title: Developmental evolution of expertise in diabetes self-management.
abstract: The following is a description of the findings of a longitudinal exploratory and descriptive research study of 22 persons nominated as expert self-managers of Type 1 diabetes. It entailed an initial interview about previous experiences with self-management, self-recorded taped diaries about self-management decisions for 1 week each, and face-to-face interviews following each weeklong recording of self-management decisions. The study generated a grounded theory about the development of expertise in diabetes self-management. The development of expertise was found to occur as transition through two or more phases, to be individualized, and to involve a complex interplay between social, contextual and personal factors, including the individual's developmental age. The research fIndings challenge the traditional understanding of rebellion in self-management as a manifestation of adolescence, behaviors other than active control as testimony to ineptitude in self-management, metabolic control as the indicator of self-management ability, and the role of others as collaborators in self-management.
authors.affiliation: University of British Columbia, School of Nursing.
authors.forename: B
authors.initials: B
authors.lastname: Paterson
authors.forename: S
authors.initials: S
authors.lastname: Thorne
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D001955:British Columbia; D002983:Clinical Competence / Q000592:standards*; D003657:Decision Making; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism / Q000517:prevention & control* / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006803:Human Development; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D015404:Nursing Methodology Research; D010353:Patient Education as Topic / Q000592:standards*; D012648:Self Care / Q000523:psychology / Q000592:standards*; D011795:Surveys and Questionnaires