The mother-daughter guilt dynamic: effects of type 1 diabetes during life transitions.
OBJECTIVE
The aim of the study was to explore and describe the strategies young women with type 1 diabetes used to manage life transitions. The paper describes one aspect of how guilt dynamic often operates between mothers and daughters and how the women managed the guilt dynamic to create stability in their lives.


BACKGROUND
When a child is diagnosed with diabetes, major transitional changes occur in the relationships between the mother and her child. The changes affect the psychological and social aspects of their lives and have a major impact on how young women manage their diabetes. A guilt dynamic between mothers and young women with diabetes emerged as a major theme in a larger study that investigated how young women with diabetes managed life transitions. Although the literature indicates that mothers of chronically ill children experience guilt feelings towards their children, little research was identified that addressed the emotional dynamics between mothers and daughters with diabetes.


METHODS
Using grounded theory method, interviews were conducted with 20 women with type 1 diabetes and five mothers during 2002 and 2003. Constant comparative analysis was used to analyse the data and develop an in-depth understanding of the experience of living with diabetes during life transitions.


RESULTS
The findings revealed that guilt feelings created a two-way dependency between mothers and their daughters with diabetes. The two-way dependency involved feelings of being a burden to each other, difficulty balancing responsibilities for diabetes management, difficulty relinquishing emotional and social dependency especially during life transitions. In addition, these issues were rarely discussed openly with each other or with health professionals. The findings provide additional information about the human experience of the mother-daughter relationship and the effect on coping with diabetes in the context of life transitions.


CONCLUSIONS
Understanding the impact diabetes has on the emotional and social well being of both women with type 1 diabetes and their mothers is critical in planning appropriate support for both groups. Most importantly, it is critical to understand the guilt dynamic that operates during young women with diabetes' life transitions when the daughters' dependency on their mother's control and responsibility for diabetes management undergo changes resulting in emotional responses, especially guilt feelings.


CONCLUSIONS
Health professionals need to understand the emotional and social impact of the guilt dynamics between young women with type 1 diabetes and their mothers. Adequate and appropriate support can minimize the guilt feelings and enhance stability and quality of life for both mothers and their daughters, especially during major life transitions, such as motherhood.
Senior Lecturer, Deakin University, School of Nursing, Melbourne Campus, Burwood, Victoria, AustraliaProfessor, Inaugural Chair in Nursing, Barwon Health and Deakin University, Geelong, Victoria, AustraliaEmeritus Professor, Deakin University, Geelong, Victoria, AustraliaProfessor, Chair in Nursing, Southern Health and Deakin University, Melbourne, Victoria, Australia.
Bodil
B
Rasmussen
Senior Lecturer, Deakin University, School of Nursing, Melbourne Campus, Burwood, Victoria, AustraliaProfessor, Inaugural Chair in Nursing, Barwon Health and Deakin University, Geelong, Victoria, AustraliaEmeritus Professor, Deakin University, Geelong, Victoria, AustraliaProfessor, Chair in Nursing, Southern Health and Deakin University, Melbourne, Victoria, Australia.
Trisha
T
Dunning
Senior Lecturer, Deakin University, School of Nursing, Melbourne Campus, Burwood, Victoria, AustraliaProfessor, Inaugural Chair in Nursing, Barwon Health and Deakin University, Geelong, Victoria, AustraliaEmeritus Professor, Deakin University, Geelong, Victoria, AustraliaProfessor, Chair in Nursing, Southern Health and Deakin University, Melbourne, Victoria, Australia.
Helen
H
Cox
Senior Lecturer, Deakin University, School of Nursing, Melbourne Campus, Burwood, Victoria, AustraliaProfessor, Inaugural Chair in Nursing, Barwon Health and Deakin University, Geelong, Victoria, AustraliaEmeritus Professor, Deakin University, Geelong, Victoria, AustraliaProfessor, Chair in Nursing, Southern Health and Deakin University, Melbourne, Victoria, Australia.
Beverly
B
O'Connell
D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology*; D005260:Female; D006167:Guilt; D006801:Humans; D009034:Mother-Child Relations / Q000523:psychology*; D011788:Quality of Life; D055815:Young Adult
Australia; diabetes; guilt; life transitions; mothers; women