Methods Study in Type 1 Diabetes

et al. 2014

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OBJECTIVEAmong the many milestones of adolescence and young adulthood, transferring from pediatric to adult care is a significant transition for those with type 1 diabetes. The aim of this study was to understand the concerns, expectations, preferences, and experiences of pretransition adolescents and parents and posttransition young adults.RESEARCH DESIGN AND METHODSParticipants completed questionnaires and responded to open-ended qualitative questions regarding self-management, self-efficacy, and their expectations and experiences with pediatric and adult care providers across the transition process.RESULTSAt a mean age of 16.1 years, most pretransition adolescents had not yet discussed transferring care with their parents or doctors. Although many posttransition young adults reported positive, supportive interactions, several described challenges locating or establishing a relationship with an adult diabetes care provider. Qualitative themes emerged related to the anticipated timing of transfer, early preparation for transition, the desire for developmentally appropriate interactions with providers, the maintenance of family and social support, and strategies for coordinating care between pediatric and adult care providers.CONCLUSIONSStandardizing transition preparation programs in pediatric care and introducing transition-oriented clinics for late adolescents and young adults prior to adult care may help address patients’ preferences and common transfer-related challenges.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 51%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Perspectives From Before and After the Pediatric to Adult Care Transition: A Mixed-Methods Study in Type 1 Diabetes

et al. 2014

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“…A similar study of urban youth with T1D conducted by Gee and colleagues found that challenges in establishing independence as a young adult were similar to those without a chronic condition, but coping with the management of diabetes magnified the difficulties of emerging adulthood and generally resulted in poor diabetes management [3].…”

Section: Background and Rationalementioning

confidence: 98%

Transitioning from Pediatric to Adult Diabetes Care

Johnson

Melton²,

Wingert

2016

PLAID

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Objective: The clinical transition from pediatric to adult diabetes care is often challenging for both young adults with type 1 diabetes (T1D) and the health care providers (HCPs) who care for this population. This study presents insights into the perceptions and needs of both patients with diabetes and HCPs during the clinical transition.Research Design and Method: Two separate surveys were administered with questions specifically tailored to each audience. Perceptions of the transition phase for both patients with T1D and HCPs were analyzed for general trends and then compared to investigate similarities and differences between patient and provider needs.Results: Both patients and HCPs expressed concerns regarding poor patient-provider communication during transition and the barriers to independently managing diabetes self-care responsibilities (e.g. navigating insurance, ordering supplies, arranging healthcare appointments). Although 45% of HCPs reported screening transition age patients for mental health issues related to diabetes, only 9% of patients stated their provider offered this opportunity. Furthermore, patients reported facing a variety of challenges not discussed with their HCP including: sexual issues (28%), depression or anxiety (17%), and eating disorders (11%). Conclusions:Training in the assessment of young adult T1D needs and effective communication techniques may assist HCPs in working more effectively with young adults. Offering mental health screenings for transition age patients may open the conversation to discuss diabetes concerns such as depression, sexual challenges, and eating disorders not currently being addressed. Both patients and providers desired improved communication with more emphasis on independently managing diabetes responsibilities and adjusting to new life situations.

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Resources, Roadblocks and Turning Points: A Qualitative Study of American Indian/ Alaska Native Adults with Type 2 Diabetes

et al. 2012

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Type 2 diabetes is a worldwide health problem that has reached epidemic proportions in some communities. Alaska Native and American Indian (AN/AI) people are disproportionately diagnosed with type 2 diabetes and incidence is increasing in many Alaska communities. Developing effective interventions requires understanding the social and psychological factors that impact effective management of diabetes, yet little is known about these factors in AN/AI communities. The objective of this study was to explore perceived psychosocial needs and barriers to management of diabetes among AN/AI adults with type 2 diabetes receiving care at the Alaska Native Primary Care Center (ANPCC) to inform programmatic efforts and potential future research. We conducted three focus groups and five interviews with 13 AN/AI adults with type 2 diabetes. Interview and focus group questions elicited perceived factors that affect management of diabetes, with a focus on the psychological, social and spiritual impacts of diabetes. Data were transcribed, coded and analyzed using thematic analysis. Key themes that emerged from these data included resources and roadblocks, as well as turning points in the trajectory of diabetes. Resources are factors with a perceived positive impact on management of diabetes, including: (1) knowledge and education about diabetes, (2) social support from other people with diabetes, (3) spirituality, and (4) self-efficacy. Roadblocks are factors with a perceived negative impact on management of diabetes and include: (1) self-reported lack of knowledge about nutrition and diet, (2) social difficulties caused by dietary restrictions, and (3) co-morbid medical conditions. Finally, turning points are experiences described by participants as having transformed roadblocks in resources and thus facilitating improvement in the management of diabetes. Future programmatic interventions to improve management of diabetes with this population should focus on improving dietary education and social support opportunities for newly-diagnosed individuals. Also, educational and support opportunities for family members and friends of individuals with diabetes should also be offered to facilitate understanding and support of their loved ones' management of diabetes, especially with regard to dietary restrictions in social settings. Efforts should also focus on strengthening newly-diagnosed individuals' self-efficacy and providing ongoing support as individuals progressively adjust to the illness over time and make behavioral changes. Future research with this population should explore the effects of family support groups and the possibility of Web-based or other alternative interventions for improving psychosocial health and management of diabetes efforts.

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The Clinical, Psychosocial, and Socioeconomic Concerns of Urban Youth Living With Diabetes

Abstract: Offering emotional and practical support to young adults coping with diabetes is key to ensuring adequate medical management as they move into the adult system and assume full responsibility for their health.

Cited by 19 publications

References 17 publications

Perspectives From Before and After the Pediatric to Adult Care Transition: A Mixed-Methods Study in Type 1 Diabetes

Perspectives From Before and After the Pediatric to Adult Care Transition: A Mixed-Methods Study in Type 1 Diabetes

Transitioning from Pediatric to Adult Diabetes Care

Resources, Roadblocks and Turning Points: A Qualitative Study of American Indian/ Alaska Native Adults with Type 2 Diabetes

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