Teenagers with type 1 diabetes--a phenomenological study of the transition towards autonomy in self-management.
BACKGROUND
Becoming autonomous is an important aspect of teenagers' psychosocial development, and this is especially true of teenagers with type 1 diabetes. Previous studies exploring the everyday problems of teenagers with diabetes have focused on adherence to self-care management, how self-determination affects metabolic control, and the perception of social support.


OBJECTIVE
The aim of the study was to elucidate lived experiences, focusing on the transition towards autonomy in diabetes self-management among teenagers with type 1 diabetes.


METHODS
Data were collected using interviews, and a qualitative phenomenological approach was chosen for the analysis.


METHODS
Thirty-two teenagers (18 females and 14 males) were interviewed about their individual experiences of self-management of diabetes.


RESULTS
The lived experiences of the transition towards autonomy in self-management were characterized by the over-riding theme "hovering between individual actions and support of others". The findings indicate that individual self-reliance and confirmation of others are helpful in the transition process. Growth through individual self-reliance was viewed as a developmental process of making one's own decisions; psychological maturity enabled increased responsibility and freedom; motivation was related to wellbeing and how well the diabetes could be managed. The theme "confirmation of others" showed that parental encouragement increased the certainty of teenagers' standpoints; peers' acceptance of diabetes facilitated incorporation of daily self-management activities; support from the diabetes team strengthened teenagers' self-esteem.


CONCLUSIONS
In striving for autonomy, teenagers needed distance from others, but still to retain the support of others. A stable foundation for self-management includes having the knowledge required to practice diabetes management and handle different situations.
Karlsson
Agneta
A
Department of Social and Welfare studies, University of Linköping, Sweden. agnka@isv.liu.se
Arman
Maria
M
Wikblad
Karin
K
D000223:Adaptation, Psychological; D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D001294:Attitude to Health; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism / Q000517:prevention & control / Q000523:psychology*; D005260:Female; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008960:Models, Psychological; D009042:Motivation; D015404:Nursing Methodology Research; D010290:Parents / Q000523:psychology; D026684:Personal Autonomy; D000297:Psychology, Adolescent; D036301:Qualitative Research; D012648:Self Care / Q000523:psychology*; D020377:Self Efficacy; D012944:Social Support; D011795:Surveys and Questionnaires; D013548:Sweden