Illness perception of adolescents with well-controlled type 1 diabetes

Type 1 diabetes mellitus is one of the most prevalent chronic diseases among adolescents. In addition, adherence to the strict diabetes regimen usually deteriorates during adolescence. As adolescents endeavour to make sense of their illness, they develop beliefs that will guide and influence their illness management. These illness perceptions have been shown to be associated with adherence to treatment and metabolic control in patients living with type 1 diabetes mellitus. However, there is a dearth of research exploring the relationships between illness perceptions and diabetes outcomes among adolescents in South Africa. This study has two objectives – firstly to explore the illness perceptions of adolescents with well-controlled type 1 diabetes mellitus and, secondly, to explore how this illness perception helps the adolescent to manage their diabetes. A qualitative approach was adopted for this study and purposive sampling was done to select the participants. The population sample consisted of adolescents between the ages of 12 and 18 years with controlled type 1 diabetes mellitus who were attending the Centre for Diabetes and Endocrinology (CDE) in Parktown, Johannesburg. Data was generated during the course of semi-structured interviews. A thematic analysis using an inductive (data driven) approach was applied. The research was conducted in accordance with Lincoln and Guba’s (1985) criteria for establishing trustworthiness, namely credibility, confirmability, dependability and transferability. Four dominant themes regarding the illness perceptions of the participants were identified. Theme one, living with diabetes becomes a way of life, highlights that the participants perceived their type 1 diabetes mellitus to be an integral part of their being and a permanent relationship to acknowledge, not oppose. Theme two, managing diabetes leads to being different, indicates how the participants perceived themselves as being distinctive because they had to observe a strict regimen to which people without type 1 diabetes mellitus did not have to adhere. The participants acknowledged that type 1 diabetes mellitus could have potential negative health consequences (theme three), especially when it is sub-optimally managed, but type 1 diabetes mellitus is perceived to be manageable (theme four), albeit by means of a strict management regimen. To explore how these illness perceptions contribute to the effective-management of participants’ type 1 diabetes mellitus, three themes were identified. By integrating it as a way of life and acknowledging potential negative health consequences, the participants understood and accepted that they had a duty to procure adequate knowledge (theme five) about the management of their diabetes. The participants embraced accountability to comply with obligatory management protocol (theme six): it is either right or wrong and non-negotiable. Discipline, maturity and accountability were regarded as fundamental to adhering to this strict protocol. Lastly, the majority of the participants recognised that acceptance of their lot/fate (theme seven) enabled them to manage their diabetes well. In conclusion, this study provides new information about the illness perceptions of adolescents with well-controlled type 1 diabetes mellitus in South Africa, as well as insight into how these perceptions aid effective management. The findings will be of use to diabetes-related healthcare experts who can constructively use the conclusions of this study to look beyond just the treatment regimen, and apply and develop these underlying perceptions of patients with type 1 diabetes mellitus to improve their diabetes management.Master