Shelagh A Mulvaney1,2, Eniola Mudasiru3, David G Schlundt4, Cara L Baughman1, Mary Fleming5, Ann VanderWoude2, William E Russell6, Tom A Elasy6, Russell Rothman7. 1. The School of Nursing, Vanderbilt University Medical Center, Nashville, Tennessee (Dr Mulvaney, Ms Baughman) 2. The Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee (Dr Mulvaney, Ms VanderWoude) 3. Emory University School of Medicine, Atlanta, Georgia (Dr Mudasiru) 4. The Department of Psychology, Vanderbilt University, Nashville, Tennessee (Dr Schlundt) 5. Meharry Medical College, Nashville, Tennessee (Dr Fleming) 6. The Department of Endocrinology, Vanderbilt University Medical Center, Nashville, Tennessee (Dr Russell, Dr Elasy) 7. The Department of Medicine and Center for Health Services Research, Vanderbilt University Medical Center, Nashville, Tennessee (Dr Rothman)
Abstract
PURPOSE: The purpose of this study was to document barriers and facilitators of self-management as perceived by adolescents with type 2 diabetes. METHODS: Focus groups were conducted with adolescents diagnosed with type 2 diabetes. Adolescents aged 13 to 19 years were recruited from an academic medical center diabetes clinic. Between 2003 and 2005, 6 focus groups were used to elicit responses from the adolescents related to self-management of their diabetes. Questions were asked by trained group facilitators. Transcripts were coded by 3 reviewers. Qualitative analyses were conducted using NVIVO software. RESULTS: A total of 24 adolescents participated in 6 focus groups. Coding resulted in 4 common domains affecting self-management: adolescent psychosocial development; the role of others with diabetes; environmental influences; and adolescents' problem-solving/coping skills. Adolescents identified both barriers to and facilitators of self-management within each domain. Barriers often related to social situations, embarrassment, seeking acceptance or perceived normalcy, and balancing competing interests. Adolescents viewed having another family member with diabetes as both a positive and a negative influence. Environmental influences, including school and family situations, had a large impact on self-management behaviors. Making sensible food choices was a common challenge. Descriptions of problem-solving or coping skills were limited, but cognitive techniques, such as reframing, were described. CONCLUSION: Adolescents with type 2 diabetes identified many barriers to self-management, particularly related to interpersonal interactions, the influence of others with diabetes, and environmental influences. Results suggest that improving self-management in adolescents may require multimodal interventions to address individual, family, and social processes.
PURPOSE: The purpose of this study was to document barriers and facilitators of self-management as perceived by adolescents with type 2 diabetes. METHODS: Focus groups were conducted with adolescents diagnosed with type 2 diabetes. Adolescents aged 13 to 19 years were recruited from an academic medical center diabetes clinic. Between 2003 and 2005, 6 focus groups were used to elicit responses from the adolescents related to self-management of their diabetes. Questions were asked by trained group facilitators. Transcripts were coded by 3 reviewers. Qualitative analyses were conducted using NVIVO software. RESULTS: A total of 24 adolescents participated in 6 focus groups. Coding resulted in 4 common domains affecting self-management: adolescent psychosocial development; the role of others with diabetes; environmental influences; and adolescents' problem-solving/coping skills. Adolescents identified both barriers to and facilitators of self-management within each domain. Barriers often related to social situations, embarrassment, seeking acceptance or perceived normalcy, and balancing competing interests. Adolescents viewed having another family member with diabetes as both a positive and a negative influence. Environmental influences, including school and family situations, had a large impact on self-management behaviors. Making sensible food choices was a common challenge. Descriptions of problem-solving or coping skills were limited, but cognitive techniques, such as reframing, were described. CONCLUSION: Adolescents with type 2 diabetes identified many barriers to self-management, particularly related to interpersonal interactions, the influence of others with diabetes, and environmental influences. Results suggest that improving self-management in adolescents may require multimodal interventions to address individual, family, and social processes.
Authors: C D Samuel-Hodge; S W Headen; A H Skelly; A F Ingram; T C Keyserling; E J Jackson; A S Ammerman; T A Elasy Journal: Diabetes Care Date: 2000-07 Impact factor: 19.112
Authors: Shelagh A Mulvaney; Korey K Hood; David G Schlundt; Chandra Y Osborn; Kevin B Johnson; Russell L Rothman; Kenneth A Wallston Journal: Diabetes Res Clin Pract Date: 2011-07-07 Impact factor: 5.602
Authors: Erinn T Rhodes; Lisa A Prosser; Tracy A Lieu; Thomas J Songer; David S Ludwig; Lori M Laffel Journal: Pediatr Diabetes Date: 2011-04-13 Impact factor: 4.866