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1
Bargren, MaryJean K. „Factors affecting dietary compliance in the adolescent with type 1 diabetes /“. View online, 2009. http://repository.eiu.edu/theses/docs/32211131396029.pdf.
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2
Maharaj, Sherry I. „The interpersonal context of Diabetes Mellitus examining the links between eating disturbances, metabolic control, and the quality of family functioning among girls with Type 1 diabetes /“. Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape10/PQDD_0025/NQ39286.pdf.
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3
Gibbins, Heidi. „Type 1 diabetes in adolescence : a shared responsibility“. Thesis, University of Warwick, 2004. http://wrap.warwick.ac.uk/4060/.
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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).
4
Welsh, A. „'Living well' with insulin-dependent diabetes in adolescence“. Thesis, University of Liverpool, 2017. http://livrepository.liverpool.ac.uk/3009508/.
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5
Graff, Leanne Marie, und Karin Yakira. „Depression and diabetes in adolescents“. CSUSB ScholarWorks, 2003. https://scholarworks.lib.csusb.edu/etd-project/2278.
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6
Esparza, Annabelle Lucia Sandoval. „The relationship between self-esteem and glycemic control in 13-17 year old adolescent girls with type 1 diabetes mellitus“. CSUSB ScholarWorks, 2005. https://scholarworks.lib.csusb.edu/etd-project/2739.
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The purpose of this study was to explore the psychosocial phenomena of self-esteem in relation to gucose control in diabetic adolescent girls living in the Inland Empire. Three central themes emerged: body image, peer acceptance, and stress.
7
Maher, Kathryn. „Assessment of Diabetes Regimen Disease Care in Youth with Type 1 Diabetes via the Diabetes Behavior Rating Scale and the 24-Hour Diabetes Interview“. VCU Scholars Compass, 2011. http://scholarscompass.vcu.edu/etd/185.
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The psychometric properties of two measures of diabetes disease care, the Diabetes Behavior Rating Scale (DBRS) and the 24-hr Diabetes Interview (24-hr) were evaluated. The 24-hr is a widely used, structured interview while the DBRS is a self-administered, fixed-choice questionnaire. Both measures were administered to 250 youth with Type 1 Diabetes (aged 11–14 years) and their parents. Overall, both measures demonstrate adequate psychometric properties. The DBRS and the 24-hr demonstrated good incremental validity and low convergent validity with each adding significant additive value. Both measures demonstrated good concurrent validity with HbA1c. As expected, scores on the 24-hr demonstrated less than adequate test-retest reliability and both measures demonstrated low parent/youth agreement. Interestingly, external validity analyses demonstrated DBRS scores were moderately related to HbA1c in non-pump but not pump regimens, while the 24-hr displayed acceptable external validity. Only three subscales significantly contributed to HbA1c suggesting a more parsimonious assessment measure. This novel, brief combination could prove efficacious for clinical practice.
8
Beardsley, Emma R. „Attachment security, coping strategies and adjustment to diabetes during adolescence“. Thesis, University of East Anglia, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.327409.
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Research shows a large variability in the degree to which adolescents with diabetes adjust to their illness. Adjustment to diabetes is important because it affects the mental health of adolescents, and has been shown to predict both adherence to treatment, and glycaemic control. This thesis proposed that attachment security has the potential to explain some of the variability in adjustment to diabetes. A causal pathway was hypothesised whereby attachment security both directly predicts adjustment to diabetes, and indirectly via choice of coping strategies. In addition, it was hypothesised that attachment security would indirectly predict adherence behaviours and glycaemic control. The relative importance of attachment to parents and peers was compared. The research hypotheses were tested in a sample of 99 adolescents aged 13-18 years, who had been diagnosed with diabetes for at least a year. Measures of attachment security, adjustment to diabetes, coping strategies, treatment adherence and glycaemic control were taken at one time point. The data were analysed using structural equation modelling to test the hypothesised causal pathway. The results suggested that attachment security both directly predicts adjustment to diabetes, and indirectly predicts adjustment to diabetes via avoidance focused coping strategies. Attachment to parents, but not to peers was associated with adjustment to diabetes, and some gender differences were observed. The results also suggested that attachment security indirectly predicts glycaemic control via adjustment to diabetes. There were no significant associations between adherence to treatment and any other variables. Neither attachment security nor adjustment to diabetes were associated with approach focused coping. It is concluded that attachment security may play an important part in both psychological and physical outcomes for adolescents with diabetes, and this has implications for attachment based interventions. The findings are discussed in relation to other theoretical models, and indications for future research are suggested.
9
Spencer, Joy Elizabeth. „Type 1 diabetes and adolescence : an exploration of lived experiences“. Thesis, University of Liverpool, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.533923.
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10
Robinson, Elizabeth M. „ASSESSING PARENTAL INVOLVEMENT IN TYPE 1 DIABETES MANAGEMENT DURING ADOLESCENCE“. VCU Scholars Compass, 2011. http://scholarscompass.vcu.edu/etd/2637.
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Type 1 diabetes is one of the most common pediatric chronic illnesses. Adolescents are at risk for poorer glycemic control; however, youth whose parents remain involved in diabetes care are in better control. The current study examined parental involvement (PI) using a multi-method, multi-source approach in a sample of 255 youth (Age M = 12.83). The Diabetes Family Responsibility Questionnaire, Parental Monitoring of Diabetes Care Scale, and 24-Hour Diabetes Interview assessed two types of PI, parental responsibility and parental monitoring. Global and specific assessment served to cross-corroborate indicators of PI related to HbA1c. Higher levels of monitoring related to lower HbA1c for both parent- and youth-report; however, the effect decreased after controlling for socioeconomic status (SES). Additionally, monitoring mediated the relation between age and HbA1c. Controlling for SES, youth whose parents demonstrated higher levels of monitoring were in better glycemic control. Both research and clinical implications are discussed.
11
Martinez, Kelly Marie. „Psychological aspects of living with diabetes, in adolescence and childhood“. Thesis, Queen's University Belfast, 2015. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.695664.
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Research thesis encompassing two papers: Psychological factors associated with diabetes self-management among adolescents with Type 1 diabetes: a systematic review The purpose of the review was to determine what psychological factors are associated with diabetes self-management. Twenty-one articles were determined to be eligible for this review. Numerous psychological factors were found to be associated with self management; however, correlations were typically small to moderate. Study validity was variable and there was little overlap between psychological factors examined. Variables are presented in a narrative synthesis. The strongest associations were found between social anxiety and diet (among boys); greater intrinsic motivation, conscientiousness and diet; and extraversion and exercise. Evidence exists for relationships between psychological factors and diabetes self-management but due to the individual nature of the studies, firm conclusions cannot be drawn. Future research needs to attempt replication and utilise validated measures to provide a stronger evidence base from which to develop theory for this population. The relationships between diabetes distress, illness perceptions and glycaemic control in adults with Type 2 diabetes This study aimed to investigate whether illness perceptions moderate the relationship between diabetes distress and glycaemic control. Participants with Type 2 DM attending diabetes outpatient clinics (n = 82) completed the Diabetes Distress Scale 17, Brief Illness Perceptions Questionnaire and the Patient Health Questionnaire 9 as well as providing demographic and clinical information. Most recent HbA 1 c and BMI were collected from medical records. Personal Control was the only significant contributor in the final regression model predicting HbA 1 c. The relationship between regimen-related distress and HbA 1 c was mediated by personal control. Moderating effects were non-significant. Personal control has an important role in explaining the link between diabetes distress and HbA 1 c. Psychological interventions seeking to improve HbA 1 c need to address individuals' perceptions of personal control.
12
Keough, Lori A. „Self-Management of Type 1 Diabetes Across Adolescence: A Dissertation“. eScholarship@UMMS, 2009. https://escholarship.umassmed.edu/gsn_diss/17.
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Little is known about what variables affect self-management practices of adolescents with T1D. Few studies have examined differences in self-management behaviors by stage of adolescence. Similarly, no studies have examined all of the attributes of self-management, including Collaboration with Parents and Goals. In order to fill the gaps in the literature, a secondary data analysis with a descriptive correlation design was conducted to describe T1D self-management behaviors (Collaboration with Parents, Diabetes Care Activities, Diabetes Problem Solving, Diabetes Communication and Goals) during early, middle and late stages of adolescence. This study also examined whether the roles of covariates (regimen, duration of illness (DOI), gender) in self-management behaviors vary by stage of adolescence. Data from 504 subjects aged 13 – 21 years were analyzed and the age variable was transformed into three adolescent stages early (13-14) (n=163), middle (15-16) (n=159) and late (17-21) (n=182).
The findings revealed significant differences between adolescent stages on Collaboration with Parents and the Diabetes Problem Solving subscale. The covariate analysis showed no significant effect modification for the covariates and stage on any of the subscales so the results did not differ from the ANOVA model. Covariate analysis showed significant associations between regimen and Collaboration with Parents, Diabetes Care Activities and Diabetes Problem Solving. DOI showed significant associations only with Diabetes Problem solving and gender had significant associations with Diabetes Care Activities and Diabetes Communication.
The mean scores on Collaboration with Parents show an incremental decline in collaboration with parents as adolescents move through stages. The higher mean Diabetes Problem Solving scores found in the late adolescent group compared correlated with a higher degree of problem solving in this group when compared to those in the early or middle adolescent stage group. Regimen had significant associations with three of the five subscales suggesting this is an important variable for future study. DOI did not have a significant impact on self-management whereas gender related differences in the areas of Diabetes Activities and Diabetes communication warrant further investigation.
13
Tshivhase, Abegail Mukhethwa. „The prevalence of maturity onset diabetes of the young (Mody) in a population from the Western Cape“. Thesis, Cape Peninsula University of Technology, 2019. http://hdl.handle.net/20.500.11838/2980.
