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. 2008 Jul-Aug;34(4):674-82.
doi: 10.1177/0145721708320902.

Self-management in type 2 diabetes: the adolescent perspective

Shelagh A Mulvaney  1   2 , Eniola Mudasiru  3 , David G Schlundt  4 , Cara L Baughman  1 , Mary Fleming  5 , Ann VanderWoude  2 , William E Russell  6 , Tom A Elasy  6 , Russell Rothman  7
Affiliations

Self-management in type 2 diabetes: the adolescent perspective

Shelagh A Mulvaney et al. Diabetes Educ. 2008 Jul-Aug.

Abstract

Purpose: The purpose of this study was to document barriers and facilitators of self-management as perceived by adolescents with type 2 diabetes.

Methods: Focus groups were conducted with adolescents diagnosed with type 2 diabetes. Adolescents aged 13 to 19 years were recruited from an academic medical center diabetes clinic. Between 2003 and 2005, 6 focus groups were used to elicit responses from the adolescents related to self-management of their diabetes. Questions were asked by trained group facilitators. Transcripts were coded by 3 reviewers. Qualitative analyses were conducted using NVIVO software.

Results: A total of 24 adolescents participated in 6 focus groups. Coding resulted in 4 common domains affecting self-management: adolescent psychosocial development; the role of others with diabetes; environmental influences; and adolescents' problem-solving/coping skills. Adolescents identified both barriers to and facilitators of self-management within each domain. Barriers often related to social situations, embarrassment, seeking acceptance or perceived normalcy, and balancing competing interests. Adolescents viewed having another family member with diabetes as both a positive and a negative influence. Environmental influences, including school and family situations, had a large impact on self-management behaviors. Making sensible food choices was a common challenge. Descriptions of problem-solving or coping skills were limited, but cognitive techniques, such as reframing, were described.

Conclusion: Adolescents with type 2 diabetes identified many barriers to self-management, particularly related to interpersonal interactions, the influence of others with diabetes, and environmental influences. Results suggest that improving self-management in adolescents may require multimodal interventions to address individual, family, and social processes.

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