Elsevier

Journal of Pediatric Nursing

Volume 21, Issue 3, May–June 2006, Pages 222-232
Journal of Pediatric Nursing

Article
Self-Care of Young Adolescents With Type 1 Diabetes

https://doi.org/10.1016/j.pedn.2005.07.013Get rights and content

The purpose of this study was to describe the universal and health deviation self-care of adolescents with Type 1 diabetes and the associations of basic conditioning factors with universal and health deviation self-care. Subjects for this study were 152 adolescents aged between 11 and 15 years with a diagnosis of Type 1 diabetes. Data were collected in the home setting of each adolescent and his or her family. The mean universal self-care scores ranged from 66.62% to 90%. The overall mean for this sample was 75.37, indicating that these adolescents took care of their self-care needs 75% of the time. Health deviation self-care was a mean of 27.26, indicating more positive self-care behaviors and treatment adherence. Health deviation and universal self-care were significantly and positively related (r = .36, p < .001). Ethnicity and adolescent sex were statistically significant in predicting universal self-care. Adolescent age was statistically significant in predicting health deviation self-care. Health deviation self-care decreases with age, suggesting that early adolescence or late school age is an appropriate time for interventions to strengthen self-care behaviors. Furthermore, the interrelationship of the two types of self-care supports the potential for a synergistic effect of intervention.

Section snippets

Theoretical Framework

Orem (1991) put forth a widely recognized theoretical model, the Self-Care Deficit Theory of Nursing, in which she defined self-care as the care one gives oneself to maintain life, health, and well-being. This self-care activity addresses three areas of self-care needs: universal, developmental, and health deviation. Universal self-care is common to all human beings during all stages of the life cycle and includes obtaining sufficient air, water, and food; fostering processes of elimination;

Literature Review

Although the self-care and self-care deficit theories of Orem (1985) were targeted toward the adult population, the descriptors of universal, developmental, and health deviation self-care needs have applicability to the adolescent population. Although the care that adolescents give themselves has been studied and documented throughout the health literature, research that actually describes the self-care needs of children and adolescents using Orem's theory is sparse. In fact, there are very few

Participants

The present sample was recruited from the outpatient endocrinology clinic of a southeastern children's hospital and enrolled in an ongoing 2-year longitudinal project on family, autonomy, and self-care in adolescents with Type 1 diabetes. Data were available for 161 families who completed the first phase of data collection, and these cross-sectional analyses are based on this young adolescent cohort. Eligible subjects for the project included young adolescents (a) aged between 11 and 15 years,

Findings

The mean duration of Type 1 diabetes in this sample was 4 years (SD = 3 years, range = 1–14.33 years). Adolescents were distributed well across the eligible age range (M = 12.86, SD = 1.48, range = 11–15) and equally by sex (50% males and 50% females). The mean Tanner stage of the adolescents was 3.28 (SD = 1.19, range = 1–5). Two-parent (79%) and Caucasian non-Hispanic (81%) families composed most of the sample. The proportion of African Americans (19%) corresponds to the proportion of African

Discussion

Adolescent scores on the SCAI indicate that adolescents 11–15 years old engage in disease-related self-care with room for improvement in positive health deviation self-care behaviors. The mean score of 27 on the SCAI falls significantly short of the optimal score of 41. The range of scores (14–37) demonstrates that some adolescents in this age group report that they are highly effective in assuming responsibility for self-care related to their diabetes. Although subscale scores indicate that

Summary

This study supports the need for continuing investigation of self-care practices, both universal and health deviation self-care behaviors, in the adolescent population. Although the self-care theory of Orem (1985) was developed from an adult health framework, it supports the premise of developmental self-care, and more research is needed to explore interventions that promote the development of self-care behaviors in the adolescent population. This investigation of adolescents with Type 1

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