1型糖尿病をもつ10代の小児/青年の糖尿病セルフケアの枠組みの構築-診断時からの体験の積み重ねに焦点をあてて-  [in Japanese] A SELF-CARE FRAMEWORK FOR TEENAGERS FOCUSED ON ACCUMULATED EXPERIENCESSINCE BEING DIAGNOSED WITH TYPE 1 DIABETES  [in Japanese]

Access this Article

Search this Article

Abstract

本研究の目的は,1型糖尿病をもつ10代の小児/青年の糖尿病セルフケアを体験の積み重ねの視点から明らかにし,小児の成長発達に沿った看護指針・評価指標の開発に有用な枠組みを構築することである。1型糖尿病をもつ10代の小児/青年の療養行動・日常生活の認識と実際,サポートについてケースごとの詳細な質的データを含む9編の学位論文から得られた52ケースを分析対象とした。各ケースの療養行動・日常生活の認識と実際,サポートについて質的帰納的に分析を行い「カテゴリー」を抽出した。ケースを9歳以下の年少発症群と10代発症で診断後1年以上の群,10代発症で診断後1年未満の群の3群に分け,小児/青年が直面する課題の状況,適切あるいは不適切なセルフケアにつながるカテゴリーの出現頻度とカテゴリー間の関係を分析した。その結果,以下が明らかとなった。年少発症の小児/青年は,時間をかけて糖尿病の基本的な療養行動を習得し療養行動がふつうになる一方で,病気のためにうまくいかない体験を積み重ねている者もいた。10代発症では,否定的な感情が強いときであっても糖尿病の基本的な療養行動の習得は短期間で可能であったが,日常生活の中で療養行動を行うためには多様なサポートを必要としていた。本研究の結果と先行研究を統合し【基本的な療養行動を習得する段階】と【生活の中で療養行動ができる段階】から成る,1型糖尿病をもつ10代の小児/青年の糖尿病セルフケアの枠組みを構築した。

We conducted a qualitative secondary analysis to explore a self-care framework for teenagers living with diabetes.The framework focuses on the accumulated experiences of teenagers since being diagnosed with type 1 diabetes. Thedata set for this study comprised 52 cases from 9 theses at a single university, and included qualitative descriptionsregarding self-care and support for, and well as detailed daily experiences of, teenagers living with diabetes. Phraseclusters were identified, compared for differences, and then categorized. The content and frequencies of the categorieswere then compared among the teenagers according to the following 3 groups: those diagnosed with diabetes inchildhood (younger than 10 years of age); those diagnosed in adolescence (age 10 years and older) who had durationof disease less than one year; and those diagnosed in adolescence who had duration of disease one year or longer.Our results suggested that as they had been learning primary diabetes self-care behavior for a long period of time,teenagers diagnosed in childhood perceived living with diabetes and practicing diabetes self-care as normal. However,if these same teenagers had accumulated any negative experiences, their perceptions tended to be deeply negative. Evenif they did not accept their diabetes, teenagers diagnosed in adolescence acquired their primary self-care behavior in ashort period of time. However, these teenagers required substantial support before they started independently practicingdiabetes self-care in their daily life.Accordingly, we integrated these findings with those from our previous research and constructed a self-careframework consisting of the following two phases:" primary diabetes self-care behavior" and" living with diabetes".This framework could potentially serve as a basis for nursing evaluation and intervention in teenagers living with type 1diabetes.

Journal

  • 千葉看護学会会誌

    千葉看護学会会誌 20(2), 1-10, 2015-01-30

    千葉看護学会

Codes

  • NII Article ID (NAID)
    120005940571
  • NII NACSIS-CAT ID (NCID)
    AA11354292
  • Text Lang
    JPN
  • Article Type
    journal article
  • ISSN
    1344-8846
  • Data Source
    IR 
Page Top