Al Bayrakdar Amani, Puzantian Houry, Noureddine Samar, Abu-Saad Huijer Huda, Nasrallah Mona, Joiner Kevin L, Martyn-Nemeth Pamela, Tfayli Hala
Nurs Res. 2025;74(2):98-107. doi: 10.1097/NNR.0000000000000781. Epub 2024 Sep 17.
Emerging adults with type 1 diabetes are at risk of poorer diabetes-related health outcomes than other age groups. Several factors affecting the health and experiences of the emerging adults are culture and healthcare specific.
The aim of this study was to explore the experience of emerging adults living with type 1 diabetes in Lebanon, describe their diabetes self-care and diabetes-related health outcomes (HbA1c and diabetes distress), and identify the predictors of these outcomes.
A convergent mixed-methods design was used with 90 participants aged 18-29 years. Sociodemographic, clinical data, and measures of diabetes distress, social support, and self-care were collected. Fifteen emerging adults participated in individual semistructured interviews. Multiple linear regression was used to determine predictors of diabetes outcomes. Thematic analysis was used to analyze qualitative data. Data integration was used to present the mixed-methods findings.
The study sample had a mean HbA1c of 7.7% ( SD = 1.36), and 81.1% reported moderate to severe diabetes distress levels. The participants had good levels of diabetes self-care and high levels of social support. HbA1c was predicted by insulin treatment type, age at diagnosis, and diabetes self-care; while diabetes distress was predicted by diabetes knowledge, blood glucose monitoring approach, and diabetes self-care. "Living with type 1 diabetes during emerging adulthood: the complex balance of a chemical reaction" was the overarching theme of the qualitative data, with three underlying themes: "Breaking of bonds: changes and taking ownership of their diabetes," "The reactants: factors affecting the diabetes experience," and "Aiming for equilibrium." The integrated mixed-methods results revealed one divergence between the qualitative and quantitative findings related to the complexity of the effect of received social support.
The suboptimal health of the emerging adults despite good self-care highlights the importance of addressing cultural and healthcare-specific factors such as diabetes knowledge and public awareness, social support, and availability of technology to improve diabetes health. Findings of this study can guide future research, practice, and policy development.
与其他年龄组相比，患有1型糖尿病的青少年面临着糖尿病相关健康状况较差的风险。影响青少年健康和经历的几个因素具有文化和医疗保健特殊性。
本研究的目的是探索黎巴嫩1型糖尿病青少年的经历，描述他们的糖尿病自我护理和糖尿病相关健康状况（糖化血红蛋白和糖尿病困扰），并确定这些结果的预测因素。
采用聚合混合方法设计，研究对象为90名年龄在18至29岁之间的参与者。收集了社会人口统计学、临床数据以及糖尿病困扰、社会支持和自我护理的测量数据。15名青少年参与了个人半结构化访谈。使用多元线性回归确定糖尿病结果的预测因素。采用主题分析法分析定性数据。使用数据整合来呈现混合方法的研究结果。
研究样本的糖化血红蛋白平均水平为7.7%（标准差=1.36），81.1%的人报告有中度至重度糖尿病困扰。参与者的糖尿病自我护理水平良好，社会支持水平较高。糖化血红蛋白由胰岛素治疗类型、诊断年龄和糖尿病自我护理预测；而糖尿病困扰由糖尿病知识、血糖监测方法和糖尿病自我护理预测。“青少年期患有1型糖尿病：化学反应的复杂平衡”是定性数据的总体主题，有三个潜在主题：“纽带的断裂：糖尿病的变化和自主掌控”、“反应物：影响糖尿病经历的因素”以及“追求平衡”。整合后的混合方法结果揭示了定性和定量研究结果之间在接受社会支持效果的复杂性方面存在一个分歧。
尽管自我护理良好，但青少年的健康状况仍不理想，这凸显了应对文化和医疗保健特定因素（如糖尿病知识和公众意识、社会支持以及技术可用性）以改善糖尿病健康的重要性。本研究结果可为未来的研究、实践和政策制定提供指导。
