Understanding adolescent type 1 diabetes self-management as an adaptive process: A grounded theory approach

Abstract

This investigation provides a conceptual understanding of the complex issues adolescents encounter while adapting to and integrating a diabetes self-management regime into their lives. It provides an invaluable framework for exploring psychological mechanisms and contextualising them within a self-management continuum. Implications for healthcare professionals are discussed and further research proposes whether the model could be applicable to other chronic illnesses.

The context of coping: a qualitative exploration of underlying inequalities that influence health services support for people living with long‐term conditions

“…Analysis of the data coded under 'coping with LTCs' revealed a striking finding: the heterogeneity of coping resources that could be utilised both within and across individual participants. Ability to cope with LTCs did not seem to follow a linear trajectory that the literature on adaptation to illness suggests (Chilton and Pires-Yfantouda 2015). Rather, people living with LTCs could exhibit sophisticated strategies for self-management and adjusting one's life in response to illness (classified as high-level coping), while simultaneously referring to a high emotional burden of illness and/or behaviours such as comfort eating or substance abuse (classified as low-level coping).…”

Supporting children and young people to assume responsibility from their parents for the self‐management of their long‐term condition: An integrative review

“…In some studies, the process of children assuming self‐management responsibility was viewed by children and parents as part of normal development but often described as a complex, uneven process (Chilton & Pires‐Yfantouda, ; Karlsson, Arman, & Wikblad, ). Roles and responsibilities of children and their parents changed over time (Christian, D'Auria, & Fox, ; Olinder et al, ) as children became less reliant on their parents and parents “let go” (Babler & Strickland, ; Ersig, Tsalikian, Coffey, & Williams, ).…”

“…Some aspects of self‐management were taken on gradually by children, including managing medication, therapies, and procedures (Buford, ; Meaux et al, ; Williams, Mukhopadhyay, Dowell, & Coyle, ), whereas skills such as decision making and liaising with services needed to be acquired suddenly on transfer to adult services (Kirk, ). The parent‐to‐child transfer of self‐management responsibility was modelled in various ways; some studies reported that the child, the parent or both, sequentially progressed through discrete stages (Babler & Strickland, ; Schilling, Knafl, & Grey, ) whereas others viewed the transfer as a fluid, bidirectional continuum where child and parental roles and responsibilities were regularly shifting (Chilton & Pires‐Yfantouda, ; Williams et al, ). For example, in some families, parents would resume management of the LTC when their child was tired, unwell, or lacking motivation (Kirk, ; Schilling et al, ) or when complications arose (Meaux et al, ).…”

The impact of using a closed‐loop system on food choices and eating practices among people with Type 1 diabetes: a qualitative study involving adults, teenagers and parents

“…The teenagers and parents in the study particularly valued the closed-loop as it was seen to offer a safety net at a point in the life course where the self management of diabetes could be neglected as a result of individuals having other priorities and wanting to fit in with their peers [26,27]. Indeed, the particular benefits of closed-loop technology to this age group have been noted by others, who have shown that in scenarios mimicking 'noncompliant' behaviours among adolescents, closed-loop systems can be safe and effective because of the system's ability to partly compensate for boluses being forgotten or underestimated [28,29].…”