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Thesis (MSc(Biomedical Technology))--Cape Peninsula University of Technology, 2019Background: Maturity Onset Diabetes of the Young (MODY) is a monogenic type of diabetes caused by a single gene mutation. Up to date 14 different MODY subtypes have been identified. Mutations in the glucokinase (MODY 3) and hepatic nuclear factor 1 alpha (HNF1A) (MODY 2) are the most frequent causes of MODY in all populations studied. Patients with MODY are misdiagnosed with type 1 or type 2 diabetes. Identifying patients with MODY is important as it affects treatment, for example, MODY 2 patients need no treatment, whereas those diagnosed with MODY 3 are very sensitive to low doses of sulphonylureas. To date, no data is available on the prevalence of MODY in populations from Africa. Thus, we aimed to investigate and report on the incidence of MODY, specifically mutations in the HNF1A gene in a population from the Western Cape. Methods: In this study, we screened for HNF1A MODY (MODY 3) mutations (rs115080759, rs140491072 rs137853245, and rs142318174) in 1639 (males = 406) individuals using real-time PCR. Positive MODY samples were confirmed by subsequent sequencing. All individuals underwent an oral glucose tolerance test. Results: The mean age of participants was 47.1±15.6 in males and 49.9±15.1 females. We identified 12 (0.73%) individuals with HNF1A gene polymorphisms; 12/1642 of rs115080759. Seven participants with a SNP in rs115080759 presented with normoglycemia, one with prediabetes, and four with diabetes. No polymorphism was detected in three SNPs; rs140491072, rs137853245 and rs142318174. Discussion and conclusion: To our knowledge, this is the first African study on MODY, and the incidence is similar to that reported in other studies. The results suggest that MODY is misdiagnosed with other types of diabetes in Africa; therefore, our findings support the introduction of diagnostic genetic testing for MODY in South Africa.
14
Vincent, Dawn A. „Acceptance of complementary and alternative medicine among pediatric patients with diabetes“. Virtual Press, 2007. http://liblink.bsu.edu/uhtbin/catkey/1366504.
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The purpose of this research study was to determine the acceptability of complementary and alternative medicine use in a pediatric population with diabetes. Subjects included 76 patients who attend or have previously attended a diabetes clinic at Riley Hospital for Children in Indianapolis, Indiana.Once patient and parent approval had been granted, the researcher conducted a telephone interview to gather information. Using SPSS statistical software, frequencies and Chi-squared analysis were performed on the data collected. It was revealed that although subjects had a wide variety of concerns with the use of CAM and were unsure about whether it "could heal diabetes or other health problems," a majority were willing to try CAM. Results also indicated that willingness to try CAM was not affected by the age of the child, the type of diabetes present, use of insulin or special diet, or current use of a vitamin or supplement.Department of Family and Consumer Sciences
15
Lucich, JoAnne. „Relationships with primary female caregivers and the management of Type I Diabetes in adolescents /“. Connect to CIFA website:, 2004. http://ourworld.compuserve.com/homepages/pdwerner/cifa1.htm.
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16
Williams, C. L. (Catherine L. ). „The role of developmental challenges of adolescence in predicting treatment adherence and glycaemic control in children with insulin dependent diabetes mellitus“. Thesis, The University of Sydney, 2004. https://hdl.handle.net/2123/27922.
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There has been a significant amount of research investigating potential reasons for the
high rates of non-adherence and poor metabolic control amongst adolescence with insulin
dependent diabetes. Adolescence is a period where young people face a range of
developmental challenges, such as individuating from their family, conforming to their
peer group and dealing with their emerging sexuality and body image. While the
relevance of these has been discussed, to date, there has been limited empirical
investigation in diabetes of their impact on adolescents’ management and adjustment to
type 1 diabetes.
The major aims of this study were to examine the relationship between some of the major
developmental challenges of adolescence, adherence and psychopathology among a
group of adolescence with Type 1 Diabetes. Sixty-two adolescents with Type 1 diabetes
completed a series of questionnaires assessing eating attitudes, family support and fear of
negative evaluation, as well as their beliefs about diabetes and measures of anxiety and
depression. In addition, participants were asked to keep a diary of blood sugar level
readings and their responses to these over seven consecutive days. Glycaemic control was
assessed using HbA1c levels at baseline and three months later.
17
Radcliff, Zach. „The Role Of Authoritative Parenting In Type 1 Diabetes Adolescent Outcomes“. VCU Scholars Compass, 2014. http://scholarscompass.vcu.edu/etd/3528.
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Due to psychosocial and hormonal changes, adolescents with Type 1 Diabetes (T1D) are at risk for poorer regimen adherence, quality of life (QOL), and glycemic control (HbA1c). Authoritative parenting (AP) supports youth development during the transition into adolescence. To date, the mechanisms behind authoritative parenting and better HbA1c are yet to be examined. Parent-youth dyads completed measures of authoritative parenting, adherence, and QOL. As hypothesized, more authoritative parenting related to higher socioeconomic status (SES; β = -.13, p = .04) rather than ethnicity. Further, more authoritative parenting related to better glycemic control via the mechanisms of higher youth QOL (β = .24, p < .001) and better diabetes adherence (β = .17, p = .008). Parents who provide more authoritative parenting have youth with better QOL, better adherence, and better glycemic control. More authoritative parenting helps youth achieve better diabetes care and quality of life during the transition into adolescence.
18
Hillege, Sharon Patricia. „The impact of type 1 diabetes on the self of adolescents and young adults“. View thesis, 2005. http://library.uws.edu.au/adt-NUWS/public/adt-NUWS20051027.134420/index.html.
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19
Oakley, Louise Claire. „Managing diabetes in adolescence : an exploration of the relevant literature and lived experiences“. Thesis, Bangor University, 2016. https://research.bangor.ac.uk/portal/en/theses/managing-diabetes-in-adolescence-an-exploration-of-the-relevant-literature-and-lived-experiences(132de3c7-6c6b-4ecb-9c6f-4c2a1edc8ca2).html.
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This thesis explores the roles of family and healthcare professionals in type 1 diabetes (T1D) in adolescence. The first paper is a systematic review of literature regarding family-based interventions for adolescents with T1D. Adolescence is known to be a particularly challenging time, associated with deterioration in diabetes management and increased family conflict. A systematic search of three electronic databases plus hand-searches of relevant papers, identified 26 papers reporting on 16 intervention studies that met the inclusion and exclusion criteria. Interventions varied considerably in their content and duration. A narrative synthesis considers the effectiveness of these interventions on health, family-related and adolescent psychosocial outcomes. The most intensive interventions had the most support, however there is also promising evidence regarding less intense, quarterly psychoeducational and problem-solving interventions. The empirical paper explored the lived experience of eight healthcare professionals’ working with adolescents with T1D and poor adherence to treatment. Data was analysed using interpretative phenomenological analysis and four superordinate themes were identified; “empathy and insight”, “negotiating relationships”, “impact on self” and “coping”. Professionals empathised with the adolescents whilst also being driven by insight of the risks of poor adherence that the adolescents could not comprehend. They valued a close relationship with the adolescents but also had to balance parental involvement. Poor adherence had a personal impact on each professional, including a sense of powerlessness and failure, but also reward. Professionals coped with these experiences in different way, including negotiating when to do more and when to let go. Clinical implications include a potential benefit of acceptance-based training and reflective practice. Contributions to theory and clinical practice considers the overall impact of these findings. Particular reference is made to the systemic factors involved in adolescent diabetes management and the role of clinical psychology within paediatric diabetes teams.
20
Bulsara, Mahesh K. „Epidemiology of severe hypoglycaemia in children and adolescents with type 1 diabetes“. Telethon Institute for Child Health Research, 2008. http://theses.library.uwa.edu.au/adt-WU2008.0226.
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[Truncated abstract] Type 1 Diabetes is emerging as a significant public health problem faced by nearly every country in the world. It has major economic and social implications with considerable burden of illness. Approximately 140,000 Australians have been diagnosed with T1DM with an annual increase in incidence rate of 3% per year, comparable to the overall global increase. The management of T1DM requires insulin therapy which places considerable burden on the patient and their carers. Coping with daily insulin injections, dietary changes, modification of physical activity and vigilant monitoring of blood glucose levels, will impact on patient?s quality of life. The optimum goal for the treatment of type 1 diabetes is to safely achieve near-normal glycaemia and failure to maintain this goal accelerates the progression of the devastating long term complications of diabetes. Unfortunately attempts to achieve near normal glycaemia are limited by the risk of excessive lowering of blood glucose levels and hypoglycaemia remains a major barrier to strict glucose control of diabetes. In general this thesis focuses on two fundamental issues related to the epidemiology of severe hypoglycaemia. Namely, methodological consideration when analysing prospective observational data and application of the most robust methodology. A prospective open cohort study of the Princess Margaret Hospital diabetes clinic established in 1992, with 99% case ascertainment was used. This hospital is the only paediatric referral centre for type 1 diabetes and every child diagnosed in the state of Western Australia is treated at this centre. ... The results of this study showed that severe hypoglycaemia remains a major problem and recent approaches to therapy may be allowing a degree of improved control without the expected increased risk of severe hypoglycaemia. The study in chapter 7 investigates genetic risk factors related to severe hypoglycaemia. A significant relationship where the presence of the iv deletion (D) allele of the angiotensin-converting enzyme (ACE) increases risk of severe hypoglycaemia has been reported. This study concludes that the presence of D allele of the ACE gene does not predict a significantly higher risk of severe hypoglycaemia. In an attempt to optimize glycemic control, patients may suffer multiple episodes of severe hypoglycaemia which can adversely affect quality of life as well as educational and intellectual disadvantage. The study in chapter 8 investigates the factors related to recurrent severe hypoglycaemia. A rigorous and informative time-to-event approach is used to account for within child correlation, staggered enrolment and timevarying covariates. This allows important risk factors to change over time. Preschool children have an increased risk of experiencing recurrent severe hypoglycaemia. The findings of this thesis highlights the importance of selecting appropriate analytical methodology to identify risk factors associated with severe hypoglycaemia and also to dismiss factors that had previously been thought to be important. This will help in formulating management plans in order to limit the impact of severe hypoglycaemia.
21
Lodefalk, Maria. „Adolescent type 1 diabetes : Eating and gastrointestinal function“. Doctoral thesis, Karolinska institutet, Stockholm, Sweden, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-46180.
