Normalizing: Adolescent Experiences in Living with Type 1 Diabetes
Babler, Elizabeth Kay
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The purpose of this research effort among adolescents ages 11 to 15 years was to gain a greater understanding, from the adolescent's perspective, of their experiences in living with diabetes and associated challenges and management issues they faced. The aim was to build a theoretical paradigm that captured the main categories and moving processes in the experiences of adolescents and provided much needed information and hypotheses to support interventional design. Classical grounded theory with constant comparative analysis using gerund coding was utilized. Fifteen individual interviews were conducted. The substantive theory that was developed was "normalizing". Normalizing is defined as the ability of the adolescents to integrate diabetes into the background of their daily life by creating routines to make diabetes `part of me'. The conceptual codes developed that describe normalizing for adolescents with diabetes included: a) `recognizing life is changing', b) `taking action to prevent a crisis', c) `disclosing to engage support', d) `taking on the burden of care', e) `accepting the `new normal'', and f) `hoping for a normal future'. For adolescents with diabetes, the normal developmental tasks of adolescence are closely related to each step of this normalizing process and help to explain why adolescents struggle with diabetes during this phase of adolescence. Needle fear, moving through transition to self-care, conflict with parents, and the interactions, reactions and emotions of others were key processes that affect the ability to normalize. Strategies used by adolescents in managing their diabetes include maintaining motivation, building trust, and learning to cope. The supportive behaviors of parents, peers, teachers, and others were helpful. When researchers and clinicians view this difficult stage of adolescent diabetes care as an attempt to normalize their life, it places a very different and positive perspective on this process with a focus on wellness and maintaining a normal life rather than a focus on illness. This creates many new opportunities to provide education and interventions to not only help the adolescents normalize but also assist their parents, peers, schools, and communities to help them normalize their life as well.
- Nursing - Seattle