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• W2187720522 abstract "Diabetes is a chronic illness which currently affects over 387 million people in the world (International Diabetes Federation, 2013). Type 1 diabetes results from the autoimmune destruction of the insulin-producing beta cells in the pancreas meaning that the pancreas does not produce enough insulin in order to regulate the blood glucose level. Therefore, the main requirements are to achieve optimal blood glucose levels, insulin therapy administrated using insulin injections (4 to 5 times per day), regular exercise, and diet, in order to maintain the metabolic control and the individual's quality of life for as long as possible. If diabetes is not managed correctly over time, it can damage the heart and the blood vessels (primarily leading to heart disease and stroke), kidneys (kidney failure), eyes (diabetic retinopathy) and nerves (diabetic neuropathy) (International Diabetes Federation, 2013). Of particular significance is Romania's situation where there are over 1.5 million cases of diabetes and there is an increasing incidence of type 1 diabetes (T1D) in children aged 0 to 17 years. A 10 years survey (from 2002 to 2011), showed that there had been a raise in incidence in all age groups (0-4; 5-9; 10-14), except for 15-17 age group (Serban, Brink, Timar, Sima, Vlad, & Timar, 2015).Diabetes self-management is a complex, multi-factorial process influenced by the interaction of individual, social and environmental variables. There is no standard definition on how to better adapt to diabetes. It is well known that the main focus after the diagnosis is to learn how to manage the illness in terms of self-care behavior. It seems like living with type 1 diabetes implies a lot of decisions with respect to medical aspects as in how to read the blood glucose level, how to decide the number of insulin injections, how to control the caloric intake. Dealing with diabetes is perhaps most difficult and challenging for children and adolescents (Ritholz, Beverly, & Weinger, 2011).In the last decade it has been a continuous development of medical devices aiming to provide more freedom and flexibility of insulin therapy for diabetes management. Despite recent advances in these high-tech electronic devices, the rates of adolescents with poor metabolic control remain unacceptably high (Peyrot, Rubin, Laurtzen, Snoek, Matthews, & Skovlund, 2005). Moreover, efforts to have a good metabolic control do not always count for predictable results. Living with diabetes is about being adherent to the medical treatment and equally about adjusting to emotional and behavioral problems that can have a negative impact on metabolic control (Frank, 2005).There is a recent shift in the attention of researchers from the quantitative research, highlighting the role of qualitative research in behavioral diabetes. Therefore, more emphasis is being placed on the daily experiences of living with type 1 diabetes in order to provide a better understanding on how adolescents face the behavioral, emotional and social demands of the illness. In a recent review, Ritholz et al. (2011) recounted the following psychosocial experiences: interpersonal relationships, diagnosis/treatment, self-care, complications and co-morbidities generated by the interplay between illness and lifestyle goals of adolescents with diabetes. Exploring personal and relationship challenges of adolescents with type 1 diabetes contributes to the increased understanding of treatment adherence.Interpersonal relationships represent an umbrella concept describing the dynamic between adolescents and families, peers and healthcare providers. After the diagnosis, adolescents are exposed to new information and they have to decide over care plans. There are gender differences in diabetes-related behaviors showing that girls incorporate diabetes into their identities more than boys. In contrast, teenage boys tend to make their disease publicly invisible (Williams, 1999). Gaining autonomy for diabetes management can be represented as a negotiation between adolescents' decisions and parental input. …" @default.
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• W2187720522 date "2015-09-01" @default.
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• W2187720522 title "Beyond Self-Care Behaviors in Diabetes: Learning from Adolescents" @default.
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