Gaillard Elsa, Beran David
Institute of Global Health, Faculty of Medicine, University of Geneva, 1202 Geneva, Switzerland.
Division of Tropical and Humanitarian Medicine, Faculty of Medicine, University of Geneva and Geneva University Hospitals, 1211 Geneva, Switzerland.
Healthcare (Basel). 2025 Jun 9;13(12):1380. doi: 10.3390/healthcare13121380.
Divergent theories exist concerning the constructs of adaptation and acceptance for chronic conditions. Understanding these processes is essential to improving care. The aim of this study is to describe these concepts from the perspective of people living with type 1 diabetes. A secondary analysis was conducted on data from a qualitative study, including interviews with 101 people in 13 countries across all continents, with participants of varying ages, genders, and diabetes durations as well as participants who were parents with children with type 1 diabetes. The initial study included a topic guide with open questions and interviews were analyzed using grounded theory resulting in a pyramid of needs for type 1 diabetes. This pyramid included the concepts of adaptation and acceptance. This study explores these themes in more depth. Adaptation and acceptance processes vary from one person to another. Adaptation includes both adjustment to daily care and a change in perspective. Acceptance is explained as a process relying on adaptation, with no defined standardized stages. Diabetes acceptance positively impacts health, daily life, and relationships. The study identifies several factors that help acceptance, such as medical supplies, a caring healthcare environment, family and peer support, parental acceptance of diabetes, and diabetes camps. Some of the elements required for adaptation and acceptance can be provided directly by the healthcare system, such as medical supplies, while others outside the healthcare system still need to be considered by caregivers, such as the individual's social environment. The psychological well-being of people with type 1 diabetes and parents should be investigated as often as possible with the provision of adaptative, integrated, and holistic care.
关于慢性病的适应和接受的概念存在不同的理论。理解这些过程对于改善护理至关重要。本研究的目的是从1型糖尿病患者的角度描述这些概念。对一项定性研究的数据进行了二次分析，该研究包括对来自各大洲13个国家的101人进行访谈，参与者年龄、性别、糖尿病病程各异，还有身为1型糖尿病患儿父母的参与者。最初的研究包括一个带有开放式问题的主题指南，并使用扎根理论对访谈进行分析，得出了一个1型糖尿病需求金字塔。这个金字塔包括适应和接受的概念。本研究更深入地探讨了这些主题。适应和接受过程因人而异。适应既包括对日常护理的调整，也包括视角的转变。接受被解释为一个依赖于适应的过程，没有明确的标准化阶段。糖尿病接受对健康、日常生活和人际关系有积极影响。该研究确定了一些有助于接受的因素，如医疗用品、关怀备至的医疗环境、家庭和同伴支持、父母对糖尿病的接受以及糖尿病营地。适应和接受所需的一些要素可由医疗保健系统直接提供，如医疗用品，而医疗保健系统之外的其他要素仍需要护理人员考虑，如个人的社会环境。应尽可能经常对1型糖尿病患者及其父母的心理健康进行调查，并提供适应性、综合性和整体性护理。
