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患有1型糖尿病的青少年父母的经历与观点。

Experiences and perspectives of the parents of emerging adults living with type 1 diabetes.

作者信息

Pritlove Cheryl, Markowitz Benjamin, Mukerji Geetha, Advani Andrew, Parsons Janet A

机构信息

Applied Health Research Centre, Li ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada

School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada.

出版信息

BMJ Open Diabetes Res Care. 2020 Oct;8(1). doi: 10.1136/bmjdrc-2019-001125.

Abstract

INTRODUCTION

Whereas it is widely recognized that emerging adulthood can be a difficult time in the life of an individual living with type 1 diabetes, relatively little is known about the experiences of their parents or guardians. These individuals once shouldered much of the burden for their child's diabetes 'self'-management, yet their contribution is often overlooked by the adult healthcare system. Here, we set out to gain an understanding of the perspectives of parents of emerging adults living with type 1 diabetes.

RESEARCH DESIGN AND METHODS

Semi-structured interviews were performed with a purposeful sample of parents of emerging adults with type 1 diabetes recruited from two urban young adult diabetes clinics and through a national diabetes charity. Thematic coding was derived using a constant comparative approach.

RESULTS

Analysis of interviews with 16 parents of emerging adults with type 1 diabetes identified three themes: parental experiences of the transition to adult care; negotiating parent-child roles, responsibilities and relationships; and new and evolving fears. Parents spoke in detail about the time surrounding their child's diagnosis of type 1 diabetes to emphasize the complexity of diabetes care and the need to establish a 'new normal' for the family. In turn, adolescence and emerging adulthood required a renegotiation of roles and responsibilities, with many parents continuing to play a role in high-level diabetes management. Several parents of emerging adults with type 1 diabetes (particularly those of young men) vocalized worries about their child's readiness to assume responsibility for their self-care, and some expressed frustration with the apparent dichotomy in the role expectations of parents between the pediatric and adult care settings.

CONCLUSIONS

Adult healthcare providers should recognize both the ongoing involvement of parents in the 'self'-management of emerging adults with type 1 diabetes and the unique aspects of the caregiver burden that they experience.

摘要

引言

虽然人们普遍认识到,对1型糖尿病患者而言,成年初显期可能是其人生中的一段艰难时期,但对于他们的父母或监护人的经历却知之甚少。这些人曾在很大程度上承担着孩子糖尿病“自我”管理的重担,然而他们的贡献却常常被成人医疗保健系统忽视。在此,我们着手了解1型糖尿病成年初显期患者父母的观点。

研究设计与方法

对从两家城市青年糖尿病诊所及一家全国性糖尿病慈善机构招募的1型糖尿病成年初显期患者的父母进行了有目的抽样的半结构式访谈。采用持续比较法进行主题编码。

结果

对16位1型糖尿病成年初显期患者父母的访谈分析确定了三个主题:向成人护理过渡的父母经历;协商亲子角色、责任和关系;以及新出现和不断演变的担忧。父母们详细讲述了孩子被诊断为1型糖尿病前后的时期,以强调糖尿病护理的复杂性以及为家庭建立“新常态”的必要性。反过来,青春期和成年初显期需要重新协商角色和责任,许多父母仍在高水平糖尿病管理中发挥作用。几位1型糖尿病成年初显期患者的父母(尤其是年轻男性的父母)表达了对孩子承担自我护理责任准备情况的担忧,一些人对儿科和成人护理环境中父母角色期望的明显二分法表示沮丧。

结论

成人医疗保健提供者应认识到父母在1型糖尿病成年初显期患者“自我”管理中的持续参与以及他们所经历的照顾者负担的独特方面。

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