Sachs' Children's Hospital, Södersjukhuset, Stockholm, Sweden.
J Adv Nurs. 2011 Jul;67(7):1547-57. doi: 10.1111/j.1365-2648.2010.05588.x. Epub 2011 Feb 16.
To gain insight into and generate theoretical knowledge about the processes involved when insulin pump-treated adolescents take or miss taking their bolus doses.
Insulin pump treatment is considered the most physiological way to imitate the healthy body's insulin profile in adolescents with diabetes. Despite insulin pump treatment, it is hard to maintain near-normal glucose control in adolescents; one reason for this is missed bolus doses with meals.
In this qualitative interview study, the grounded theory method was chosen as a model for the collection and analysis of data. Twelve adolescents (five boys and seven girls, mean age: 14·4 years, range: 12-19 years) from different Swedish paediatric diabetes clinics, four parents and one paediatric diabetes nurse were interviewed during 2008 and 2009. Two adolescents and two parents were re-interviewed after approximately 10 months. Data from clinical visits and diabetes camps were used to verify emerging categories.
Responsibility in the context of taking or missing bolus doses emerged as the core category. It is elaborated and explained through three subcategories: distribution of responsibility, transfer of responsibility and clarification of responsibility. The findings describe the need to clarify the responsibility for diabetes self-management in continuous negotiations between adolescents and parents to avoid missed doses.
Negotiations to clarify the responsibility for diabetes self-management must be a continuous process between adolescents and parents. Diabetes care teams can facilitate and encourage these negotiations.
深入了解并生成关于接受胰岛素泵治疗的青少年服用或漏服餐时胰岛素剂量的过程的理论知识。
胰岛素泵治疗被认为是模仿糖尿病青少年健康人体胰岛素模式的最生理方式。尽管进行了胰岛素泵治疗，青少年仍难以维持接近正常的血糖控制；导致这种情况的一个原因是漏用餐时的胰岛素剂量。
在这项定性访谈研究中，选择扎根理论方法作为数据收集和分析的模型。2008 年至 2009 年间，从瑞典不同的儿科糖尿病诊所采访了 12 名青少年（5 名男孩和 7 名女孩，平均年龄 14.4 岁，范围 12-19 岁）、4 名家长和 1 名儿科糖尿病护士。大约 10 个月后，对 2 名青少年和 2 名家长进行了重新采访。临床就诊和糖尿病夏令营的数据用于验证新出现的类别。
在服用或漏服餐时胰岛素剂量的背景下，责任成为核心类别。它通过三个子类别进行阐述和解释：责任分配、责任转移和责任澄清。研究结果表明，为避免漏服剂量，必须在青少年和家长之间不断协商以明确糖尿病自我管理的责任。
青少年和家长之间必须持续进行明确糖尿病自我管理责任的协商。糖尿病护理团队可以促进和鼓励这些协商。
