Making the leap and finding your feet: A qualitative study of disclosure and social support in university students with type 1 diabetes

Abstract

University poses unique challenges surrounding disclosure for students living with type 1 diabetes, with implications for social support and self-management. Semi-structured interviews with students and peer interviewers living with type 1 diabetes explored university experiences of disclosure and social support. Thematic analysis identified three major themes: disclosure as a measured process, the need for lived experience for true understanding and personal growth and self-awareness. Findings emphasize the need to scaffold the university transition for individuals with type 1 diabetes as disclosure can elicit effective social support. In addition, the importance of lived experience suggests support from students with type 1 diabetes could considerably impact diabetes management.

Qualitative analysis of helpful and unhelpful aspects of social relationships among young adults with type 1 diabetes

“…Our participants thus appeared to be strategic in who they disclosed to, providing personal health information to those who were helpful, but not disclosing or providing only basic diabetes information to those who were unhelpful or uninformed about diabetes, consistent with prior research. 14,15,17,18 Participants' reluctance to disclose to work colleagues about diabetes is also consistent with reports that, compared to older adults, young adults are particularly unlikely to disclose diabetes in occupational settings. 6,18 While we did not specifically query why disclosure was unlikely, some individuals spontaneously expressed that their desire to not burden others, avoid stigma or be independent in their management made disclosure less likely.…”

“…Our findings are consistent with previous reports that receiving diabetes-specific support, including emotional support and reminders, was helpful for young adults during the transition to college. 10,14,15 Our reports indicate the continuing need to balance T A B L E 4 Sample quotes and reference counts for information disclosed to helpful and hindering people in the past week…”

“…Young adults’ disclosure of having and managing type 1 diabetes is important to educate others for optimizing helpful social relationships 14,15 . However, young adults face barriers to disclosure, such as privacy concerns and avoiding stigma 14–16 . Some evidence suggests young adults are strategic when deciding to whom, to what extent and when to disclose diabetes problems, 17 rarely disclosing diabetes‐related information to peers and co‐workers due to embarrassment, stigma and fears of being overlooked for career advancement 14,15,18 .…”

“…14,15 However, young adults face barriers to disclosure, such as privacy concerns and avoiding stigma. [14][15][16] Some evidence suggests young adults are strategic when deciding to whom, to what extent and when to disclose diabetes problems, 17 rarely disclosing diabetes-related information to peers and co-workers due to embarrassment, stigma and fears of being overlooked for career advancement. 14,15,18 A better understanding of young adults' disclosures of their diabetes management experiences is necessary because disclosure and educating others about diabetes may facilitate one's ability to utilize social resources to benefit diabetes management.…”

“…[14][15][16] Some evidence suggests young adults are strategic when deciding to whom, to what extent and when to disclose diabetes problems, 17 rarely disclosing diabetes-related information to peers and co-workers due to embarrassment, stigma and fears of being overlooked for career advancement. 14,15,18 A better understanding of young adults' disclosures of their diabetes management experiences is necessary because disclosure and educating others about diabetes may facilitate one's ability to utilize social resources to benefit diabetes management. 17 The present qualitative study was conducted to illuminate how others are involved in daily aspects of diabetes management during young adulthood, a high-risk time of development.…”