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Adolescents with type 1 diabetes (T1DM) are given nutritional education, but the knowledge about their adherence to the food recommendations and associations between dietary intake and metabolic control is poor. Gastrointestinal symptoms are more prevalent in adults with T1DM than in healthy controls, which may be due to disturbed gastrointestinal motility. The meal content affects the gastric emptying rate and the postprandial glycaemia in healthy adults and adults with type 2 diabetes. Meal ingestion also elicits several postprandial hormonal changes of importance for gastrointestinal motility and glycaemia. Eating disorders are more prevalent in young females with T1DM than in healthy females, and are associated with poor metabolic control. The prevalence of eating disorders in adolescent boys with T1DM is not known. This thesis focuses on eating and gastrointestinal function in adolescents with T1DM. Three population-based, cross-sectional studies demonstrated that adolescents with T1DM consume healthy foods more often and have a more regular meal pattern than age- and sex-matched controls. Yet both boys and girls are heavier than controls. The intake of saturated fat is higher and the intake of fibre is lower than recommended in adolescents with T1DM. Patients with poor metabolic control consume more fat and less carbohydrates than patients with better metabolic control. Gastrointestinal symptoms are common in adolescents with T1DM, but the prevalence is not increased compared with controls. Gastrointestinal symptoms in patients are associated with female gender, daily cigarette smoking, long duration of diabetes, poor metabolic control during the past year, and an irregular meal pattern. Adolescent boys with T1DM are heavier and have higher drive for thinness than healthy boys, but do not differ from them in scales measuring psychopathology associated with eating disorders. In a randomized, cross-over study, we found that a meal with a high fat and energy content reduces the initial (0–2 hours) postprandial glycaemic response and delays gastric emptying in adolescents with T1DM given a fixed prandial insulin dose compared with a low-fat meal. The glycaemic response is significantly associated with the gastric emptying rate. Both a high- and a low-fat meal increase the postprandial concentrations of glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide 1 (GLP-1) and suppress the postprandial ghrelin levels in adolescents with T1DM. The postprandial changes of these hormones are more pronounced after the high-fat meal. Insulin-like growth factor binding-protein (IGFBP) –1 concentrations decrease after insulin administration irrespective of meal ingestion. The GLP-1 response is negatively associated with the gastric emptying rate. The fasting ghrelin levels are negatively associated with the postprandial glycaemic response, and the fasting IGFBP-1 levels are positively associated with the fasting glucose levels. We conclude that nutritional education to adolescents with T1DM should focus more on energy intake and expenditure to prevent and treat weight gain. It should also focus on fat quality and fibre intake to reduce the risk of macrovascular complications and improve glycaemia. Gastrointestinal symptoms in adolescents with T1DM should be investigated and treated as in other people irrespective of having diabetes. However, adolescents with long duration of diabetes, poor metabolic control, and symptoms from the upper gut should have their gastric emptying rate examined during euglycaemia. There may be an increased risk for development of eating disorders in adolescent males with T1DM since they are heavier than healthy boys and have higher drive for thinness. This should be investigated in future, larger studies. For the first time, we showed that a fat-rich meal delays gastric emptying and reduces the initial glycaemic response in patients with T1DM. The action profile of the prandial insulin dose to a fat-rich meal may need to be postponed and prolonged compared with the profile to a low-fat meal to reach postprandial normoglycaemia. Circulating insulin levels affect postprandial GIP, GLP-1, and ghrelin, but not IGFBP-1, responses less than the meal content. The pronounced GIP-response to a fat- and energy-rich meal may promote adiposity, since GIP stimulates lipogenesis. Such an effect would be disadvantageous for adolescents with T1DM since they already have increased body fat mass and higher weights compared with healthy adolescents. Adolescents with T1DM may have subnormal postprandial ghrelin suppression, which may be due to their increased insulin resistance or elevated growth hormone levels. This needs to be investigated in future, controlled studies.
22
Tossavainen, née Riihimaa P. (Päivi). „Markers of microvascular complications in adolescents with type 1 diabetes“. Doctoral thesis, University of Oulu, 2003. http://urn.fi/urn:isbn:951426892X.
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Abstract
The markers of microvascular complications of type 1 diabetes were evaluated in adolescents in a cross sectional survey of 100 out of 138 eligible patients aged 9-19 years with a duration of diabetes over two years who visited the Paediatric Outpatient Clinic at Oulu University Hospital in 1997-1999, and one hundred healthy controls.
Two patients in early or mid-puberty had non-proliferative diabetic retinopathy, but no other signs of microvascular complications.
The five patients with persistent microalbuminuria were all girls; one prepubertal, one late pubertal and three postpubertal. Their mean glycated haemoglobin A1c (HbA1c) was higher, but they had a similar duration of diabetes and age distribution to those without microalbuminuria.
The adolescent patients were predisposed to higher fasting serum total and low-density lipoprotein cholesterol and triglyceride levels and higher diastolic blood pressure than the control subjects. The proportional total body fat was highest in the girls with diabetes by the end of puberty, while serum leptin levels did not differ between the patients and healthy controls. The patients had low fasting serum insulin levels and high insulin-like growth factor-binding protein 1 levels, related to hypoinsulinaemia.
Distal motor nerve function in the lower extremities were already affected before puberty, and distal and proximal nerve function deteriorated as puberty advanced. Ten patients had neurophysiologically confirmed distal diabetic polyneuropathy, and they were older and they had longer duration of diabetes and higher HbA1c than patients without polyneuropathy.
Although cardiovascular function was in the main well preserved in the adolescents with type 1 diabetes, the power spectrum analysis of heart rate variability showed attenuated autonomic nervous system reactivity.
Taken together these data show that a relatively small proportion of adolescents with type 1 diabetes have signs of microvascular complications. The prevalences of diabetic retinopathy, persistent microalbuminuria and distal diabetic polyneuropathy were 2%, 6% and 10%, respectively. Pubertal maturation seems to promote the progression of early signs of microvascular complications in patients affected by type 1 diabetes.
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Harpa, Natasja, und Erika Andersson. „Barn och ungdomars erfarenheter av att leva med diabetes typ 1 : En litteraturstudie“. Thesis, Umeå universitet, Institutionen för omvårdnad, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-132268.
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Bakgrund: Diabetes typ 1 är en stor folksjukdom som främst drabbar yngre människor. Att drabbas av diabetes är påfrestande fysiskt och psykiskt. Det är därför ett viktigt ämne att belysa för att kunna underlätta och förbättra vården av barn och ungdomar med diabetes. Syfte: Syftet med litteraturstudien var att belysa barn och ungdomars erfarenheter av att leva med diabetes typ 1. Metod: Litteraturstudien är en sammanställning av 10 kvalitativa studier där samtliga kvalitetsgranskats, analyserats och sammanställts. Deltagarna i litteraturstudien var 6–22 år gamla. Resultat: Resultatet visade på barn och ungdomars erfarenheter av att leva med diabetes typ 1 från att få diagnosen, ta kontroll över sjukdomen, få stöd från hälsoprofessioner, familj och vänner till att lära sig leva ett förändrat men ”normalt” liv.Konklusion: Att leva med diabetes är en ständig kamp om att leva så normalt och självständigt som möjligt. Detta underlättas genom stöd och tillräcklig information från familj och vårdpersonal. Denna fördjupande kunskap och förståelse av barn och ungdomars erfarenheter av att leva med diabetes kan bidra till förbättrad diabetesvård som kan underlätta för dessa att leva ett gott liv trots diabetes.Background: Diabetes type 1 is a large endemic disease that mainly affects younger people. Diabetes has shown to be straining physically and psychologically and is an important subject to highlight to ease and improve the care for adolescents with diabetes. Purpose: The aim with this literature study was to highlight children and adolescents experience of living with diabetes type 1. Method: The literature study is a compilation of 10 qualitative studies that has been quality reviewed, analysed and compiled. The participants in the study was 6-22 years old. Results: The result showed children and adolescents experiences of living with diabetes type 1. From being diagnosed, taking control of the disease, getting support from healthcare, family and friends to learning how to live a changed but “normal” life.Conclusions: To live with diabetes is a constant struggle to live as normal and independent as possible. This facilitates with care and information from family and health professionals. Increased knowledge and understanding of children and adolescence experience of living with diabetes may help to improve diabetes healthcare which can ease their life despite diabetes.
24
MacRae, Lesley-Anne. „An interpretative phenomenological exploration of insulin dependent diabetes mellitus during adolescence : the lived experience“. Thesis, Glasgow Caledonian University, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.555792.
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Adolescence has been shown to be a critical time for effective self-management of insulin-dependent diabetes mellitus (IDDM) with many individuals struggling to achieve optimal levels of self-care. This study explored the experience of adolescent life with IDDM via the use of qualitative interviews, the transcripts of which were analysed using Interpretative Phenomenological Analysis (JP A). Ten adolescents between the ages of 16 and 19 years were interviewed, using'a semi-structured interview technique. Three recurrent themes were elicited across the data set and are presented within this thesis. These are: the view of IDDM as an illness, the emotional cost of IDDM, and the relationship with health care professionals. These themes allow a dialogue to continue between health-based research and that of service provision. The first theme, 'View of IDDM as an Illness', demonstrated that IDDM was often perceived as being a complex, unpredictable and at times difficult to manage illness that demanded routine. It was also perceived as incurring self-management challenges including those that were more social in nature (for example, restricting certain aspects of adolescent life). The second theme, 'The emotional cost of IDDM', indicated that experience of negative emotions, anxiety, fear and frustration in particular, was commonplace for a number of the adolescents. The source of these emotions was widespread and included peer interactions, how IDDM was perceived as an illness, difficulties inherent in achieving and maintaining good metabolic control and also those that related to the third theme, namely 'Relationship with Health Care Professionals' . Within this third theme, factors such as trust and entitlement to 3 information regarding IDDM were core features, with negative emotional states being induced when these needs were not met. Inherent within all of these themes and sub-themes was the role of emotions. They were found to be central determinants of not only the ways in which IDDM was represented but they were also seen to guide coping in terms of self-management decisions and behaviours. When considered in terms of the current literature a number of similarities and distinctions were found. Current predictive models commonly treat each construct as independent units. The present results show that complex relationships may exist, often with considerable emotional associations. Crucially, it is proposed that the metabolic implications of such emotional experience are not given sufficient attention in the current literature. With regards to ways in which the adolescents coped with the emotional experience of IDDM, the present fmdings demonstrate that aspects from a number of models of stress and coping could be applied but that one model on its own was insufficient. Any future model has to appreciate the impact of emotions in not only initial appraisals of health threats but also their contribution to subsequent appraisals of coping dependent on the behavioural outcome, in addition to the emotional outcomes and the impact of these on IDDM-specific cognitions, self-management and metabolic stability.
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Viklund, Gunnel. „Education for Teenagers with Type 1 Diabetes“. Doctoral thesis, Uppsala universitet, Institutionen för medicinska vetenskaper, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-9391.
