Type 1 diabetes management responsibilities between adolescents with T1D and their parents: An integrative review

Abstract

Purpose Diabetes self‐management for adolescents with type 1 diabetes (T1D) is a complex and multifaceted process that requires careful consideration of a supportive or shared approach to care. The purpose of this review was to synthesize the qualitative and quantitative evidence regarding the nature of adolescent−parent interactions and relationships in the context of T1D management. Of particular interest was the role of interdependence in this relationship. Methods An integrative review of the literature was conducted between January 2021 and April 2021 using Whittemore and Knafl's (2005) methodological strategies. Results Eleven studies published between 2003 and 2018 met the review criteria. Thematic analysis identified the following three themes related to parent−adolescent relationships in care including the Effectiveness of Parental Involvement and T1D Management, Shared Responsibility and T1D Task Management, and Gaining Independence in T1D Management. This review highlights the importance of both parent and adolescent shared involvement in T1D management. In particular, parental involvement appears necessary for improved glycemic control, better adherence to the T1D management regime, and for practicing self‐management in adolescents with T1D. Practice Implications Better understanding of the parent−child interaction in diabetes care will provide important information to aid family nurses to identify, support, and help maintain the sharing of T1D management responsibilities between parents and their adolescents.

Managing type 1 diabetes of a child: Parents' perspectives

“…Some of the recommendations for an increased role for healthcare professionals include helping parents to recognize their goals and the independence of the child, adapting consultations and focusing on difficulties perceived by the child but not solely on the health condition (Nightingale et al, 2019). Farthing et al (2022) suggested that healthcare professionals can observe how the parents and children with T1D interact with each other in subsequent visits and integrate the responsibilities of shared T1D management into the overall care plan of the child and the family over time. Future research can explore how the child and their family change through the professional's help.…”

Adolescents, parents, and providers' experiences of triadic encounters in paediatric diabetes clinics: A qualitative study

“…The parents in this study appeared to be actively involved in clinic encounters and their contributions were viewed by most providers as essential whilst others felt that parents hindered communication with adolescents. While research studies indicate that parental oversight is problematic when it is ‘over protective’, 5 it is at the same time a strong predictor of adolescents' adherence to diabetes regimen 28,29 . These conflicting findings may be due to differing perceptions/needs, parenting style and adolescents temperament 30 but there is general agreement that maintaining parental involvement in diabetes management during adolescence is critical 29,31 .…”

“…While research studies indicate that parental oversight is problematic when it is ‘over protective’, 5 it is at the same time a strong predictor of adolescents' adherence to diabetes regimen. 28 , 29 These conflicting findings may be due to differing perceptions/needs, parenting style and adolescents temperament 30 but there is general agreement that maintaining parental involvement in diabetes management during adolescence is critical. 29 , 31 Parents can find it challenging to balance responsibility whilst promoting their adolescent's autonomy and so providers could help by encouraging parents to gradually ‘step back’ and advising them on how to support their adolescent efforts to engage in clinic encounters.…”

“… 28 , 29 These conflicting findings may be due to differing perceptions/needs, parenting style and adolescents temperament 30 but there is general agreement that maintaining parental involvement in diabetes management during adolescence is critical. 29 , 31 Parents can find it challenging to balance responsibility whilst promoting their adolescent's autonomy and so providers could help by encouraging parents to gradually ‘step back’ and advising them on how to support their adolescent efforts to engage in clinic encounters. Providing split consultations could convey respect for adolescents' developing autonomy, facilitate open communication and help them to engage with providers and some research indicates that parents are supportive of adolescents having time alone with their provider.…”

Diabetes Patients’ Acceptance of Injectable Treatment, a Scientometric Analysis

“…Type 1 diabetes is characterized by a lack of or near-lack of b-cells, so insulin is necessary for people with this type of diabetes. In addition to hyperglycemia, hypoinsulinism may contribute to other metabolic disorders such as hypertriglyceridemia and ketoacidosis, as well as potentially life-threatening tissue catabolism [1]. Most individuals with type 1 diabetes should be treated with multiple daily injections of insulin or a continuous infusion of subcutaneous insulin.…”