Mulvaney Shelagh A, Mudasiru Eniola, Schlundt David G, Baughman Cara L, Fleming Mary, VanderWoude Ann, Russell William E, Elasy Tom A, Rothman Russell
The School of Nursing, Vanderbilt University Medical Center, Nashville, Tennessee (Dr Mulvaney, Ms Baughman)
The Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee (Dr Mulvaney, Ms VanderWoude)
Diabetes Educ. 2008 Jul-Aug;34(4):674-82. doi: 10.1177/0145721708320902.
The purpose of this study was to document barriers and facilitators of self-management as perceived by adolescents with type 2 diabetes.
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.
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.
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.
本研究旨在记录2型糖尿病青少年所感知到的自我管理障碍和促进因素。
对被诊断为2型糖尿病的青少年进行焦点小组访谈。从一家学术医疗中心的糖尿病诊所招募了13至19岁的青少年。在2003年至2005年期间，使用6个焦点小组来获取青少年与糖尿病自我管理相关的反应。由经过培训的小组主持人提问。笔录由3名评审员进行编码。使用NVIVO软件进行定性分析。
共有24名青少年参加了6个焦点小组。编码产生了影响自我管理的4个常见领域：青少年心理社会发展；其他糖尿病患者的作用；环境影响；以及青少年的问题解决/应对技能。青少年在每个领域都确定了自我管理的障碍和促进因素。障碍通常与社交场合、尴尬、寻求认可或感知正常以及平衡相互竞争的利益有关。青少年认为有另一位家庭成员患有糖尿病既有积极影响也有消极影响。包括学校和家庭情况在内的环境影响对自我管理行为有很大影响。做出明智的食物选择是一个常见的挑战。对问题解决或应对技能的描述有限，但描述了一些认知技巧，如重新构建。
2型糖尿病青少年确定了许多自我管理障碍，特别是与人际互动、其他糖尿病患者的影响以及环境影响有关。结果表明，改善青少年的自我管理可能需要多模式干预来解决个人、家庭和社会过程。
