期刊
JOURNAL OF ADVANCED NURSING
卷 70, 期 11, 页码 2634-2650出版社
WILEY
DOI: 10.1111/jan.12413
关键词
adolescents; autonomy-supportive intervention; decision-making; nursing; outpatient clinic; type 1 diabetes
类别
资金
- Research Foundation at Hilleroed Hospital
- Novo Nordisk Foundation
- Lundbeck Foundation
- Sahva Foundation
- Tryg Foundation
- Foundation of Lieutenant Commander Harald Jensen and Wife
- Paediatric Department at Hilleroed Hospital
- Research Foundation of the Capital Region of Denmark
- Foundation of Mrs. Lilly Benthine Lund
- Foundation of Ville Heise
- Foundation of Cabinetmaker Sophus Jacobsen and Wife
- Health Insurance Foundation
- Beckett Foundation
AimTo explore and illustrate how the Guided Self-Determination-Youth method influences the development of life skills in adolescents with type 1 diabetes supported by their parents and healthcare providers. BackgroundEvidence-based methods that accomplish constructive cooperation between adolescents with poorly controlled type 1 diabetes, their parents and healthcare providers are needed. We adjusted an adult life skills intervention comprising reflection sheets and advanced communication for use by adolescent-parent-professional triads in outpatient visits. DesignA qualitative realistic evaluation design comprising eight context-mechanism-outcome configurations directed the analysis of the Guided Self-Determination-Youth's influence on adolescent-parent-professional triads to evaluate what worked for whom, how and in what circumstances. Thirteen adolescents aged 13-18years diagnosed with type 1 diabetes for 1year and having poor glycaemic control participated together with 17 parents and eight healthcare providers. Data were collected from December 2009-March 2012 and consisted of digitally recorded outpatient Guide Self-Determination-Youth visits collected during the intervention period (115-245months) and semi-structured interviews at 6-month follow-up. FindingsEmerging life skills in adolescents were identified as: (1) developing new relatedness with healthcare providers and parents; (2) becoming decision makers in their own lives with diabetes; and (3) growing personally. Reflection sheets combined with healthcare providers' advanced communication were central to promoting mutual problem-solving. ConclusionA life skills approach turned outpatient visits into person-specific visits with improved cooperation patterns in the triads. Combining reflection sheets and advanced communication skills supported adolescents in beginning a process of developing life skills.
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