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Parent Perceptions of Caring for Adolescents With Type 2 Diabetes

¹ Center for Evaluation & Program Improvement, Vanderbilt University, Nashville, Tennessee
² Department of Pediatrics, Vanderbilt University, Nashville, Tennessee
³ Department of Psychology, Vanderbilt University, Nashville, Tennessee
⁴ Department of Medicine, Vanderbilt University, Nashville, Tennessee
⁵ Center for Health Services Research, Vanderbilt University, Nashville, Tennessee

Address correspondence and reprint requests to Shelagh Mulvaney, PhD, Center for Evaluation & Program Improvement, Vanderbilt University, 230 Appleton Place, Peabody No. 151, Nashville, TN 37203. E-mail: shelagh.mulvaney{at}vanderbilt.edu

OBJECTIVE—No studies have been performed to examine parent perceptions of caring for adolescents with type 2 diabetes. In this qualitative study, we examined parent perceptions of barriers and strategies to address barriers to self-care in adolescents with type 2 diabetes.

RESEARCH DESIGN AND METHODS—Families of adolescents with type 2 diabetes were recruited from a pediatric diabetes clinic. Focus groups were used to elicit parent experiences and perceptions of diabetes management of their adolescents with type 2 diabetes. Questions concerning barriers to self-care behaviors were asked by trained group facilitators. Transcripts were coded into themes by three reviewers. Qualitative analyses were conducted using NVIVO software.

RESULTS—Between 2003 and 2005, six focus groups were conducted with a total of 27 parents or guardians. Parents identified many barriers to and practical strategies for positive adolescent self-management. Five domains that influence self-management were identified: the role of others with diabetes, parenting skills, perceived lack of normalcy, environment, and adolescent development. Parents identified many barriers to dietary and exercise habits that were unique to the circumstances of adolescents with type 2 diabetes.

CONCLUSIONS—Parents identified many barriers to self-management that may be unique to adolescents with type 2 diabetes. The importance of others and environmental influences in the self-management behavior of adolescents with type 2 was evident. Interventions that are designed to improve self-management should include components that address multiple influences such as peers, school professionals, parents, siblings, and/or family systems.

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