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Balancing Parental Involvement With Adolescent Friendly Health Care in Teenagers With Diabetes: Are We Getting It Right?
Abstract Purpose Current guidance about adolescent-friendly health care emphasizes the benefits of seeing young people alone for confidential consultations. Yet in young people with Type 1 diabetes mellitus (T1DM), parental involvement has been shown to contribute to better diabetes control. This st...
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Published in: | Journal of adolescent health 2014-07, Vol.55 (1), p.59-64 |
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description | Abstract Purpose Current guidance about adolescent-friendly health care emphasizes the benefits of seeing young people alone for confidential consultations. Yet in young people with Type 1 diabetes mellitus (T1DM), parental involvement has been shown to contribute to better diabetes control. This study aimed to better understand how these apparent tensions are reconciled in clinical practice by identifying how frequently adolescents with T1DM are seen alone and exploring parents' opinions about this. Methods A convenience sample of consecutive parents of adolescents (aged 12–21 years) with T1DM was recruited from the outpatient clinic of a specialist diabetes service and asked to complete a 30-item written survey. Results A total of 137 surveys were returned from 146 eligible parents (94%) of whom 106 had complete data. Thirteen percent of adolescents with T1DM had ever been seen alone for a confidential consultation with their doctor. The most common concern for parents about confidential care was not being informed about important information, not just about T1DM, but also about common adolescent risk behaviors and mental health states. Discussion These findings suggest that young people with T1DM are not being routinely seen alone for confidential care. This could be attributed to: parents or adolescents declining confidential care; clinicians being time-poor and/or lacking the necessary skills; or a culture of uncertainty about the value of confidential care. A discussion is now required about how best to enact adolescent-friendly care in the chronic-illness outpatient setting, where parental involvement is understood to be important for effective chronic illness management. |
doi_str_mv | 10.1016/j.jadohealth.2013.11.024 |
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Yet in young people with Type 1 diabetes mellitus (T1DM), parental involvement has been shown to contribute to better diabetes control. This study aimed to better understand how these apparent tensions are reconciled in clinical practice by identifying how frequently adolescents with T1DM are seen alone and exploring parents' opinions about this. Methods A convenience sample of consecutive parents of adolescents (aged 12–21 years) with T1DM was recruited from the outpatient clinic of a specialist diabetes service and asked to complete a 30-item written survey. Results A total of 137 surveys were returned from 146 eligible parents (94%) of whom 106 had complete data. Thirteen percent of adolescents with T1DM had ever been seen alone for a confidential consultation with their doctor. The most common concern for parents about confidential care was not being informed about important information, not just about T1DM, but also about common adolescent risk behaviors and mental health states. Discussion These findings suggest that young people with T1DM are not being routinely seen alone for confidential care. This could be attributed to: parents or adolescents declining confidential care; clinicians being time-poor and/or lacking the necessary skills; or a culture of uncertainty about the value of confidential care. A discussion is now required about how best to enact adolescent-friendly care in the chronic-illness outpatient setting, where parental involvement is understood to be important for effective chronic illness management.