Parents’ perspectives of factors affecting parent–adolescent communication about type 1 diabetes and negotiation of self-management responsibilities

Abstract

Adolescence is an important time in which young people take on type 1 diabetes (T1D) self-management responsibility. Parents are key facilitators of this process. Little is known about parents’ experiences of communicating with their children about T1D during adolescence. Semi-structured interviews were conducted with 32 parents (24 mothers and 8 fathers) of adolescents (11–17 years) living with T1D to explore how parents communicate about T1D and self-management with their adolescent children. Parents were recruited through two national child and adolescent diabetes and endocrine clinics and online advertisement through a national diabetes advocacy organisation. Interviews were transcribed verbatim and thematically analysed. Six themes were identified: parent factors, quality of the parent–adolescent relationship, communication strategies, adolescent factors, communication triggers and family/system factors. Understanding factors that impact communication about self-management between parents and adolescents will enable healthcare professionals to provide support and targeted interventions as parent and adolescent roles change over time.

Developing Self-Management of Type 1 Diabetes in the Australian School Setting: Perspectives of Adolescent Involvement in Sharing Responsibility for Diabetes Management

“…Tese results suggest that older adolescents may not have been routinely aforded a role in the responsibility sharing process that was commensurate with their greater level of responsibility, relative to younger adolescents [11]. Although parents have reported an overall decrease in conversations about diabetes as adolescents mature, they note a greater tendency for older adolescents to seek advice, express opinions, and initiate conversations about diabetes, particularly with respect to management challenges [20,26,46]. Providing greater opportunity for involvement in the development of diabetes management strategies may therefore be particularly critical for older adolescents who are learning to self-manage diabetes.…”

“…Te importance of parents' participation in the care team is well-supported with evidence that better outcomes are associated with continued parental involvement in diabetes care across adolescence [4,26]. Communication about responsibility for diabetes care, between parents and adolescents, is critical for responsibility uptake, with negotiation to the point of agreement associated with better metabolic outcomes [33,34,46]. Te results of this study highlight the unique views that parents and students have when it comes to responsibility for diabetes care at school-supporting the need for representation of both in negotiation of schoolbased responsibility allocation.…”