Understanding Type 1 Diabetes Self-Care Management Among Adolescents and Their Parents in Jordan: A Qualitative Study.

Abstract

Introduction and Background: Type 1 diabetes is the most common endocrine condition among adolescents. Diabetes self-care management (DSCM) is particularly challenging during adolescence. The perspectives of adolescents with type 1 diabetes and their parents in Jordan have not been studied previously and no qualitative research has been published on adolescents with type 1 diabetes in Jordan. Aim: To understand how adolescents with the diagnosis of type 1 diabetes and their parents manage the condition in the context of Jordanian culture. Methodology: Constructivist grounded theory principles. Methods: 48 participants were recruited using purposive and theoretical sampling techniques including adolescents, parents, and health-care providers were used in 38 semi-structured, audio-recorded interviews. Data were collected and analysed concurrently using different levels of coding, constant comparative analysis, and memo writing. Findings: Adolescents and their parents' descriptions of living with diabetes emphasised their belief that, for them diabetes was a part of God's destiny. They believed they had responsibility for accepting, managing, and integrating diabetes into their lives. Mothers, family members, and others had important roles in DSCM. Adolescents and parents identified individual-level and system-level barriers to DSCM. An example of an individual-level barrier was others' labelling of adolescents for having diabetes, while an example of a system-level barrier was limited insurance coverage including limited access to blood glucose testing strips. Discussion: The findings indicate how culture can influence DSCM among adolescents and their parents in Jordan. Two aspects of culture were identified: collectivism and cultural beliefs. Collectivism included the role others had in adolescents' DSCM. Cultural beliefs included three different sets of beliefs which are: religious beliefs; beliefs about relationships; and beliefs about type 1 diabetes. Conclusion: This study contributes to understanding the perspectives of adolescents with type 1 diabetes and their parents' in Jordan. The findings have implications for their healthcare.

Date of Award	1 Aug 2019
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Peter Callery (Supervisor) & Yin-Ling Lin (Supervisor)