title: Balancing parental involvement with adolescent friendly health care in teenagers with diabetes: are we getting it right?
abstract: OBJECTIVE
  Current guidance about adolescent-friendly health care emphasizes the benefits of seeing young people alone for confidential consultations. Yet in young people with Type 1 diabetes mellitus (T1DM), parental involvement has been shown to contribute to better diabetes control. This study aimed to better understand how these apparent tensions are reconciled in clinical practice by identifying how frequently adolescents with T1DM are seen alone and exploring parents' opinions about this.
  
  
  METHODS
  A convenience sample of consecutive parents of adolescents (aged 12-21 years) with T1DM was recruited from the outpatient clinic of a specialist diabetes service and asked to complete a 30-item written survey.
  
  
  RESULTS
  A total of 137 surveys were returned from 146 eligible parents (94%) of whom 106 had complete data. Thirteen percent of adolescents with T1DM had ever been seen alone for a confidential consultation with their doctor. The most common concern for parents about confidential care was not being informed about important information, not just about T1DM, but also about common adolescent risk behaviors and mental health states.
  
  
  CONCLUSIONS
  These findings suggest that young people with T1DM are not being routinely seen alone for confidential care. This could be attributed to: parents or adolescents declining confidential care; clinicians being time-poor and/or lacking the necessary skills; or a culture of uncertainty about the value of confidential care. A discussion is now required about how best to enact adolescent-friendly care in the chronic-illness outpatient setting, where parental involvement is understood to be important for effective chronic illness management.
authors: Centre for Adolescent Health, Royal Children's Hospital, Parkville, Victoria, Australia; Murdoch Childrens Research Institute, Parkville, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia. Electronic address: rony.duncan@mcri.edu.au.
authors: Rony E
authors: RE
authors: Duncan
authors: Centre for Adolescent Health, Royal Children's Hospital, Parkville, Victoria, Australia; Faculty of Social Sciences, Radboud University Nijmegen, Netherlands.
authors: Maureen
authors: M
authors: Jekel
authors: Murdoch Childrens Research Institute, Parkville, Victoria, Australia; Department of Endocrinology and Diabetes, Royal Children's Hospital, Parkville, Victoria, Australia.
authors: Michele A
authors: MA
authors: O'Connell
authors: Department of General Practice, The University of Melbourne, Parkville, Victoria, Australia.
authors: Lena A
authors: LA
authors: Sanci
authors: Centre for Adolescent Health, Royal Children's Hospital, Parkville, Victoria, Australia; Murdoch Childrens Research Institute, Parkville, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia.
authors: Susan M
authors: SM
authors: Sawyer
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D016497:Adolescent Health Services / Q000331:legislation & jurisprudence / Q000592:standards* / Q000706:statistics & numerical data; D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities / Q000592:standards / Q000706:statistics & numerical data; D002648:Child; D003219:Confidentiality / Q000331:legislation & jurisprudence / Q000592:standards*; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000706:statistics & numerical data; D011368:Professional-Family Relations; D012648:Self Care / Q000523:psychology / Q000592:standards; D011795:Surveys and Questionnaires; D014739:Victoria; D055815:Young Adult
keywords: Adolescent; Chronic disease; Confidentiality; Diabetes mellitus; Ethics; Parents; Self-management