Living with sensor-augmented pump therapy in type 1 diabetes: adolescents' and parents' search for harmony

Judy Rashotte; Kelley Tousignant; Christine Richardson; Frances Fothergill-Bourbonnais; Meranda M Nakhla; Patricia Olivier; Margaret L Lawson

doi:10.1016/j.jcjd.2014.02.002

Living with sensor-augmented pump therapy in type 1 diabetes: adolescents' and parents' search for harmony

Can J Diabetes. 2014 Aug;38(4):256-62. doi: 10.1016/j.jcjd.2014.02.002. Epub 2014 Jul 9.

Authors

Judy Rashotte¹, Kelley Tousignant², Christine Richardson¹, Frances Fothergill-Bourbonnais², Meranda M Nakhla¹, Patricia Olivier¹, Margaret L Lawson³

Affiliations

¹ Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
² School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.
³ Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada. Electronic address: lawson@cheo.ca.

PMID: 25023738
DOI: 10.1016/j.jcjd.2014.02.002

Abstract

Objective: Adolescents have difficulty successfully sustaining use of continuous glucose monitoring even when it is introduced to experienced pump users. However, little is known about how adolescents and parents perceive and manage sensor-augmented pump therapy (SAPT) in daily life. The purpose of this study was to explore adolescents' and parents' daily experience of living with SAPT.

Methods: We used an interpretive phenomenological study design. We conducted in-depth, digitally recorded interviews with 7 adolescents and 9 parents recruited through 1 Canadian pediatric diabetes program. Adolescents who participated were 13 to 17 years of age with type 1 diabetes mellitus and had experience (current or past) living with SAPT. Transcripts of the interviews were subjected to a thematic analysis guided by the procedure outlined by Colaizzi.

Results: The overarching theme, seeking harmony, reflected adolescents' and parents' daily struggles with balancing multiple tensions that arose from managing SAPT and harmonizing seemingly opposing choices that were brought to the fore, while also struggling to live with both wellness and chronic illness. Four themes constituted the struggle to find harmony living with diabetes managed with SAPT: struggling with hopes and expectations for SAPT, being ready for SAPT, living the burdens of continuous glucose monitoring and creating partnerships.

Conclusions: Healthcare providers can facilitate adolescent and parental decision-making about the optimal timing for SAPT introduction. Success with SAPT requires exploration of adolescent and parental expectations for SAPT as well as the degree to which parents have previously fostered their adolescent's involvement in and responsibility for diabetes management.

Keywords: adolescents; diabète de type 1; parents; qualitative research; recherche qualitative; sensor-augmented pump therapy; traitement par pompe reliée à un capteur; type 1 diabetes.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Canada
Diabetes Mellitus, Type 1 / drug therapy*
Diabetes Mellitus, Type 1 / economics*
Female
Humans
Insulin / administration & dosage*
Insulin / therapeutic use
Insulin Infusion Systems / psychology*
Interviews as Topic
Male
Stress, Psychological*

Substances

Insulin