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Education for teenagers with diabetes has had limited effects to date, especially regarding metabolic control. The development had been towards more patient-centred approaches, like empowerment, motivational interviews and family behavioural programmes. A patient-centred approach means that the patient is expected to take control of the management of the disease. The empowerment approach has been implemented in adults with diabetes, with some positive results. The aims of this thesis were to evaluate empowerment group education and education in a camp setting, and to validate the “Check your health” instrument which can be used to assess the effects of such education programmes on perceived health and the burden of diabetes. Thirty-two teenagers between 12 and 17 years of age were randomized to either an intervention group or a wait-listed control group. The intervention consisted of six group sessions with an empowerment approach as the theoretical frame. Thirty-one of the teenagers were interviewed two weeks after the empowerment education programme was completed. The programme did not have any positive effect on metabolic control between-groups, but within groups HbA1c and readiness to change increased. According to the definition of empowerment, which pinpoints decision-making, the interviews were analysed with that in focus. In the interviews the teenagers described five categories they perceived as important for decision-making competence: cognitive maturity, personal qualities, experience, social network and parent involvement. Parent involvement was described as both constructive and destructive. These categories were interpreted in the overall theme that “teenagers deserve respect and support for their shortcomings during the maturity process”. Ninety teenagers between 14 and 17 years of age attended education in a camp setting and were compared to a reference group, who had declined participation. The camp did not have any positive effect on metabolic control, but the frequency of insulin pump use after camp education increased. In a cross-sectional comparison, the campers had more positive attitudes towards diabetes and self-care than the non-campers did. The “Check your health” instrument was tested for reliability and validity in 199 teenagers between 12 and 17 years of age. The instrument was found to be reliable and valid for use on a group level in teenagers with diabetes. In conclusion, empowerment education programmes should be tailored to suit young people with diabetes, and should preferably be integrated into routine care. Teenagers who prefer individual education may be offered an individual education plan. Parents should be involved in all education of teenagers with diabetes, with the purpose of increasing teamwork and decreasing control and conflict. Continued assessment of teenagers perceived health and perceived burden of diabetes can be carried out using the “Check your health” instrument.
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Markowitz, Jessica Tuttman Lowe Michael R. „Body mass index and disordered eating in adolescent females with Type 1 Diabetes /“. Philadelphia, Pa. : Drexel University, 2008. http://hdl.handle.net/1860/2806.
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Blom, Evelina, und Isabelle Berggren. „Barns upplevelse av att leva med diabetes mellitus typ 1 : En litteraturstudie“. Thesis, Högskolan i Borås, Akademin för vård, arbetsliv och välfärd, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-11825.
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Diabetes mellitus typ 1 är en autoimmun sjukdom, vilket innebär att immunsystemet ser betacellerna i bukspottskörteln som främmande och angriper dem. Cellerna kan då inte producera insulin längre, vilket är ett livsviktigt hormon för kroppen. I Sverige insjuknar cirka två barn varje dag i diabetes mellitus typ 1. Sjukdomen påverkar barnets vardag och kommer alltid vara en styrande del genom livet. Många barn oroar sig över hypoglykemi samt andra komplikationer som är relaterade till sjukdomen. Syftet med studien är att beskriva upplevelser av hur vardagen påverkats hos barn som är diagnostiserade med diabetes mellitus typ 1. Metoden är en sammanställning av empirisk data och baseras utifrån Axelssons (2012) modell. Studien innehåller 11 artiklar som består av både kvalitativa och kvantitativa ansatser. Examensarbetet fokuserar på barn i åldern 6-14 år och artiklarna i studien belyser upplevelsen av att leva med diabetes mellitus typ 1. Resultatet visade att barnen upplevde känslor av utanförskap och att de kände sig annorlunda jämfört med sina vänner. Familjen hade en betydelsefull roll för barnen och sjukdomen påverkade även omgivningen. Resultatet presenteras utifrån fyra huvudkategorier och tio subkategorier. I diskussionen belyser vi känslan av att vara barn och leva med en kronisk sjukdom, familjens betydelse samt att förlika sig med sjukdomen. En grundläggande aspekt som framkommer i diskussionen är även vikten av adekvat och individanpassad information efter barnets utvecklingsnivå.
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Cosson, Ionar Cilene de Oliveira. „Aspectos de saúde relacionados a fatores de risco para o DM2 em adolescentes do Município de Rio Branco - AC, Brasil“. Universidade de São Paulo, 2011. http://www.teses.usp.br/teses/disponiveis/6/6132/tde-17052012-091217/.
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Introdução: O diabetes é considerado um problema crescente de saúde pública, devido o aumento da sua incidência e prevalência, principalmente na infância e na adolescência, além da sua inclusão entre as dez principais causas de mortalidade no Brasil e no mundo. Objetivos: Conhecer aspectos da saúde relacionados aos fatores de risco para o DM2 em adolescentes do ensino público do Município de Rio Branco Acre e a percepção dos pais dos adolescentes sobre a doença diabetes, assim como sinais e sintomas, medidas preventivas e suas aspirações sobre o tema. Procedimentos Metodológicos: O estudo quanti-qualitativo foi do tipo transversal com amostragem probabilística e representativa de 720 adolescentes, de ambos os sexos e com idades entre 10 e 18 anos, matriculados nas escolas públicas do ensino fundamental, da área urbana do Município de Rio Branco Acre. A análise estatística foi do tipo descritiva: distribuição de frequência, medidas de tendência central e medidas de dispersão. Os testes de Qui-quadrado de Pearson e Fischer foram utilizados para verificar possíveis associações entre as variáveis categóricas e, para verificar a diferença de médias, o teste t de Student. Para o estudo qualitativo utilizou-se a técnica de grupo focal e a análise de conteúdo na amostra constituída por seis pais de adolescentes com glicemias de jejum alteradas/limítrofes. Para a coleta de dados foram utilizados os seguintes instrumentos: questionário socioeconômico e demográfico, o Rec24h, para avaliação do consumo alimentar e o IPAQ para avaliação do nível da atividade física, além do roteiro semi-estruturado para a condução do grupo focal. Resultados: Dos 720 adolescentes, 51,8por cento eram do sexo feminino, com média de idade de 12,73 anos, (dp ± 1,57), variando entre 10 e 18 anos; a etnia autorreferida predominante foi a branca 576 (80por cento ). Foi possível observar que 153 (21,3por cento ) estavam com sobrepeso, 273 (37,9por cento ) sedentários, além de 244 relatos de história familiar de diabetes. O sexo masculino apresentou maior média de consumo de energia, macronutrientes e fibras. A média glicêmica foi de 55,18mg/dl, com 10 (1,4por cento ) adolescentes apresentando glicemia plasmática de jejum alterada/limítrofe. As frequências entre a associação de fatores de risco para o diabetes foi maior entre 2 (87,8por cento ) que 3 (12,2por cento ) fatores. O grupo de pais demonstrou ter conhecimento de alguém diabético com relacionamento familiar ou social, dificuldade em entender o processo de manifestação da doença e interesse em conhecer os fatores de risco da mesma. Conclusão: Os fatores de risco para o diabetes estão presentes entre os adolescentes do Município de Rio Branco AcreIntroduction: Diabetes is considered a growing public health problem because of its increased incidence and prevalence, especially during childhood and adolescence in addition to its inclusion among the ten leading causes of death in Brazil and all over the world. Objectives: To find out what are the health aspects related to risk factors for type 2 diabetes in adolescents from the public school system in the city of Rio Branco - Acre and to find out what is the perception of the parents of teenagers about diabetes, as well as what are the signs and symptoms, the preventive measures and their expectancies regarding this issue. Methodological Procedures: This quantitative and qualitative study was cross-sectional study with probability sampling representing 720 adolescents of both sexes and aged between 10 and 18 years, who were enrolled in public primary schools in the urban area of the municipality of Rio Branco - Acre. The statistical analysis was descriptive: frequency distribution, central tendency measures and dispersion measures. The Chi-square tests of Pearson and Fischer were used to investigate possible association among the categorical variables and to detect averages differences we used the \"t\" Student test. For the qualitative study we used the focus group technique and the content analysis on a sample of six parents of adolescents with impaired / borderline fasting glucose. To collect data we used the following instruments: socioeconomic and demographic questionnaire and anthropometric data, Rec24h to assess dietary intake and the IPAQ to evaluate the level of physical activity, besides the semi-structured guidelines to conduct the focus group. Results: Of 720 adolescents, 51.8per cent were female, mean age of 12.73 years (SD ± 1.57), ranging between 10 and 18 years, the predominant self-reported ethnicity was Caucasian 576 (80 per cent ). It was observed that 153 (21.3per cent ) were overweight, 273 (37.9per cent ) sedentary, besides the 244 reports of a family history of diabetes. Males had higher mean intake of energy, macronutrients and fiber. Mean blood glucose was 55.18 mg / dl, with 10 (1.4per cent ) adolescents with fasting plasma glucose impaired / borderline. The frequency among factor associat ion of risk factors for diabetes was higher between 2 (87,8per cent ) than 3 (12,2per cent ) factors.The group of parents demonstrated, through their statements that they knew someone with diabetes in their family or social relationships; they had difficulties to understanding the disease manifestation process and they were interested in getting to know which were the risk factors. Conclusion: The risk factors for diabetes are present among the adolescents in the city of Rio Branco Acre.
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Maher, Kathryn. „THE EFFECT OF YOUTH DIABETES SELF-EFFICACY ON THE RELATION AMONG FAMILY CONFLICT, DISEASE CARE AND GLYCEMIC CONTROL“. VCU Scholars Compass, 2014. http://scholarscompass.vcu.edu/etd/3495.
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The aim of the current study was to examine the associations among youth diabetes self-efficacy, family conflict, disease care and glycemic control via a comprehensive path model. Data were from a baseline assessment of a longitudinal RCT of 257 adolescent/parent dyads (adolescents aged 11–14). Each member of the dyad separately completed the Self-efficacy for Diabetes Self-Management Scale, Family Environment Conflict subscale, Diabetes Family Conflict Scale, Diabetes Behavior Rating Scale, and 24-hr Diabetes Interview Blood Glucose Frequency subscale. Additionally, a biological marker of glycemic control, or HbA1c, and relevant demographic variables were collected. A mediation model found higher youth diabetes self-efficacy mediated the link between lower family conflict and better disease care (β = -.08, p <.01) to glycemic control (β = .05, p <.05.). Further, the relation of higher self-efficacy to better glycemic control was mediated by better disease care (β = -.06, p <.05). Higher youth diabetes self-efficacy (β = -.16, p <.05), lower family conflict (β = .19, p <.001), and better disease care (β = -.17, p <.01) each were directly related to better glycemic control. The overall model with relevant demographic factors fit the data well [χ² (2) = .50, p = .78, CFI = 1.00, RMSEA= .00] and accounted for 13% of the variance in self-efficacy, 32% of the variance for disease care, and 25% of the variance in glycemic control. Interventions that target better youth diabetes self-efficacy and lower family conflict concurrently may promote better disease care and glycemic control.
