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Title: Adherence to the type 1 diabetes treatment regime in adolescents and young adults
Author: Laver, Fiona J.
Awarding Body: University of Oxford
Current Institution: University of Oxford
Date of Award: 2012
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Non-adherence to the type 1 diabetes treatment regime is an ongoing problem that is costly on both an individual and societal level. Adolescents and young adults have some of the lowest rates of adherence to the regime. The first paper is a systematic review of 27 quantitative studies investigating the influence of the family on adolescent adherence. Key findings included the importance of a high-quality adolescent-parent relationship characterised by high-levels of cohesion, collaboration and support. Parental well-being and parenting style was also shown to influence adolescent adherence. The positive association of parental diabetes-specific monitoring with adolescent adherence was also highlighted. Clinical implications include the need for interventions that enhance the parent-adolescent relationship and that educate parents about helpful parenting styles and strategies for involvement in their adolescent's diabetes management. The second paper focused attention on one particular diabetes adherence behaviour about which little is understood; non-attendance at diabetic retinopathy screening appointments. The study aimed to understand the experiences of young people who repeatedly do not attend these appointments and identify the factors influencing their attendance decisions. A qualitative study which employed a modified grounded theory methodology was carried out. Semi-structured interviews were used to explore the experiences of nine young adults diagnosed with type 1 diabetes. The grounded theory model developed illustrates that participants both knew and believed they should attend screening. This created conflict with their actual non-attendance behaviour. Four strategies that participants employed to resolve this conflict were identified and were facilitated by a number of external and cognitive factors. One incentive to attend screening was identified and was participants' desire to obtain reassurance about the health status of their eyes. Interventions that reduce the perceived 'hassle' associated with attendance are recommended, as are interventions that encourage a realistic perception of the risk of developing diabetic retinopathy.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Clin.Psy.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available