Self-management in type 2 diabetes: the adolescent perspective.

Mulvaney SA, Mudasiru E, Schlundt DG, Baughman CL, Fleming M, VanderWoude A, Russell WE, Elasy TA, Rothman R
Diabetes Educ. 2008 34 (4): 674-82

PMID: 18669809 · PMCID: PMC2757076 · DOI:10.1177/0145721708320902

PURPOSE - The purpose of this study was to document barriers and facilitators of self-management as perceived by adolescents with type 2 diabetes.

METHODS - Focus groups were conducted with adolescents diagnosed with type 2 diabetes. Adolescents aged 13 to 19 years were recruited from an academic medical center diabetes clinic. Between 2003 and 2005, 6 focus groups were used to elicit responses from the adolescents related to self-management of their diabetes. Questions were asked by trained group facilitators. Transcripts were coded by 3 reviewers. Qualitative analyses were conducted using NVIVO software.

RESULTS - A total of 24 adolescents participated in 6 focus groups. Coding resulted in 4 common domains affecting self-management: adolescent psychosocial development; the role of others with diabetes; environmental influences; and adolescents' problem-solving/coping skills. Adolescents identified both barriers to and facilitators of self-management within each domain. Barriers often related to social situations, embarrassment, seeking acceptance or perceived normalcy, and balancing competing interests. Adolescents viewed having another family member with diabetes as both a positive and a negative influence. Environmental influences, including school and family situations, had a large impact on self-management behaviors. Making sensible food choices was a common challenge. Descriptions of problem-solving or coping skills were limited, but cognitive techniques, such as reframing, were described.

CONCLUSION - Adolescents with type 2 diabetes identified many barriers to self-management, particularly related to interpersonal interactions, the influence of others with diabetes, and environmental influences. Results suggest that improving self-management in adolescents may require multimodal interventions to address individual, family, and social processes.

MeSH Terms (15)

Adaptation, Psychological Adolescent Adult Child Diabetes Mellitus, Type 2 Educational Status Female Humans Interviews as Topic Male Parents Problem Solving Psychology, Adolescent Self Care Surveys and Questionnaires

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