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Adolescents with type I diabetes : an interpretive description of expertise in everyday decision making O’Flynn-Magee, Kathy


Adolescence is often perceived as a challenging time and the notion of expertise in this population is not a common one. The lives of adolescents with type 1 diabetes are extraordinarily complex and their diabetes management requires them to make numerous decisions on a day to-day basis. Little is known about adolescents' everyday decision making therefore the purpose of this study was to explore how adolescents with type 1 diabetes who were nominated as having expertise in diabetes management make everyday decisions. Using interpretive description as the methodology for this qualitative study, I employed a variety of methods to collect data from six adolescents with type 1 diabetes. I interviewed participants twice, used a "Think-Aloud" strategy that involved participants' use of an audio tape recorder to verbalize their decision-making, and I facilitated a focus group with five of the six participants in order to share my initial analysis and to generate new data. The use of a variety of data collection methods resulted in rich data that might not have been captured had I relied on a single data collection strategy. Findings from this study revealed that participants' everyday decision making is both an art and a science, both of which are enacted in the social context of adolescents' lives. Of particular note was the importance attributed to the support of families and friends. In addition to the social context of their lives, adolescents' decision making was influenced by personal, gendered, and socio-political contexts. The contexts that emerged from the study's analysis beg for a tentative link to expertise. Although expertise in adolescents with type 1 diabetes is neither well defined nor well articulated at this time, the findings from this study support the notion of expertise in adolescents as a credible objective. These findings should encourage us, as nurses, to try to understand'and recognize expertise in adolescent clients, to acknowledge and foster it in those who have it, and to discover ways to develop it in those who do not.

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