Document Type

Dissertation

Degree

Doctor of Philosophy

Major

Nursing

Date of Defense

5-8-2015

Graduate Advisor

Anne Fish, PhD, RN, FAHA

Committee

Kuei-Hsiang Hsueh

Kimberly Allen

Wilma Calvert

Neil White

Abstract

Adolescents must enter adult health care services at age 18, yet most are not ready and have not mastered daily self management of their type 1 diabetes. The purpose of this study was to determine the feasibility of a transition planning intervention, focused on educating adolescent/parent dyads about diabetes self management in preparation for the transition from pediatric to adult health care, using a newly developed transition plan and framework. The setting was a diabetes endocrinology clinic where 95% of young type 1 diabetics in the metropolitan area are seen. The intervention included supporting the parent in the relinquishing of diabetes management responsibilities to the adolescent. This study measured the transition readiness and self management practices of the adolescent as well as the parents’ ability to promote autonomy in their adolescents' transition to self management. In addition, this study sought to gain information from the dyads on the usefulness of this intervention. The intervention consisted of four weekly sessions emphasizing a review of type 1 diabetes pathophysiology, daily living with type 1 diabetes, leaving the parental home, and reproductive health. A non-experimental, pre-post feasibility design was used and 11 adolescent/parent dyads consented to participate. Seven dyads completed the intervention. Using descriptive statistics, mean scores improved for transition readiness, diabetes care activities, problem solving, communication, and goals setting. Post intervention evaluations completed by participants were favorable. Most agreed or strongly agreed that the transition intervention was helpful in getting adolescents ready for transition and taking care of diabetes as a young adult. They would recommend this intervention to others. Based on the findings of this study and evidence found in the literature, the intervention will soon be packaged into brief 15-minute teaching sessions presented during quarterly clinic visits for all adolescents age 15-18 at the study site. If any adolescent remains in the clinic until age 19 or later, the intervention will continue quarterly until the adolescent transitions to adult health care. In addition, based on the responses given by the adolescent/parent dyads at completion of the sessions, this intervention contains useful information relevant to the adolescents’ transition to adult health care.

OCLC Number

916495504

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