</description><identifier>ISSN: 1054-139X</identifier><identifier>EISSN: 1879-1972</identifier><identifier>DOI: 10.1016/j.jadohealth.2013.11.024</identifier><identifier>PMID: 24518535</identifier><identifier>CODEN: JAHCD9</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject><![CDATA[Adolescent ; Adolescent Behavior - psychology ; Adolescent Health Services - legislation & jurisprudence ; Adolescent Health Services - standards ; Adolescent Health Services - statistics & numerical data ; Adolescents ; Adult ; Aged ; Ambulatory Care Facilities - standards ; Ambulatory Care Facilities - statistics & numerical data ; Biological and medical sciences ; Child ; Chronic disease ; Confidentiality ; Confidentiality - legislation & jurisprudence ; Confidentiality - standards ; Consultation ; Diabetes ; Diabetes mellitus ; Diabetes Mellitus, Type 1 - psychology ; Diabetes Mellitus, Type 1 - therapy ; Diabetes. Impaired glucose tolerance ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Ethics ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; Female ; Humans ; Male ; Medical sciences ; Middle Aged ; Parent-Child Relations ; Parental participation ; Parents ; Parents - psychology ; Patient Compliance - psychology ; Patient Compliance - statistics & numerical data ; Pediatrics ; Physician-Patient Relations ; Practice Patterns, Physicians' - standards ; Practice Patterns, Physicians' - statistics & numerical data ; Professional-Family Relations ; Self Care - psychology ; Self Care - standards ; Self-management ; Surveys and Questionnaires ; Victoria ; Young Adult ; Young people]]></subject><ispartof>Journal of adolescent health, 2014-07, Vol.55 (1), p.59-64</ispartof><rights>Society for Adolescent Health and Medicine</rights><rights>2014 Society for Adolescent Health and Medicine</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c542t-83e6d6a65ada8322726e32ecf88c7a914ee84800c0690603d20737c7efbe33cc3</citedby><cites>FETCH-LOGICAL-c542t-83e6d6a65ada8322726e32ecf88c7a914ee84800c0690603d20737c7efbe33cc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902,30977</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=28601315$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24518535$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Duncan, Rony E., Ph.D</creatorcontrib><creatorcontrib>Jekel, Maureen, M.Sc</creatorcontrib><creatorcontrib>O'Connell, Michele A., M.D</creatorcontrib><creatorcontrib>Sanci, Lena A., Ph.D</creatorcontrib><creatorcontrib>Sawyer, Susan M., Ph.D</creatorcontrib><title>Balancing Parental Involvement With Adolescent Friendly Health Care in Teenagers With Diabetes: Are We Getting It Right?</title><title>Journal of adolescent health</title><addtitle>J Adolesc Health</addtitle><description>Abstract Purpose Current guidance about adolescent-friendly health care emphasizes the benefits of seeing young people alone for confidential consultations. Yet in young people with Type 1 diabetes mellitus (T1DM), parental involvement has been shown to contribute to better diabetes control. This study aimed to better understand how these apparent tensions are reconciled in clinical practice by identifying how frequently adolescents with T1DM are seen alone and exploring parents' opinions about this. Methods A convenience sample of consecutive parents of adolescents (aged 12–21 years) with T1DM was recruited from the outpatient clinic of a specialist diabetes service and asked to complete a 30-item written survey. Results A total of 137 surveys were returned from 146 eligible parents (94%) of whom 106 had complete data. Thirteen percent of adolescents with T1DM had ever been seen alone for a confidential consultation with their doctor. The most common concern for parents about confidential care was not being informed about important information, not just about T1DM, but also about common adolescent risk behaviors and mental health states. Discussion These findings suggest that young people with T1DM are not being routinely seen alone for confidential care. This could be attributed to: parents or adolescents declining confidential care; clinicians being time-poor and/or lacking the necessary skills; or a culture of uncertainty about the value of confidential care. A discussion is now required about how best to enact adolescent-friendly care in the chronic-illness outpatient setting, where parental involvement is understood to be important for effective chronic illness management.