UBC Theses and Dissertations
Management experiences of adolescents living with type 2 diabetes Tzianetas, Roula
Although type 2 diabetes (T2D) is typically a condition that affects adults, it has recently been diagnosed in children and adolescents as well. Management is multifaceted, continual and involves diet therapy, exercise, blood glucose monitoring, taking medications and glycaemic control. While there is extensive literature on compliance issues in adults with T2D, no studies have examined how adolescents diagnosed with the condition manage their care. This study addressed this lack of information by using a qualitative research approach to explore the individual experiences of adolescents living with T2D. Participants included adolescents with T2D (n = 8; Body Mass Index [BMI] = 22-34 kg/m2) attending the B.C. Children's Hospital diabetes clinic and health professionals (n = 2) working at the clinic. Each adolescent was interviewed for 60-90 minutes during which they described activities surrounding: dietary habits, activity, medication use and blood glucose testing. Likewise, two health professionals were interviewed for 60-90 minutes to obtain their perspectives on the challenges faced in this field. Interviews were tape-recorded and transcribed verbatim. Trustworthiness (rigor) was established using strategies such as member checks, peer debriefing, triangulation, and audits. Data was managed using the ATLAS. ti software and then analyzed using qualitative methods. Ethical approval was received from B.C. Children's Hospital and the University of British Columbia. Informed consent was obtained from the health professionals, all participants and their parents. The adolescents with T₂D encountered emotional, cognitive, and behavioural responses to the diabetes itself and each component of diabetes management. Self-care practices fluctuated depending on internal forces (i.e. personality, personal models and interpersonal relationships) and external forces (i.e. family, peers, community and health professionals). While health professionals acknowledged that emotions and cognitions play a role in management, treatment strategies focused on task completion, specifically blood glucose testing and the continuous reinforcement of information. Re-directing strategies that take into consideration how personality, understandings, and social context of an adolescent's life influence the implementation of diabetes management components are significant to their overall care.
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