Clarifying responsibility for self-management of diabetes in adolescents using insulin pumps – a qualitative study
Article first published online: 16 FEB 2011
© 2011 Blackwell Publishing Ltd
Journal of Advanced Nursing
Volume 67, Issue 7, pages 1547–1557, July 2011
How to Cite
Olinder, A. L., Nyhlin, K. T. and Smide, B. (2011), Clarifying responsibility for self-management of diabetes in adolescents using insulin pumps – a qualitative study. Journal of Advanced Nursing, 67: 1547–1557. doi: 10.1111/j.1365-2648.2010.05588.x
- Issue published online: 12 JUN 2011
- Article first published online: 16 FEB 2011
- Accepted for publication 18 December 2010
- adolescent parenting;
- diabetes mellitus type 1;
- grounded theory;
- insulin pump;
olinder a.l., nyhlin k.t. & smide b. (2011) Clarifying responsibility for self-management of diabetes in adolescents using insulin pumps – a qualitative study. Journal of Advanced Nursing67(7), 1547–1557.
Aim. To gain insight into and generate theoretical knowledge about the processes involved when insulin pump-treated adolescents take or miss taking their bolus doses.
Background. Insulin pump treatment is considered the most physiological way to imitate the healthy body’s insulin profile in adolescents with diabetes. Despite insulin pump treatment, it is hard to maintain near-normal glucose control in adolescents; one reason for this is missed bolus doses with meals.
Method. In this qualitative interview study, the grounded theory method was chosen as a model for the collection and analysis of data. Twelve adolescents (five boys and seven girls, mean age: 14·4 years, range: 12–19 years) from different Swedish paediatric diabetes clinics, four parents and one paediatric diabetes nurse were interviewed during 2008 and 2009. Two adolescents and two parents were re-interviewed after approximately 10 months. Data from clinical visits and diabetes camps were used to verify emerging categories.
Findings. Responsibility in the context of taking or missing bolus doses emerged as the core category. It is elaborated and explained through three subcategories: distribution of responsibility, transfer of responsibility and clarification of responsibility. The findings describe the need to clarify the responsibility for diabetes self-management in continuous negotiations between adolescents and parents to avoid missed doses.
Conclusion. Negotiations to clarify the responsibility for diabetes self-management must be a continuous process between adolescents and parents. Diabetes care teams can facilitate and encourage these negotiations.