Type 1 diabetes in adolescence : a shared responsibility
Type I diabetes effects over 16,500 children in the UK. For these young people, care is needed to maintain 'near normal' blood glucose levels in order to relieve the unpleasant symptoms of high and low blood glucose. Although good metabolic control may decrease the risk of severe long term complications, adolescents often have difficulty juggling all the aspects of a complex and demanding treatment regimen, and poor adherence is commonplace. The literature review proposes a theoretical framework for understanding the role of responsibility in the management of type 1 diabetes during adolescence. The pattern of responsibility is explored in relation to the individual and their interpersonal context. In terms of health outcome, the effects of individual and shared responsibility are considered, necessitating a balance between the adolescent's assumption of responsibility and their level of parental involvement. Suggestions for clinical practice are discussed, methodological limitations raised, and future research opportunities identified. The role of dietary self efficacy in predicting self care during adolescence is established. Using data for two distinct phases of adolescence, paper 1 examines whether social support from family and friends makes any additional contribution to the prediction of dietary self care, over and above that of self efficacy. For the younger group (aged 12-13), the prediction of self care is improved by better perceived support from friends. An interactive effect of shared family responsibility is also reported, confirming the importance of shared responsibility, between parent and child, to facilitate good self management as highlighted in the literature review. None of the variables are significant predictors of self care in the older group (14-18 year olds).