</description><subject>Adolescent</subject><subject>Adolescent Behavior - psychology</subject><subject>Adolescent Health Services - legislation & jurisprudence</subject><subject>Adolescent Health Services - standards</subject><subject>Adolescent Health Services - statistics & numerical data</subject><subject>Adolescents</subject><subject>Adult</subject><subject>Aged</subject><subject>Ambulatory Care Facilities - standards</subject><subject>Ambulatory Care Facilities - statistics & numerical data</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Chronic disease</subject><subject>Confidentiality</subject><subject>Confidentiality - legislation & jurisprudence</subject><subject>Confidentiality - standards</subject><subject>Consultation</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetes Mellitus, Type 1 - psychology</subject><subject>Diabetes Mellitus, Type 1 - therapy</subject><subject>Diabetes. Impaired glucose tolerance</subject><subject>Endocrine pancreas. Apud cells (diseases)</subject><subject>Endocrinopathies</subject><subject>Ethics</subject><subject>Etiopathogenesis. Screening. Investigations. Target tissue resistance</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Parent-Child Relations</subject><subject>Parental participation</subject><subject>Parents</subject><subject>Parents - psychology</subject><subject>Patient Compliance - psychology</subject><subject>Patient Compliance - statistics & numerical data</subject><subject>Pediatrics</subject><subject>Physician-Patient Relations</subject><subject>Practice Patterns, Physicians' - standards</subject><subject>Practice Patterns, Physicians' - statistics & numerical data</subject><subject>Professional-Family Relations</subject><subject>Self Care - psychology</subject><subject>Self Care - standards</subject><subject>Self-management</subject><subject>Surveys and Questionnaires</subject><subject>Victoria</subject><subject>Young Adult</subject><subject>Young people</subject><issn>1054-139X</issn><issn>1879-1972</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>7QJ</sourceid><recordid>eNqNkstuEzEUhi0EoiXwCsgbJDYTfJmxPSxAaaBtpEogKCo7y_GcSTw4M63tROTt8TSBSqy6Orb8_-fi7yCEKZlSQsW7btqZZliD8Wk9ZYTyKaVTwson6JQqWRe0luxpPpOqLCivf56gFzF2JFsFJc_RCSsrqipenaLfZ8ab3rp-hb-aAH0yHi_63eB3sMk3fOPSGs-awUO04_08OOgbv8eX98XxPJuw6_E1QG9WEOLB8cmZJSSI7_Esv98AvoCUxiKLhL-51Tp9fImetcZHeHWME_Tj_PP1_LK4-nKxmM-uCluVLBWKg2iEEZVpjOKMSSaAM7CtUlaampYAqlSEWCJqIghvGJFcWgntEji3lk_Q20Pe2zDcbSEmvXF5FJ-nhmEbNa0qVSspuHqElNeSqCrHCVIHqQ1DjAFafRvcxoS9pkSPiHSnHxDpEZGmVGdE2fr6WGW73EDzz_iXSRa8OQpMtMa3YeQTH3RK5Gz3PZwddJC_b-cg6GgzHAuNC2CTbgb3mG4-_JfEete7XPcX7CF2wzb0GY-mOjJN9PdxpcaNopwQqVjN_wBQ2Mhp</recordid><startdate>20140701</startdate><enddate>20140701</enddate><creator>Duncan, Rony E., Ph.D</creator><creator>Jekel, Maureen, M.Sc</creator><creator>O'Connell, Michele A., M.D</creator><creator>Sanci, Lena A., Ph.D</creator><creator>Sawyer, Susan M., Ph.D</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7QJ</scope></search><sort><creationdate>20140701</creationdate><title>Balancing Parental Involvement With Adolescent Friendly Health Care in Teenagers With Diabetes: Are We Getting It Right?</title><author>Duncan, Rony E., Ph.D ; Jekel, Maureen, M.Sc ; O'Connell, Michele A., M.D ; Sanci, Lena A., Ph.D ; Sawyer, Susan M., Ph.D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c542t-83e6d6a65ada8322726e32ecf88c7a914ee84800c0690603d20737c7efbe33cc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adolescent</topic><topic>Adolescent Behavior - psychology</topic><topic>Adolescent Health Services - legislation & jurisprudence</topic><topic>Adolescent Health Services - standards</topic><topic>Adolescent Health Services - statistics & numerical data</topic><topic>Adolescents</topic><topic>Adult</topic><topic>Aged</topic><topic>Ambulatory Care Facilities - standards</topic><topic>Ambulatory Care Facilities - statistics & numerical data</topic><topic>Biological and medical sciences</topic><topic>Child</topic><topic>Chronic disease</topic><topic>Confidentiality</topic><topic>Confidentiality - legislation & jurisprudence</topic><topic>Confidentiality - standards</topic><topic>Consultation</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Diabetes