The concept of self-management of type 1 diabetes in children and adolescents: an evolutionary concept analysis.
OBJECTIVE
An evolutionary concept analysis was undertaken to clarify the concept of self-management of type 1 diabetes in children and adolescents.


BACKGROUND
Several problems exist in the literature on self-management of type 1 diabetes in children and adolescents. There is no uniform terminology and there is no uniform definition of the concept. Also, there is no differentiation in the literature between self-management of diabetes in children and adults.


METHODS
Ninety-nine references were reviewed and analysed in the disciplines of nursing, medicine, and psychology. After separate analyses revealed no significant differences across disciplines, the analyses were combined to describe the attributes, antecedents, consequences, and surrogate and related concepts.


RESULTS
The three essential attributes of the concept were identified as process, activities, and goals. Self-management of type 1 diabetes in children and adolescents is an active and proactive process; it is daily, lifelong, and flexible, and it involves shifting and shared responsibility for diabetes care tasks and decision-making between child and parent. It is a process that involves collaboration with health care providers. Self-management of type 1 diabetes in children and adolescents also consists of varied and many activities related to giving insulin, monitoring metabolic control, regulating diet and exercise, to name just a few. The concept also involves goals, which may differ from one parent/child dyad to another. A working definition of the concept is suggested.


CONCLUSIONS
It is hoped that a more uniform definition of the concept will enable researchers to continue investigating antecedents and consequences of the concept in a way that allows for aggregating results.
Schilling
Lynne S
LS
Yale University, School of Nursing, New Haven, Connecticut 06536-0740, USA. lynne.schilling@yale.edu
Grey
Margaret
M
Knafl
Kathleen A
KA
D000293:Adolescent; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000451:nursing*; D005190:Family / Q000523:psychology; D006801:Humans; D009042:Motivation; D010353:Patient Education as Topic; D012648:Self Care; D012944:Social Support; D009626:Terminology as Topic