title: Moving the Journey Towards Independence: Adolescents Transitioning to Successful Diabetes Self-Management.
abstract: OBJECTIVE
  To gain a greater understanding of adolescent's experiences living with Type 1 diabetes mellitus (T1DM) and create a theoretical paradigm.
  
  
  METHODS
  Grounded theory as described by Glaser was used. Fifteen in-depth interviews were conducted with adolescent's ages 11-15 with T1DM. Symbolic interactionism is the theoretical framework for grounded theory. Data were collected; transcribed, coded, and analyzed simultaneously using constant comparative analysis and findings were grounded in the words of participants.
  
  
  RESULTS
  A theoretical model was created with the concept of "normalizing". Normalizing was defined as the ability to integrate diabetes into one's daily life to make diabetes 'part of me'. Phase four of the model, and the focus of this manuscript was "Moving the Journey towards Independence" and included: 1) taking over care, 2) experiencing conflict with parents, and 3) realizing diabetes is hard. The major task for adolescents in this phase was separating from parents to independently manage diabetes. The normalizing task for this phase was: "taking on the burden of care". Adolescents described challenges with independent care and increased parental conflict including: fearing needles, forgetting insulin, feeling embarrassed and believing that diabetes was a burden in their life. Additionally, juggling the multiple responsibilities of home, school and work along with managing a chronic illness during adolescence is challenging.
  
  
  CONCLUSIONS
  Transitioning to diabetes self-management is a challenge for adolescents. This model advances understanding of the moving processes in adolescents transitioning; additionally, hypotheses are presented that may be used for developing interventions to promote success in self-management.
authors.affiliation: University of Washington School of Nursing, Psychosocial & Community Health, Seattle, WA. Electronic address: bethbabler@gmail.com.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Babler
authors.affiliation: University of Washington School of Nursing, Psychosocial & Community Health, Seattle, WA.
authors.forename: Carolyn June
authors.initials: CJ
authors.lastname: Strickland
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000294:Adolescent Behavior; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D066296:Grounded Theory; D015438:Health Behavior; D006801:Humans; D007328:Insulin / Q000008:administration & dosage*; D007407:Interviews as Topic; D008297:Male; D010287:Parent-Child Relations; D036301:Qualitative Research; D011788:Quality of Life; D012494:Sampling Studies; D012648:Self Care / Q000379:methods* / Q000523:psychology
chemical_list: D007328:Insulin
keywords: Adolescent; Conflict; Parent; Self-management; Type 1 diabetes