School of Nursing, The University of Texas at Austin, USA.
J Nurs Res. 2010 Dec;18(4):258-65. doi: 10.1097/JNR.0b013e3181fbe107.
Diabetes self-management is challenging for adolescents with type 1 diabetes mellitus (T1DM). School plays a crucial role in the adolescents' lives. However, evidence of inadequate quality of school-based diabetes care has been reported in the literature.
The purpose of this preliminary study was to obtain an initial understanding of school-based lived experiences of adolescents with T1DM to serve as a foundation of future research.
The Heideggerian hermeneutic phenomenological approach served as the philosophical underpinning for this study. Two Taiwanese adolescents with T1DM were purposively recruited. Individual, audio-recorded, semistructured interviews were conducted. Verbatim transcripts were analyzed through hermeneutic circle.
Participants described their school-based lived experiences as a dynamic learning process. Four interwoven themes were discovered: (a) learning to be master of their disease, (b) learning to find ways to feel comfortable, (c) learning to not be different, and (d) learning to not let others (especially parents) worry about them.
CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Diabetes care professionals, school nurses, school personnel, and parents should help strengthen resilience of the adolescents to overcome common social obstacles in schools. Creating a supportive learning environment is warranted to help incorporate diabetes management into their daily lives. Future studies should consider specific situational obstacles that the adolescents face to design effective interventions to improve school-based diabetes care.
对于 1 型糖尿病（T1DM）青少年来说，自我管理糖尿病具有挑战性。学校在青少年的生活中起着至关重要的作用。然而，文献中报道了学校提供的糖尿病护理质量不足的证据。
本初步研究旨在初步了解 T1DM 青少年的学校生活体验，为未来的研究奠定基础。
海德格尔解释学现象学方法为这项研究提供了哲学基础。我们有目的地招募了两名台湾 T1DM 青少年。进行了个人、录音、半结构化访谈。通过解释循环对逐字记录进行分析。
参与者描述了他们的学校生活体验是一个动态的学习过程。发现了四个交织的主题：（a）学习成为自己疾病的主宰，（b）学习找到舒适的方法，（c）学习不与众不同，以及（d）学习不让他人（尤其是父母）担心。
结论/对实践的启示：糖尿病护理专业人员、学校护士、学校人员和家长应帮助增强青少年的适应能力，以克服学校中常见的社会障碍。值得创建一个支持性的学习环境，以帮助他们将糖尿病管理融入日常生活。未来的研究应考虑青少年面临的具体情境障碍，以设计有效的干预措施来改善学校的糖尿病护理。
