Concept analysis of self-care assumption in adolescents with Type 1 diabetes

¶ … Walker and Avant (2010) as a technique of describing real phenomena in the realms of nursing practice. Concept analysis is noted by Walker & Avant (2005, pg. 63) to "allows the theorist, researcher, or clinician to come to grips with the various possibilities within the concept of interest." Walker and Avant (2010) developed a special eight step process to be employed in content analysis. These eight steps are what we employ in this paper in the investigation of the assumption of self-care by adolescents suffering from Type 1 diabetes Mellitus.

The aim of this specific concept analysis is to examine the concept of assumption of self-care by adolescents suffering from Type 1 diabetes Mellitus. Walker and Avant's (2010) methodology of concept analysis was employed in the identification of the antecedents, the defining attributes, the consequences, the empirical referents as well as the cases that are associated with the concept.

Purpose

The purpose of the concept analysis is to provide a more clear understanding as well as description of the concept of assumption of self-care by adolescents suffering from Type 1 diabetes Mellitus. This is in line with the views of Rodgers (2000) and Walker & Avant (2010). This is accomplished by the employment of various methodologies for analysis. In this work however, Walker & Avants' concept analysis methodology is chosen as the preferred one.Adolescents are faced with a major developmental task in regard to their transition to adulthood as well as its associated necessity of taking responsibility of themselves. The achievement of this major developmental task in consideration with the fact that they suffer from Type 1 diabetes Mellitus, a disease which is best managed through self-care is noted by the National Diabetes Information Clearinghouse (2008) to be critical to the lives of close to 186,300 adolescents who suffer from this disease in the U.S. This is further compounded that the young adults would soon leave their parent's care. The purpose of this paper is to investigate "the concept of assumption of self-care by adolescents suffering from Type 1 diabetes Mellitus" with the intention of gaining clarity. This clarity is needed in order to effectively differentiate the concept of responsibility of care from adherence, management and compliance in order to effectively guide the assessment as well as management of the responsibility.

Uses

At this stage, we indentify the various uses of the concept under study in literature. The uses were mainly limited to extant literature on adolescents suffering from Type 1 diabetes Mellitus.It was necessary to identify if all of the attributes of responsibility are the same or different across the numerous conditions. This paper therefore adopted a conservative approach with only the specific diagnosis that existed on most literature being taken into account for examination.

Model Cases

Frank is a 18-year-old who suffers from Type 1 diabetes Mellitus and is under observation in a local Diabetes clinic. Over the previous few years, Frank has been observed maturing into a young, energetic, brilliant and independent minded person in his diabetes care. He is very responsible as indicated by his narration on how he takes care of himself. For instance, he checks his glucose level everyday; he also constantly adjusts his insulin dose coupled with a strict regime of exercise and a strict meal plan. He noted that this process has taken place gradually and that he has of late become more independent when compared to when he was younger. He performs his diabetes care activities independently and without any reminders.

Alternative Cases

The related hypothetical case is a clinical example of the concept of assumption of the responsibility of self-care but with the lack of the defining attributes such as gradual process but is specific to a diabetes care regimen as well possessing the attribute of being individualized.

Jill is a 17-year-old lady who has diabetes and is constantly being seen in the clinic. Her glycemic control is very good. She has a treatment regimen which was outlined by her physician, a regimen which she follows precisely. Her blood glucose levels are constantly checked about five to six times per day her insulin dose is appropriately adjusted on the basis of his blood glucose levels. Jill does exactly what she is told by her parents in order to adjust his level of diabetes as she does not make her adjustments independently.

Antecedents & Consequences

Readiness is noted as an antecedent since it closely relates to the knowledge, abilities as well as development (Pacaud et al., 2007; Weissberg-Benchell et al., 2007).Readiness is closely related to the level of adolescence motivation.

The next group of antecedents is closely related to the expectations for individual responsibility. It is usually noted that this expectation was also held by parents. Healthcare providers are also noted to hold these expectations. Societal expectations are noted by Weissberg-Benchell et al., (2007) to be a customary behavior for the adolescents. Interactions with other individual are also noted to be an antecedent.

Empirical Referents

The attributes used in this case must be able to indicate the level of responsibility (high or low).The measures that are used include Diabetes Family Responsibility Questionnaire, The Diabetes Responsibility Scale and The Diabetes Responsibility Scale.

Conclusion

This concept analysis can be used to provide clearance for the clinicians who engage with adolescents suffering from Type 1 diabetes Mellitus. These people go through a process of assumption of responsibility during their adolescent years and clinicians are therefore advised to accurately assess this variable/concept when treating the adolescents. The adolescents should be taught on how to be independent and autonomous in their decision-making process and behavior in regard to the concept of self-care.