Managing the Unmanageable through Interdependence in Adolescents Living with Type 1 Diabetes and their Parents: A Constructivist Grounded Theory
Date
2022-10-18
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
ORCID
0000-0003-4117-2768
Type
Thesis
Degree Level
Doctoral
Abstract
Type 1 diabetes (T1D) is a chronic, incurable, autoimmune disease that generally develops before adulthood. Management of T1D requires on-going care and monitoring that demands major lifestyle changes for adolescents with T1D and their families. Maintaining, supporting, and establishing good T1D management during adolescence is important to ensure health and longevity since poor management is associated with significant long-term complications. Little is known about the nature of adolescence shared responsibility or interdependence with parents, and the characteristics of interdependence in the day-to-day management of T1D in adolescents. The purpose of this research was to describe the experiences of interdependence of adolescents with T1D and their parents. An integrative review of the qualitative and quantitative literature examining the nature of adolescent-parent interactions in T1D management showed that parental involvement was important for improved glycemic control. Limited qualitative evidence was found. Subsequently, a constructivist grounded theory approach was chosen to develop a theoretical understanding of the experiences and processes of interdependence in adolescents with T1D and their parents. Data was collected, transcribed, and analyzed from 32 open-ended online or telephone interviews of 11 adolescents aged 10–18 with T1D and eight of their parents. The substantive theory that emerged from the data describes the dynamic relationship associated with interdependence between adolescents with T1D and their parents that varies situationally and by age. Rich data related to the possibility of dying from T1D discovered in the initial grounded theory study, led to a secondary, reflexive thematic analysis. Three themes were generated: Reality of Death, Fearing the Highs and Lows, and Finding a Way through Fears that explained the participants’ feelings of their fear of death. The findings fill an important knowledge gap in T1D management, providing information on how to support interdependence in T1D management for families. The substantive theory presented in this dissertation is hypothesis generating and should stimulate future research about the role of interdependence in T1D management in other populations. Better understanding of the parent-child interaction in diabetes care will contribute important information to aid family nurses to identify and support interdependent sharing of T1D management responsibilities between parents and their adolescents.
Description
Keywords
interdependence, adolescents, type 1 diabetes, constructivist grounded theory, parental support
Citation
Degree
Doctor of Philosophy (Ph.D.)
Department
Nursing
Program
Nursing