Teenagers with type 1 diabetes - a phenomenological study of the transition towards autonomy in self-management

Background: Becoming autonomous is an important aspect of teenagers' psychosocial development, and this is especially true of teenagers with type 1 diabetes. Previous studies exploring the everyday problems of teenagers with diabetes have focused on adherence to self-care management, how self-determination affects metabolic control, and the perception of social support. Objective: The aim of the study was to elucidate lived experiences, focusing on the transition towards autonomy in diabetes self-management among teenagers with type 1 diabetes. Design and method: Data were collected using interviews, and a qualitative phenomenological approach was chosen for the analysis. Participants: Thirty-two teenagers (18 females and 14 males) were interviewed about their individual experiences of self-management of diabetes. Findings: The lived experiences of the transition towards autonomy in self-management were characterized by the overriding theme hovering between individual actions and support of others. The findings indicate that individual selfreliance and confirmation of others are helpful in the transition process. Growth through individual self-reliance was viewed as a developmental process of making one's own decisions; psychological maturity enabled increased responsibility and freedom; motivation was related to wellbeing and how well the diabetes could be managed. The theme confirmation of others showed that parental encouragement increased the certainty of teenagers' standpoints; peers! acceptance of diabetes facilitated incorporation of daily self-management activities; support from the diabetes team strengthened teenagers' self-esteem. Conclusion: In striving for autonomy, teenagers needed distance from others, but still to retain the support of others. A stable foundation for self-management includes having the knowledge required to practice diabetes management and handle different situations. (c) 2006 Elsevier Ltd. All rights reserved.