title: Stressors in Teens with Type 1 Diabetes and Their Parents: Immediate and Long-Term Implications for Transition to Self-Management.
abstract: Teens with Type 1 diabetes and their parents experience every day and illness-related stress; however, understanding of how these stressors relate to the transition to adulthood is limited. The purpose of this study was to identify stressors of teens with Type 1 diabetes (T1DM) and their parents related to the impending transition to adulthood.
  
  
  METHODS
  This study used open-ended questions to identify every day and illness-related stressors among 15 teens with T1DM and 25 parents seen in one pediatric diabetes clinic. Qualitative descriptive analysis identified themes in interview transcripts.
  
  
  RESULTS
  The primary teen stressor related to impending transition centered on ineffective self-management, often when they were taking over responsibility for T1DM management. Parents' concerns included immediate and long-term negative outcomes of teen self-management as well as financial resources and health insurance for the teen. Teens and parents both expressed specific concerns about outcomes and prevention of nocturnal hypoglycemia, and identified uncertainties related to teen health and diabetes-focused health care when no longer living in the parent's home.
  
  
  CONCLUSIONS
  Teens with Type 1 diabetes and their parents understand that independent teen self-management is a component of transition to adulthood, but worry about teen self-management outcomes. Concerns specific to health care transition included health insurance, T1DM resources, and teens' abilities to handle new situations.
  
  
  CONCLUSIONS
  Identifying current and future self-management concerns of individuals and families can facilitate targeted education and interventions to support successful transition to adulthood.
authors.affiliation: College of Nursing, The University of Iowa, Iowa City, IA. Electronic address: anne-ersig@uiowa.edu.
authors.forename: Anne L
authors.initials: AL
authors.lastname: Ersig
authors.affiliation: University of Iowa Carver College of Medicine, Stead Family Department of Pediatrics, Iowa City, IA.
authors.forename: Eva
authors.initials: E
authors.lastname: Tsalikian
authors.affiliation: University of Iowa Carver College of Medicine, Stead Family Department of Pediatrics, Iowa City, IA.
authors.forename: Julie
authors.initials: J
authors.lastname: Coffey
authors.affiliation: College of Nursing, The University of Iowa, Iowa City, IA.
authors.forename: Janet K
authors.initials: JK
authors.lastname: Williams
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D015190:Blood Glucose Self-Monitoring / Q000379:methods / Q000523:psychology; D002648:Child; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007328:Insulin / Q000008:administration & dosage; D007407:Interviews as Topic; D008297:Male; D010287:Parent-Child Relations; D018570:Risk Assessment; D012648:Self Care / Q000523:psychology*; D013315:Stress, Psychological / Q000453:epidemiology / Q000517:prevention & control*; D013997:Time Factors; D060305:Transition to Adult Care
chemical_list: D007328:Insulin
keywords: Anxiety; Family; Parents; Stress; Teenagers; Type 1 diabetes