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Eliasson, Sandra, und Josefine Sandström. „Ungdomars upplevelse av att leva med diabetes mellitus typ 1 : En litteraturstudie“. Thesis, Högskolan i Borås, Akademin för vård, arbetsliv och välfärd, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-9979.
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Bakgrund: Diabetes mellitus typ 1 är en autoimmun sjukdom och antalet som insjuknar ökar varje år. Under ungdomstiden sker mycket i människans kropp och det kan vara en utmaning att balansera blodsockernivåer när hormonerna i kroppen svajar. Ungdomar med diabetes mellitus typ 1 står därför inför stora utmaningar för att lyckas med sin behandling. Syfte: Syftet är att belysa ungdomars upplevelser av att leva med diabetes mellitus typ 1. Metod: Metoden är en litteraturstudie baserad på både kvalitiva och kvantitativa studier. Analysen är genomförd utifrån en modell av Axelsson (2012). Resultat: I resultatet framkom att ungdomarna med diabetes mellitus typ 1 växte in i rollen i att bli mer självständiga i sin behandling. Detta var inte alltid lätt. Ungdomarna påverkades av hur deras vänner bemötte diagnosen, hur de blev bemötta av vården samt hur villiga deras föräldrar var att lämna över ansvaret. Resultatet presenteras utifrån fyra huvudteman samt nio subteman. Diskussion:I diskussionen tar vi upp vikten av att jobba med målet att patienten ska få kunskap så att denne kan sköta sin behandling självständigt. Vikten av stöd för att motverka känslor av skam för sjukdomen och dess behandling belyses också.
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Sander, Emily Paige. „Group-based, Family-focused Intervention for Family Conflict and Treatment Adherence In Adolescents with Type I Diabetes: A Feasibility and Efficacy Study“. Xavier University / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=xavier1401308861.
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Elleri, Daniela. „Closed-loop insulin delivery in children and adolescents with type 1 diabetes“. Thesis, University of Cambridge, 2014. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.648562.
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Santos, Inês Dias Duque dos. „A influência da diabetes na qualidade de vida do adolescente: Estudo de caso“. Master's thesis, ISPA - Instituto Universitário, 2013. http://hdl.handle.net/10400.12/2770.
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Dissertação de Mestrado em Psicologia Clínica apresentada ao ISPA - Instituto UniversitárioO presente estudo centra-se na análise do impacto da doença crónica, neste caso da Diabetes tipo 1, na qualidade de vida de um adolescente. Assim, este estudo teve como principal objetivo conhecer e compreender o modo como o adolescente com Diabetes tipo 1 vivencia a sua experiência de doença nesta fase do desenvolvimento onde se dão inúmeras mudanças, refletindo sobre os fatores que influenciam positiva e negativamente a qualidade de vida nesta mesma situação de doença, através da realização de um estudo de caso. Fez parte da presente investigação um adolescente do sexo masculino, portador de Diabetes tipo 1, com 13 anos. O instrumento utilizado para a recolha de dados foi uma entrevista semi-estruturada, que vai de encontro à temática em estudo. Esta entrevista divide-se em quatro grupos: Informação Pessoal; Relações Familiares; Qualidade de Vida – O Antes e o Depois de ser Diabético; Vida Interior. Os resultados obtidos revelaram que a situação de doença crónica tem repercussões na vida interior do adolescente, afetando o processo de autonomização, o autoconceito, os sonhos e o modo como se desenrolam as relações interpessoais. De todos estes fatores emergem sentimentos de revolta, ansiedade e inferioridade, uma fragilidade interior e surgimento de traços depressivos. São então aspetos que tem implicações, na sua maioria negativas na qualidade de vida. Existem também aspetos que influenciam positivamente a qualidade de vida do adolescente, como o apoio proveniente da família e grupo de pares, bem como traços de personalidade característicos do adolescente que lhe possibilitam um certo equilíbrio emocional.
ABSTRACT: The present study focuses on the analysis of the chronic disease impact, in this specific case the Diabetes Type 1, on the adolescent’s quality of life. So, this study has as its major goal, to know and understand how an adololescent with Diabetes Type 1 , experiences the illness within his personal development process, in which, several changes occur, thinking over the factors that affect in positive and negative ways the quality of life in this illness scenario, based on a case study. This investigation was done on a mail adolescent, with Diabetes Type 1, 13 years old. The instrument used to data collection was a semi-structured interview, that goes towards the theme of study. This interview is splitted in four sections: Personal Information; Family Relationships; Quality of Life – the before and the after of being Diabetic; Internal Life. The results obtained reveal that the situation of chronic disease, has impact on the adolescent internal life, afecting the empowerment process, the image of himself, his dreams and on how interpersonal relationships are developed. From all these factos, feelings of rebellion, anxiety and inferiority arise, together with an internal weakness and the emergence of depressive signs. So, they are mainly aspects that have a negative impact on the his quality of life. However , there are also some aspects that show a positive impat on his quality of life, such as the family and peers’ support, as well as personal characteristics that help him to reach a certain emotional balance.
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Duffin, Anthony C. „Structural and functional changes in the feet of young people with Type I Diabetes Mellitus /“. View thesis, 2002. http://library.uws.edu.au/adt-NUWS/public/adt-NUWS20030724.100739/index.html.
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Holker, Vickie M. „Adolescent diabetic treatment adherence and the impact of parental involvement“. Laramie, Wyo. : University of Wyoming, 2008. http://proquest.umi.com/pqdweb?did=1798480951&sid=1&Fmt=2&clientId=18949&RQT=309&VName=PQD.
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Perez, Luciana Cassarino. „Adolescentes com diabetes melito tipo I : resiliência, qualidade de vida e suporte social“. reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2013. http://hdl.handle.net/10183/76535.
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Esta dissertação está composta de três estudos que investigaram aspectos de resiliência, qualidade de vida e suporte social em adolescentes com diabete melito tipo 1 (DM1). O primeiro estudo consiste de uma revisão sistemática da literatura sobre resiliência e suporte social em adolescentes com DM1. Em geral os estudos revisados relacionam o suporte social com a melhora no controle glicêmico, manejo da doença e adesão ao tratamento. No segundo estudo buscou-se identificar possíveis correlações entre as variáveis qualidade de vida e suporte social em adolescentes com DM1. Participaram 102 adolescentes, 46 meninos e 56 meninas, entre 12 e 17 anos, pacientes de um serviço de atendimento da cidade de Porto Alegre. Os participantes responderam aos instrumentos KIDSCREEN-52 e Versão Brasileira do Social Support Appraisals. Foi verificado que de forma geral os adolescentes avaliam bem sua qualidade de vida e o suporte social recebido, sendo que as variáveis apresentaram correlação positiva moderada. O terceiro estudo investigou processos de resiliência em adolescentes com DM1, identificando fatores de risco e proteção, através de estudos de caso múltiplos. Participaram três adolescentes, uma menina e dois meninos, entre 13 e 14 anos, também pacientes do serviço de atendimento, e suas mães. Os instrumentos utilizados foram entrevistas semiestruturadas e o Mapa dos Cinco Campos. Constatou-se que fatores de proteção como suporte social, vinculação afetiva e características pessoais de autoestima, otimismo e altruísmo, contribuem para a manifestação de processos de resiliência. Destaca-se a importância de fortalecer a rede de apoio como fator de proteção para o enfrentamento do DM1, principalmente através da integração entre os diferentes contextos nos quais o adolescente está inserido.This dissertation is composed of three studies that investigated aspects of resilience, quality of life and social support of adolescents with type 1 diabetes. The first study consists of a systematic review of literature about resilience and social support in adolescents with type 1 diabetes. Most of the studies reviewed demonstrated that social support is related with the improvement of glycemic control, disease management and treatment adherence. The second study investigated correlations between quality of life and social support in adolescents with type 1 diabetes. In total, 102 adolescents, 46 boys and 56 girls, between 12 and 17 years old, participated in the study. Participants were patients of a healthcare program in the city of Porto Alegre. Two questionnaires, the KIDSCREEN-52 and the Brazilian version of Social Support Appraisals were used to evaluate quality of life and social support. Results showed positive moderate correlation between the variables, and good assessment of quality of life and social support. In the third part of the research, study case method was used to identify risk and protective factors and to investigate processes of resilience in adolescents with type 1 diabetes. Three adolescents, one girl and two boys, between 13 e 14 years old, and their mothers participated in the study. Semi-structured interviews and the Five Field Map were used as instruments. It was found that social support, close bonds and personal characteristics such as self-esteem, optimism and altruism, contribute to the development of resilience processes. The research highlights the importance of strengthening the support network as a protective factor for coping with T1D, particularly through the integration between the different contexts in which the adolescent is inserted.
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Robinson, Elizabeth M. „The Contribution of Parent Psychosocial Functioning to Parental Monitoring, Youth Adherence, and Glycemic Control during Adolescence“. VCU Scholars Compass, 2014. http://scholarscompass.vcu.edu/etd/3908.
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Objective: Type 1 diabetes is one of the most common pediatric chronic illnesses. Adolescents are at risk for poorer adherence and in turn, poorer glycemic control; however, youth whose parents remain involved in diabetes care are in better control. A parent’s level of involvement is dependent in part upon his or her own social and emotional functioning. Much is known about the link between separate aspects of parent psychosocial functioning (e.g., depressive symptoms, parental stress) and parent involvement in diabetes care, adherence, and glycemic control. However, no study to our knowledge has examined these constructs simultaneously as they interrelate to one another and to youth diabetes status. Given the complexity of human behavior, use of multiple indicators of parent psychosocial status should provide a comprehensive portrayal of precursors to parental monitoring. Methods: The current study used structural equation modeling (SEM) in a sample of 257 parent-youth (aged 11-14) dyads (91% mothers) to examine comprehensive parent psychosocial functioning including parental distress, authoritative parenting, and parental self-efficacy for diabetes management as related to parental monitoring, youth adherence and glycemic control. Results: The SEM model fit the data well [χ2 (121) = 209.24, p < .001, CFI = .93, TLI = .91, RMSEA = .06, SRMR = .08]. Overall, the model accounted for 30% of the variance in parental monitoring, 27% of the variance in adherence, and 22% of the variance in glycemic control. Specifically, lower levels of parental distress (i.e., depressive symptoms, parenting stress, and hypoglycemic fear) related to higher parental self-efficacy for diabetes management and more authoritative parenting, each of which in turn related to more parental monitoring. Further, higher parental self-efficacy related directly to better youth adherence. Conclusions: The current study shows interrelated paths of parent psychosocial functioning associated with parental monitoring of youth diabetes care and ultimately, youth adherence and glycemic control. Interventions that target diabetes adherence in adolescents with T1D should consider screening for and treatment of parental distress.
