The school-based lived experiences of adolescents with type 1 diabetes.
BACKGROUND
School plays a critical role in influencing the health, safety, development, and well-being of adolescents with type 1 diabetes mellitus (T1DM). However, scant research has been conducted to understand the lived experiences of these adolescents in school settings.


OBJECTIVE
This study investigates the school-based lived experiences of Taiwanese adolescents with T1DM.


METHODS
A Heidegger's hermeneutic phenomenological approach was used, and 14 Taiwanese adolescents with T1DM were enrolled through purposive snowball sampling until data saturation was reached. Data were collected using audio-recorded, semistructured interviews and analyzed using the hermeneutic circle supported by qualitative analysis software NVivo 9.0. Reflective journaling, peer debriefing, memo writing, and member checking were performed to enhance the trustworthiness of the findings.


RESULTS
Six interrelated themes were identified: (a) the same yet different, (b) covert and overt, (c) limitations and freedom, (d) independent and dependent, (e) derailing and being on track, and (f) disease identity and denial. Multiple factors, including disease identity, social anxiety and pressure, ignorance of school personnel and classmates, and transition to independent self-management threatened the at-school health and well-being of participants.


CONCLUSIONS
Much work remains to be done to adequately improve the school-life experiences of adolescents with T1DM. Interventions to facilitate their autonomy, self-efficacy, diabetes knowledge, disease identity, and handling of situational obstacles are suggested as well as improving the understanding of T1DM for teachers and classmates and facilitating more proactive care by school nurses.
1PhD, RN, Assistant Professor, Chang Jung Christian University, Taiwan, ROC 2PhD, RN, FAAN, Professor, School of Nursing, The University of Texas at Austin, USA 3PhD, RN, FAAN, Professor, School of Nursing, The University of Texas at Austin, USA.
Yueh-Ling
YL
Wang
Sharon A
SA
Brown
Sharon D
SD
Horner
D000223:Adaptation, Psychological; D000293:Adolescent; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D033262:Narration; D012572:School Health Services; D012573:School Nursing; D012648:Self Care / Q000523:psychology*; D013334:Students / Q000523:psychology*; D013624:Taiwan