Adults with Type 1 Diabetes: Lifetime Support and Management

Friday, 25 July 2014

Donna Freeborn, PhD, FNP, CNM1
Jordan Scanlon, RN1
Tina Dyches, PhD2
Susanne Olsen Roper, PhD3
Barbara Mandleco, RN, PhD1
(1)College of Nursing, Brigham Young University, Provo, UT
(2)Department of Counseling Psychology and Special Education, Brigham Young University, Provo, UT
(3)Marriage, Family and Human Development, Brigham Young University, Provo, UT

Purpose:

To explore family support and it effects on diabetes management of adults with type 1 diabetes

Methods: This study consisted of two in-depth interviews of 23 adult females and 12 adult males ranging in age from 19 to 70 years (M=36.54, SD=16.65). Participants’ ages at diagnosis with type 1 diabetes ranged from two to 35 years (M=15.06, SD=9.84) with one to 54 years since diagnosis (M=21.46, SD=12.87). This qualitative study, using the biographical method, consisted of two in-depth interviews. The first interview allowed the participant to answer the prompt “tell me about growing up and living with type 1 diabetes.” The interviewers used additional prompts such as “tell me more about” or “can you explain that further” but the participant directed the interview. The second interview took place approximately one week later. This interview began by the interviewers soliciting clarification, if needed, from the first interview. Then interviewers asked questions including: a) Tell us about when you were diagnosed with type 1 diabetes; b) How were your family and friends supportive/non-supportive? c) How compliant have you been throughout your lifetime to your health care regime? d) What were the biggest factors in helping you stay compliant?

Results:

Factors that increased compliance included: positive family involvement both with siblings and parents; increased early independence in managing their diabetes; education about type 1 diabetes for both children and families; involvement of other influential adults in teaching the importance of diabetes management; motivation to live up to their dreams; and, increased knowledge that compliance was possible. Factors that decreased compliance included:  children viewing diabetes as a chore; feeling different from other children and family members; over protective parents who did not encourage independent self-management of diabetes; changing routines such as going on vacation or transitioning to college; and, being stressed due to the emphasis on diabetes management and health.

Conclusion:

Participants described that at the time of their diagnosis with type 1 diabetes they believed that their life was over and they would never be able to do the things they wanted to do.  Children with type 1 diabetes need clear education about their disease, how they can still participate in favorite activities and their role in assuming independent self-management skills. Children and their families all need to be taught that they can lead healthy and normal lives and that they should be optimistic about the future. Type 1 diabetes is a life-time condition and those living with the disease, whether they be children or adults, need support to manage the condition and live healthy, active lives.