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Vict?rio, Vanessa Marques Gibran. „Adolescentes com Diabetes Mellitus Tipo 1: Estresse, enfrentamento e ades?o ao tratamento“. Pontif?cia Universidade Cat?lica de Campinas, 2016. http://tede.bibliotecadigital.puc-campinas.edu.br:8080/jspui/handle/tede/853.
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Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES
Type 1 Diabetes Mellitus (DM1) is a chronic health condition characterized by excess blood glucose and deficient production of insulin by the pancreas, requiring daily intake of insulin for metabolic control. Metabolic control is affected by psychosocial variables, especially during adolescence, a phase in which individuals are at the risk of stress responses. The way adolescents deal with stress partially depends on their coping repertoire. Adaptive coping strategies enable better glycemic control and adherence to treatment, which is based on medication and self-care behavior, such as following a specific diet, blood sugar monitoring and exercising. Considering the characteristics of this development phase and DM1, this study analyzed the relationships among stressors, coping and treatment adherence in adolescents with DM1 based on the Motivational Theory of Coping. Ten adolescents participated in the study, five of each sex, aged between 12 and 15 years old, with a medical diagnosis of DM1, attending elementary/middle school (7) or high school (3). A sociodemographic questionnaire including the Brazil Economic Classification Criteria, the Diabetes Self-Care Activities Measure (DSCA), the Questionnaire on Stress in Patients with Diabetes (QSD-R), the Adolescent/Child?s Self-Report Responses to Stress (RSQ-Pediatric Diabetes- DPed) with linguistic validation authorized by the authors, together with the Coping Diabetes Scale for Adolescents (COPE-DIA), especially developed for this study, were individually applied. Data were collected in the Associa??o de Diabetes Juvenil [Juvenile Diabetes Association] facility in Birigui, SP, Brazil and at the adolescents? homes. Data analysis was quantitative using non-parametric statistics and qualitative with the description of two cases. Behavior with greater adherence, verified through DSCA, were Blood glucose monitoring and Medication taking (insulin and/or pills). According to the QSD-R, Stress caused by hypoglycemia was considered the most significant stressor by most adolescents, followed by Therapeutic Regime and Somatic Complaints. The most frequent stressors, according to the two instruments that assessed diabetes stressors, were linked to diabetes treatment and feelings of guilt for not complying with medical recommendations. According to RSQ-D-Ped, the adolescents dealt with DM1 by using the following coping strategies: Involuntary Engagement (Excitement and Rumination) and Secondary Control Coping (Positive Thinking, Acceptance, Distraction and Cognitive Restructuring). According to COPE-DIA, stressors were more frequently considered a challenge than a threat to the individuals? basic needs for Relationship, Competence and Autonomy, presenting the following coping strategies: Search for Information, Search for Support, Problem-Solving, Isolation (related to the need of Relationship), Escape, Delegation and Helplessness (related to the need of Competence). Anger was the most frequently reported emotional response. Coping seems to affect the relationship between the therapeutic regimen and exercise. This analysis of motivational variables involved in the process of treatment adherence among adolescents with diabetes provided prescriptive data for future interventions directed to this population. This study also contributed to the field of research proposing a more developmentalist analysis of variables relevant for treatment adherence in this age group.
O Diabetes Mellitus Tipo 1 (DM1) ? uma condi??o cr?nica de sa?de caracterizada pelo excesso de glicose no sangue e produ??o deficiente de insulina pelo p?ncreas, exigindo a ingest?o di?ria de insulina para o controle metab?lico. Este ? afetado por vari?veis psicossociais, especialmente durante a adolesc?ncia, que ? uma fase de risco para rea??es de estresse. A forma como o adolescente lida com o estresse depende, em parte, de seu repert?rio de enfrentamento. As estrat?gias de enfrentamento [EE] adaptativas permitem um melhor controle glic?mico e maior ades?o ao tratamento. Este ?ltimo est? baseado em medicamentos e comportamentos de autocuidado, como o seguimento de dieta alimentar, o monitoramento da glicemia e a realiza??o de atividades f?sicas. Considerando as caracter?sticas dessa fase de desenvolvimento e do DM1, esta pesquisa analisou as rela??es entre estressores, o enfrentamento da doen?a e a ades?o ao tratamento, em adolescente com DM1, a partir da Teoria Motivacional do Coping. Participaram 10 adolescentes, 5 de cada sexo, com idade entre 12 e 15 anos e diagn?stico m?dico de DM1; cursavam o Ensino Fundamental (7) e o Ensino M?dio (3). Foram aplicados, individualmente, um Question?rio Sociodemogr?fico, com o Crit?rio de Classifica??o Socioecon?mica Brasil, o Question?rio de Atividades de Autocuidado (QAD), o Question?rio de Estresse Face ? Diabetes-R (QSD-R), o Adolescente/Child?s Self-Report Responses to Stress (RSQ-Pediatric Diabetes- D-Ped), com valida??o lingu?stica autorizada, e a Escala de Coping do Diabetes para Adolescentes (COPE-DIA) especialmente elaborada. Os dados foram coletados na Associa??o de Diabetes Juvenil (ADJ), na cidade de Birigui/SP e nas resid?ncias dos adolescentes. A an?lise de dados foi quantitativa, atrav?s de an?lise estat?stica n?o param?trica, e qualitativa, com descri??o de dois casos. Os comportamentos do QAD com maior ades?o foram: Monitoramento da glicemia e Uso de Medica??o (insulina e/ou comprimidos). O Estresse Face ? Hipoglicemia foi considerado o estressor mais significativo pela maioria dos adolescentes, seguido do Regime Terap?utico e das Queixas Som?ticas, no QSD-R. Considerando os dois instrumentos que avaliaram os estressores do diabetes, foram mais frequentes aqueles ligados aos cuidados com o tratamento do diabetes e ao sentimento de culpa pelo n?o cumprimento das orienta??es m?dicas. Os adolescentes lidavam com o DM1 com EE de Engajamento Involunt?rio (Excita??o Emocional e Rumina??o) e Engajamento de Controle Secund?rio (Pensamento Positivo, Aceita??o, Distra??o e Reestrutura??o Cognitiva), segundo o RSQ-D-Ped. Pelo COPE-DIA, avaliaram os estressores mais como um desafio do que amea?a ?s suas necessidades b?sicas de Relacionamento, Compet?ncia e Autonomia, apresentando EE de Busca de Informa??o, Busca de Suporte, Resolu??o de Problemas, Isolamento (relativos ? necessidade de Relacionamento), Fuga, Delega??o e Desamparo (relativos ? necessidade de Compet?ncia). A rea??o emocional de raiva foi a mais frequente. O coping parece afetar a rela??o entre o regime terap?utico e a atividade f?sica. Essa an?lise das vari?veis motivacionais envolvidas no processo de ades?o ao tratamento em adolescentes com diabetes forneceu dados prescritivos para futuras interven??es com essa popula??o. Contribui tamb?m para a ?rea de pesquisa, ao propor uma an?lise mais desenvolvimentista das vari?veis relevantes ? ades?o ao tratamento nessa faixa et?ria.
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Karlsson, Agneta. „Transition towards autonomy and psychological empowerment in self-management, among teenagers with type 1 diabetes“. Licentiate thesis, Linköping University, Linköping University, Health, Activity, Care, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-11025.
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The general aim of this thesis was to study the transition process from dependency towards anatomy and psychological empowerment among teenagers with type 1 diabetes. Thirty-two teenagers (18 female/14 male) aged 13-17 took part in conversational interviews. The interviews followed a semi-structured question guide. Data comprised 31 tape recorded interviews (one informant did not want to be tape recorded). The research design was based on a phenomenological and life world perspective including two different analysis methods.
The transition towards autonomy among teenagers with type 1 diabetes was elucidated in a phenomenological approach (paper I). Through the teenagers’ narratives about their daily life experiences with type 1 diabetes there emerged the over-riding theme “Hovering between individual actions and support of others”. This theme illustrates the main problem related to diabetes management - duality in dependence and independence. The themes “growth through individual self-reliance” and “growth through confirmation of others” seem to facilitate the transition process from dependency towards autonomy. Experiences of the Empowerment Education Programme (EEP) were studied by a qualitative content analysis (paper II). From the teenagers’ descriptions the over-riding theme was formulated as “Sense of community”, and this covered the categories of social fellow feeling, collaborative learning, and community of interests. A synthesis of the findings illustrates that individual self-reliance, confirmation of others, and sense of community are closely related to individual inner resources, trust in others, and the feeling of belonging, which are all suggested as specific goals of empowerment and fulfilment of psychological empowerment. A model was created to explain the relation between psychological empowerment and growth through individual self-reliance, confirmation of others, and sense of community. Professional nursing care might start from the unique situation and context the individual experiences and exists in. Social meetings with like-minded youth were highly appreciated among the teenagers. The teenagers showed their willingness to transform themselves towards becoming more independent in self-management, and the teenage years may be the right period to empower and coach the teenagers towards autonomy and prepare them for adulthood living with type 1 diabetes.
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Johansson, Amanda, und Caroline Santos. „Föräldrars upplevelser av att leva med en ungdom med diabetes typ 1 : En litteraturöversikt“. Thesis, Högskolan i Skövde, Institutionen för hälsovetenskaper, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-19337.
