Original Research: Empirical Research – Qualitative
Adolescents developing life skills for managing type 1 diabetes: a qualitative, realistic evaluation of a guided self-determination-youth intervention
Article first published online: 3 APR 2014
© 2014 John Wiley & Sons Ltd
Journal of Advanced Nursing
Volume 70, Issue 11, pages 2634–2650, November 2014
How to Cite
2014) Adolescents developing life skills for managing type 1 diabetes: a qualitative, realistic evaluation of a guided self-determination-youth intervention. Journal of Advanced Nursing 70(11), 2634–2650>. doi: 10.1111/jan.12413, , , & (
- Issue published online: 13 OCT 2014
- Article first published online: 3 APR 2014
- Manuscript Accepted: 8 MAR 2014
- Novo Nordisk Foundation
- Foundation of Mrs. Lilly Benthine Lund
- Foundation of Ville Heise
- Foundation of Cabinetmaker Sophus Jacobsen and Wife
- Lundbeck Foundation
- Sahva Foundation
- Tryg Foundation
- Foundation of Lieutenant Commander Harald Jensen and Wife
- Health Insurance Foundation
- Beckett Foundation
- Research Foundation at Hilleroed Hospital
- Research Foundation of the Capital Region of Denmark
- autonomy-supportive intervention;
- outpatient clinic;
- type 1 diabetes
To explore and illustrate how the Guided Self-Determination-Youth method influences the development of life skills in adolescents with type 1 diabetes supported by their parents and healthcare providers.
Evidence-based methods that accomplish constructive cooperation between adolescents with poorly controlled type 1 diabetes, their parents and healthcare providers are needed. We adjusted an adult life skills intervention comprising reflection sheets and advanced communication for use by adolescent-parent-professional triads in outpatient visits.
A qualitative realistic evaluation design comprising eight context-mechanism-outcome configurations directed the analysis of the Guided Self-Determination-Youth's influence on adolescent-parent-professional triads to evaluate what worked for whom, how and in what circumstances. Thirteen adolescents aged 13–18 years diagnosed with type 1 diabetes for ≥1 year and having poor glycaemic control participated together with 17 parents and eight healthcare providers. Data were collected from December 2009–March 2012 and consisted of digitally recorded outpatient Guide Self-Determination-Youth visits collected during the intervention period (11·5–24·5 months) and semi-structured interviews at 6-month follow-up.
Emerging life skills in adolescents were identified as: (1) developing new relatedness with healthcare providers and parents; (2) becoming decision makers in their own lives with diabetes; and (3) growing personally. Reflection sheets combined with healthcare providers' advanced communication were central to promoting mutual problem-solving.
A life skills approach turned outpatient visits into person-specific visits with improved cooperation patterns in the triads. Combining reflection sheets and advanced communication skills supported adolescents in beginning a process of developing life skills.