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Bakgrund: Diabetes typ 1 är en kronisk, autoimmun sjukdom där kroppen har en otillräcklig mängd insulin som med tiden upphör helt. Med goda egenvårdskunskaper samt stöttning från föräldrar och sjuksköterska kan ungdomen leva ett gott liv med diabetes. Syfte: Belysa föräldrars upplevelser av att leva med en ungdom med diabetes typ 1. Metod: 10 valda artiklarna sammanställdes i flera steg och utgör grunden av en litteraturöversikt som är analyserade med en kvalitativ innehållsanalys enligt Segesten (2017b). Sökningen genomfördes i databasen CHINAHL. Resultat: Fyra teman identifierades: Rädsla för lågt blodsocker, som uppkom framförallt på natten då inte samma förutsättningar fanns till uppsyn som på dagen. Att släppa taget, där föräldrar upplevde svårigheter att lämna över sitt ansvar över sjukdomen till ungdomen. Hantering av oro, där föräldrar upplever en konstant oro och försöker på olika sätt hanteradet på lämpligaste sätt. Behov av stöd och kunskap, där föräldrar upplever brist påinformation samt känslomässigt stöd från sjukvården. Konklusion: Rädsla för lågt blodsocker var betydligt hos föräldrarna samt deras behov av information och känslomässigt stöd. Kunskap kring sjukdomen visade sig vara central för att kunna fatta bra beslut i ungdomens sjukdom och vård.Backgrund: Type 1 diabetes is a chronic, autoimmune disease in which the body has an insufficient amount of insulin to then cease completely. With good self-care knowledge and support from parents and nurses, young people can live a good life with diabetes. Aim: Illustrate parents experience of living with an adolescence with type 1 diabetes. Method: 10 selected articles were compiled in several steps and forms the basis of an literature review which were analyzed with a qualitative content analysis (Segesten, 2017b). The search was performed in the database CHINAHL. Results: Four themes were identified: Fear of low bloodsugar, which arose mainly at night when the same conditions were not in place as during the day. Letting go showed difficulties for parents in handing over responsibility over the disease to the adolescence. Management of anxiety, where parents experience a constant anxiety and try in different ways to handle it in the most appropriate way. Need for support and knowledge, where parents experience a lack of information and emotional support from the healthcare. Conclusion: Fear of low bloodsugar was significant for the parents and the need for information and emotional support. Knowledge about the disease proved to be important inorder to be able to make good decisions regarding the adolescents care.
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Adhan, Sophia, und Susanne Ahlinder. „Ung och söt : en litteraturstudie som beskriver faktorer inom omvårdnad som har betydelse för compliance hos ungdomar med diabetes typ 1“. Thesis, Röda Korsets Högskola, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:rkh:diva-44.
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Bakgrund:Att vara ung och få en kronisk sjukdom innebär för de flesta en omvälvande förändring i livet som kan påverka hela familjen. Diabetes typ 1 kräver mycket av en ung person och dennes familj, t.ex. att följa ett regelbundet schema för insulinintag, blodsockermätning, att hålla en särskild diet och föra regelbunden dagbok över blodsockervärdena, regelbunden fysisk aktivitet och att hantera lågt eller högt blodsocker. Compliance beskriver hur patientent vid en viss sjukdom följer råd och ordinationer. Syfte: Syftet med litteraturstudien var att beskriva faktorer som har betydelse för compliance hos ungdomar med diabetes typ 1. Metod: Studien var baserad på 11 vetenskapliga artiklar med både kvantitativ och kvalitativ ansats. Resultat: Studien betonade vikten av att sjuksköterskan, den diabetesutbildade sjuksköterskan och föräldrarna i hanteringen av diabetesvård riktar adekvat information till ungdomarna. Ungdomar som har en kronisk sjukdom uppnådde god compliance när de hade energi, viljestyrka, kände motivation samt tog eget ansvar för sin behandling. Störst påverkan på compliance hos dessa ungdomar är när familj och vänner kan medverka, därefter kommer sjukvårdens roll och på tredje plats kommer egenvården. Slutsats: Sjukdomen skapar påfrestningar på familjen och det är viktigt med stöd till den unge från familj- anhöriga och vänner, sjuksköterskan och läkaren. Ungdomar med diabetes typ 1 måste i sitt dagliga liv se till att hålla en jämn och stabil blodsockernivå för att uppnå ett gott behandlingsresultat. Motion förbättrar känsligheten för insulin, ökar förbränningen av glukos, minskar hjärt- och kärlsjukdomar och förebygger fetmaBackground: To be young and have a chronic disease involving the most revolutionary change in life that can affect the whole family. Type 1 diabetes requires a lot from adolescents and their families, such as to follow a regular schedule for insulin intake, blood glucose monitors, to keep a special diet and keep a regular diary of blood glucose control, regular physical activity and to deal with high or low blood sugar. Compliance describes how patients with specific disease follow advice and prescriptions. Aim: The aim of this literature study was to describe the factors that are important for compliance in adolescents with type 1 diabetes. Method: The study was based on 11 scientific articles in both quantitative and qualitative approach. Results: The study emphasized the importance of the nurse, the diabetic trained nurse, and that parents should in the management of diabetes care provide adequate information to adolescents. Adolescents who have a chronic disease achieved good compliance when they had the energy, willpower, motivation and felt responsibility. The factor that has the greatest impact on compliance in adolescents with type 1 diabetes is when family and friends can participate, then the medical establishments and in the third place comes self-care. Conclusion: The disease creates pressures on family and it’s important for the adolescence to have support from families, relatives and friends, nurses and doctors. Adolescents with type1 diabetes must in their daily lives try to keep a steady and stable blood sugar level in order to achieve good treatment outcomes. Exercises improve insulin sensitivity, increase the burning of glucose, reduce cardiovascular disease and prevent obesity.
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Duffin, Anthony C., University of Western Sydney, of Science Technology and Environment College und of Science Food and Horticulture School. „Structural and functional changes in the feet of young people with Type 1 diabetes mellitus“. THESIS_CSTE_SFH_Duffin_A.xml, 2002. http://handle.uws.edu.au:8081/1959.7/408.
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Diabetes can affect the structure and function of the foot, resulting in severe limitation of mobility and reduction of life expectancy. Early warning signs include limited joint mobility (LJM), soft tissue changes, high plantar pressure (HPP), high pressure time integrals (P/TI) and plantar callus. These abnormalities were examined in 216 young people with diabetes and 57 controls. The fingers, toes, ankle subtalar and first metatarsophalangeal joints shows reduced motion and the plantar aponeurosis was thicker in diabetic subjects. Skin thickness was the same for diabetic and control subjects. LJM in the feet was more common in males and older subjects. Subtalar and finger LJM was associated with early sensory nerve changes and finger LJM was associated with retinopathy and higher HbAtc. Thicker plantar aponeurosis was associated with male gander and larger feet. High peak pressure, high P/TI and callus were no more common in diabetic subjects than controls. However, high P/TI and callus were associated with early sensory nerve changes in young people with diabetes. Diabetic subjects with callus were significantly older than those without callus. Those with HPP had higher body mass index and less motion at the first MTP joints than those without HPP. Although plantar callus, HPP and high P/TI were no more common in young people with diabetes these abnormailities may be complicated by diabetes. Cushioning, custom orthoses or both in combination significantly reduced peak pressure and P/TI in diabetic subjects.Doctor of Philosophy (PhD)
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Faulds, Eileen. „Self-Management Among Pre-teen and Adolescent Insulin Pump Users (SPIN)“. The Ohio State University, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=osu1587390858875183.
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Ramkrans, Anders, und Gabriella Söderberg. „Mötet med vården, den egna mognaden och stödet från nära relationer : En litteraturstudie om tonåringars, med diabetes typ 1, upplevelser av vad som utvecklar deras egenansvar för den personliga hälsan“. Thesis, Högskolan i Borås, Institutionen för Vårdvetenskap, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-20547.
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Diabetes typ 1 är en alltmer vanlig sjukdom bland barn och tonåringar. Att vara tonåring och samtidigt ha en kronisk sjukdom är en utmaning och ställer krav på tonåringen. Tonårstiden kretsar kring att frigöra sig från sina föräldrar och utveckla sin egen identitet. Sjukvården har ett stort ansvar att ge en så god vård som möjligt och hjälpa tonåringen genom denna period i livet då tonåringen ska utveckla ett egenansvar för sin diabetes och hälsa.Syftet med denna uppsats var att belysa tonåringars, med diabetes typ 1, upplevelser av vad som utvecklar deras egenansvar för den personliga hälsan. Uppsatsens är en litteraturstudie bygger på kvalitativa vårdvetenskapliga artiklar. Analys har genomförts med kvalitativ innehållsanalys.I resultatet framkom att tonåringars upplevelser av vad som utvecklar deras egenansvar för den personliga hälsan var mötet med vården, den egna mognaden och stödet från nära relationer.Under arbetets gång har vikten av livsvärldsperspektivet och patientperspektivet tydliggjorts för att hjälpa tonåringen i utvecklandet av ett egenansvar för sin hälsa.Nyckelord: Diabetes, Adolescence, self care, teenager, patientperspective, healthProgram: Sjuksköterskeutbildning
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Teneralli, Rachel Ellen. „EXAMINING THE RELATIONSHIP BETWEEN EARLY LIFE ANTIBIOTIC EXPOSURE AND RISK OF AN IMMUNE MEDIATED DISEASE DURING CHILDHOOD THROUGH ADOLESCENCE“. Diss., Temple University Libraries, 2018. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/527904.
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Public HealthPh.D.
Rates of immune-mediated diseases (IMDs) have rapidly increased. Although the exact etiology has not yet been fully elucidated, disruptions to the microbiome has been proposed as a potential mechanism. We conducted a retrospective, longitudinal, birth cohort study utilizing electronic health records (EHR) to investigate the association between early life antibiotic exposure and the risk of developing juvenile idiopathic arthritis (JIA), pediatric psoriasis, or type 1 diabetes. Incident rate ratios (IRR) were estimated using modified Poisson regression models and adjusted for significant confounders. Children exposed to two or more antibiotics prior to 12 months of age had a 69% increased risk of developing JIA (1.69 IRR, 95% CI [1.04-2.73]), which rose to 97% when exposed prior to 6 months (1.97 IRR, 95% CI [1.11-3.49]). Children exposed to a penicillin antibiotic had a 62% increase in risk for psoriasis (1.62 IRR, 95% CI [1.06-2.49]), which rose slightly to 64% when exposure occurred between 6 and 12 months of age [(1.64 IRR, 95% CI [1.04-2.59]). We found a moderate to strong association between early antibiotic exposure and risk for JIA and psoriasis when exposure was examined by age, frequency, and type of antibiotic, but not for type 1 diabetes. Potential interactions effects between infection and antibiotics with an increased susceptibility to early life infections among children with an IMD was also observed. Overall, children exposed to antibiotics at an early age have an increased probability of developing an IMD after 12 months of age. However, alternative explanations for this association should be considered.
Temple University--Theses
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Gilmour, Vairi A. W. „Parents' experiences during the transition from childhood to adolescence with Type 1 Diabetes : parent-child relationships and support received during this time and clinical research portfolio“. Thesis, University of Glasgow, 2016. http://theses.gla.ac.uk/7598/.
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Background: Type 1 Diabetes (T1D) management often worsens as children become adolescents. This can be a difficult time for parents as they hand over responsibility of diabetes management to their adolescent. Objectives: To look at the experiences of parents with a child with T1D as they move to adolescence and take more responsibility for their diabetes management. To find out about parents’ experience of support during this transition. Subjects: Three parents of adolescents with T1D. Participants were recruited from the NHS Highland Paediatric Diabetes Service. Methods: Participants took part in a one-to-one semi-structured interview with a researcher. Interpretative Phenomenological Analysis was used to analyse the interviews and find common themes across the interviews. Results: Participants experienced worry throughout their child’s transition to adolescence. They found it difficult to let their child take responsibility for their diabetes but acknowledged that their involvement caused tensions with their adolescent. Participants’ experience was that there were a number of practical adjustments to be made with a diagnosis of T1D and educating the network around their child was important. The participants reported that the diagnosis of T1D had an impact on the whole family and not just the child with the diagnosis. The parents felt well supported medically but said that the amount of time before their first clinic appointment felt too long. All participants had concerns about their adolescent moving to the adult diabetic service. Conclusions: Participants experienced worry relating to aspects of their adolescents T1D that they could not control, but were aware of the tensions caused by trying to keep elements of control. Areas of future research were identified.
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Cheetham, Tim D. „The growth hormone/insulin-like growth factor I axis in insulin-dependent diabetes mellitus during adolescence : studies of recombinant human insulin-like growth factor I (rhIGF-I) administration“. Thesis, University of Leicester, 1996. http://hdl.handle.net/2381/34300.
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The fall in insulin sensitivity during adolescence is accentuated in insulin-dependent diabetes mellitus (IDDM) and has been linked to enhanced growth hormone (GH) secretion. The rise in GH release is related to low insulin-like growth factor I (IGF-I) levels and low IGF bioactivity. Abnormalities of the IGF binding proteins (IGFBP's), including low insulin-like growth factor binding protein-3 (IGFBP-3) and elevated insulin-like growth factor binding protein-1 (IGFBP-1) concentrations are also observed. The rise in GH concentrations may lead to increased insulin requirements that cannot easily be met by current treatment regimens and can result in deteriorating blood glucose control. GH release also enhances ketogenesis and has been linked to the development of microvascular complications. The impact of a subcutaneous injection of rhIGF-I (40 mug/kg) on GH concentrations, insulin sensitivity and the IGFBP's was studied in adolescents with IDDM (n=17). A control night was compared with a night when rhIGF-I was administered at 18.00h. Blood samples were taken regularly overnight and glucose concentrations controlled by a variable-rate insulin infusion. GH concentrations on the control night correlated with glycated haemoglobin levels. The administration of rhIGF-I led to a sustained increase in IGF-I levels, IGF bioactivity and reductions in GH secretion and the insulin infusion requirements to maintain euglycaemia. The change in GH secretion was due to reduced pulse amplitude rather than pulse frequency. The attributes assessing GH release correlated with free insulin concentations on control and rhIGF-I nights, and the reduction in GH release was related to the fall in insulin levels. The concentrations of IGFBP-3 did not fall after rhIGF-I as they did during the control study, but IGFBP-1 levels were unchanged. In longer term studies (n=6), daily rhIGF-I administration (40 ug/kg) for one month led to a reduced isophane insulin dose and a fall in glycated haemoglobin concentrations. GH levels were reduced and IGFBP-3 concentrations rose in 5 of the 6 subjects studied. The administration of rhIGF-I may have a therapeutic role in IDDM during adolescence by reducing GH concentrations and increasing insulin sensitivity.
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Hillege, Sharon Patricia, University of Western Sydney, College of Social and Health Sciences und School of Applied Social and Human Sciences. „The impact of type 1 diabetes on the self of adolescents and young adults“. THESIS_CSHS_ASH_Hillege_S.xml, 2005. http://handle.uws.edu.au:8081/1959.7/175.
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This qualitative study was designed to gain an insight into the ways in which adolescents and young adults managed ?self? in their day - to - day diabetes management. It also examined the effect that illness self representations had on that management. A grounded theory approach using a symbolic interactionist framework was adopted based on 27 in- depth semi structured interviews with adolescents and young adults with diabetes. Respondents described the effects of diabetes management on the physical, emotional, social and related selves. They also described their various illness self representations. It often took an inordinate amount of work for the respondents to manage their diabetes. This ?management? work could be related to problems with their physiological control, emotional stressors, the need to be socially interactive, differing priorities or relational issues. Certainly even the most resilient respondents experienced periods of vulnerability and needed to nurture the ?self? The study generates new knowledge which builds upon the existing body of knowledge relating to the management of self in adolescents and young adults in the context of T1DM. The study established that whilst some health professionals are sensitive and cognizant of the needs of adolescents and young adults with diabetes, there is room for improvement in the way in which health professionals understand the complexities involved in diabetes management for adolescents and young adultsDoctor of Philosophy (PhD)
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Mattosinho, Mariza Maria Serafim. „Itinerário terapêutico do adolescente com diabetes mellitus tipo 1 e seus familiares“. Florianópolis, SC, 2013. https://repositorio.ufsc.br/handle/123456789/106562.
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Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro de Ciências da Saúde. Programa de Pós-graduação em EnfermagemMade available in DSpace on 2013-12-05T21:29:19Z (GMT). No. of bitstreams: 0
Este é um estudo de natureza qualitativa, do tipo convergente assistencial, que teve como objetivo compreender o itinerário terapêutico de um grupo de adolescentes com diabetes mellitus tipo 1 e seus familiares, vinculados a um Hospital Geral de Florianópolis. Neste estudo, o itinerário terapêutico foi compreendido como o percurso realizado pelos adolescentes e familiares na busca por cuidados e tratamentos para a sua condição de saúde. Utilizei, como marco de referência, o Sistema de Cuidado a Saúde, composto pelos subsistemas Profissional, Popular e Familiar, desenvolvido por Arthur Kleinman. Participaram deste estudo vinte pessoas, entre adolescentes e familiares de cinco famílias. Seus domicílios foram o cenário principal da coleta de dados, realizada através de entrevistas em profundidade. Na análise dos dados evidenciou-se duas categorias. A primeira, Decisões e negociações sobre a saúde, os cuidados e os tratamentos apresenta o itinerário terapêutico a partir da compreensão dos sujeitos do estudo. Através da análise dos dados, observou-se que o percurso não é linear, mas sim, constituído por um processo complexo, composto de vários momentos: algo não está bem; a descoberta da doença; o diabetes veio para mudar minha vida; o viver com DM; a avaliação dos tratamentos e cuidados realizados e a participação da família. Na busca por cuidados e tratamentos, esperam encontrar explicação, diagnóstico e cura da doença. A segunda categoria, o percurso nos três subsistemas de saúde, representa onde os sujeitos do estudo realizaram seus cuidados e tratamentos. Aqui, observa-se que a busca por cuidados e tratamentos parte do subsistema familiar, depois simultaneamente do popular e do profissional, com prevalência de um ou de outro em determinados momentos. Porém, o subsistema familiar está sempre presente na hora das decisões, avaliações e realizações de algum outro cuidado. Entre os cuidados realizados no subsistema familiar, os integrantes do estudo referiram: fé, reza e suporte familiar. No subsistema profissional realizam: dieta, exercício, insulina e homeopatia; e, no subsistema popular, que aparece como mais um recurso que se sobrepõe aos demais, encontra-se: o uso de chás, garrafadas, idas a benzedeiras e a centros espíritas. Vários fatores contribuem para a entrada e a saída de um subsistema de saúde, tais como: acessibilidade, custo/benefício, eficácia, experiências anteriores, valores e crenças e a maneira como são ouvidos pelas pessoas que integram cada um dos subsistemas. A compreensão do itinerário terapêutico vem mostrar que o conhecimento dos profissionais de saúde não é o único, havendo diferentes saberes em saúde. Portando, compreender o itinerário de adolescentes com diabetes mellitus tipo 1 e seus familiares contribuiu na elucidação da maneira pela qual eles se orientam em seu mundo, nos permitindo uma atuação profissional mais convergente à situação vivenciada por estas pessoas.
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Fonte, David. „Processus et enjeux psychosociaux associés au développement des compétences psychosociales : une investigation en éducation thérapeutique du patient“. Thesis, Aix-Marseille, 2017. http://www.theses.fr/2017AIXM0292.
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À partir d’une approche psychosociale de la situation thérapeutique, cette thèse interroge les processus et les enjeux psychosociaux associés au développement des compétences psychosociales dans le contexte de l’éducation thérapeutique du patient diabétique de type 1. Suite aux limites identifiées par une revue systématique de la littérature (N = 60 articles), nous avons réalisé une recherche qualitative auprès d’adolescents diabétiques (N = 28) dans le but de mieux comprendre leurs besoins en termes de compétences psychosociales. Ce travail nous a ensuite amenés à dégager trois perspectives de recherche que nous avons exploités à partir de différentes stratégies méthodologiques : une étude expérimentale (N = 102) et une étude transversale (N = 261) auprès d’adultes diabétiques ; une étude prospective visant à suivre l’évolution du profil sociocognitif d’adolescents diabétiques (N = 24) ; et une étude qualitative à partir dix focus groups composés d’adolescents diabétiques (N = 26), de leurs parents (N = 9) et de professionnels de santé (N = 11). L’articulation de ces études montre que les compétences psychosociales sont régulées par des processus psychosociaux qui sont en jeu dans le contexte dynamique de la relation thérapeutique. Ces compétences s’inscrivent dans un système d’actions et d’interprétations socialement façonné par des enjeux thérapeutiques et relationnels ainsi que par une symbolique sociale. Leur développement semble déterminé par le statut social et l’identité des acteurs, les motivations et les attentes propres à chacun, ainsi que par la représentation de l’autre mobilisée pour construire le climat de la relation thérapeutiqueBased on a psychosocial approach to the therapeutic situation, this thesis examines the psychosocial processes and issues involved in the development of psychosocial skills in the context of the therapeutic education of type 1 diabetic patients. Following the limitations identified by our systematic review (N = 60 articles), we conducted a qualitative research with diabetic adolescents (N = 28) in order to better understand their needs in terms of psychosocial skills. This work led us to identify three research perspectives that we carried out using different methodological strategies: an experimental study (N = 102) and a transversal study (N = 261) with diabetic adults; a prospective study to following the evolution of the sociocognitive profile of adolescents with diabetes (N = 24); and a qualitative study using ten focus groups of adolescents with diabetes (N = 26), parents (N = 9) and health professionals (N = 11). The articulation of these studies shows that psychosocial skills are regulated by psychosocial processes that are at stake in the dynamic context of the therapeutic relationship. These skills are part of a system of actions and interpretations socially shaped by therapeutic and relational issues as well as by a social symbolism. Their development seems to be determined by the social status and identity of the actors, their motivations and expectations, and by the representation of others mobilized to build the climate of the therapeutic relationship