Mellitus, Type 1 - psychology</topic><topic>Diabetes Mellitus, Type 1 - therapy</topic><topic>Diabetes. Impaired glucose tolerance</topic><topic>Endocrine pancreas. Apud cells (diseases)</topic><topic>Endocrinopathies</topic><topic>Ethics</topic><topic>Etiopathogenesis. Screening. Investigations. Target tissue resistance</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Parent-Child Relations</topic><topic>Parental participation</topic><topic>Parents</topic><topic>Parents - psychology</topic><topic>Patient Compliance - psychology</topic><topic>Patient Compliance - statistics & numerical data</topic><topic>Pediatrics</topic><topic>Physician-Patient Relations</topic><topic>Practice Patterns, Physicians' - standards</topic><topic>Practice Patterns, Physicians' - statistics & numerical data</topic><topic>Professional-Family Relations</topic><topic>Self Care - psychology</topic><topic>Self Care - standards</topic><topic>Self-management</topic><topic>Surveys and Questionnaires</topic><topic>Victoria</topic><topic>Young Adult</topic><topic>Young people</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Duncan, Rony E., Ph.D</creatorcontrib><creatorcontrib>Jekel, Maureen, M.Sc</creatorcontrib><creatorcontrib>O'Connell, Michele A., M.D</creatorcontrib><creatorcontrib>Sanci, Lena A., Ph.D</creatorcontrib><creatorcontrib>Sawyer, Susan M., Ph.D</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><jtitle>Journal of adolescent health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Duncan, Rony E., Ph.D</au><au>Jekel, Maureen, M.Sc</au><au>O'Connell, Michele A., M.D</au><au>Sanci, Lena A., Ph.D</au><au>Sawyer, Susan M., Ph.D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Balancing Parental Involvement With Adolescent Friendly Health Care in Teenagers With Diabetes: Are We Getting It Right?</atitle><jtitle>Journal of adolescent health</jtitle><addtitle>J Adolesc Health</addtitle><date>2014-07-01</date><risdate>2014</risdate><volume>55</volume><issue>1</issue><spage>59</spage><epage>64</epage><pages>59-64</pages><issn>1054-139X</issn><eissn>1879-1972</eissn><coden>JAHCD9</coden><abstract>Abstract Purpose Current guidance about adolescent-friendly health care emphasizes the benefits of seeing young people alone for confidential consultations. Yet in young people with Type 1 diabetes mellitus (T1DM), parental involvement has been shown to contribute to better diabetes control. This study aimed to better understand how these apparent tensions are reconciled in clinical practice by identifying how frequently adolescents with T1DM are seen alone and exploring parents' opinions about this. Methods A convenience sample of consecutive parents of adolescents (aged 12–21 years) with T1DM was recruited from the outpatient clinic of a specialist diabetes service and asked to complete a 30-item written survey. Results A total of 137 surveys were returned from 146 eligible parents (94%) of whom 106 had complete data. Thirteen percent of adolescents with T1DM had ever been seen alone for a confidential consultation with their doctor. The most common concern for parents about confidential care was not being informed about important information, not just about T1DM, but also about common adolescent risk behaviors and mental health states. Discussion These findings suggest that young people with T1DM are not being routinely seen alone for confidential care. This could be attributed to: parents or adolescents declining confidential care; clinicians being time-poor and/or lacking the necessary skills; or a culture of uncertainty about the value of confidential care. A discussion is now required about how best to enact adolescent-friendly care in the chronic-illness outpatient setting, where parental involvement is understood to be important for effective chronic illness management.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>24518535</pmid><doi>10.1016/j.jadohealth.2013.11.024</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Adolescent Adolescent Behavior - psychology Adolescent Health Services - legislation & jurisprudence Adolescent Health Services - standards Adolescent Health Services - statistics & numerical data Adolescents Adult Aged Ambulatory Care Facilities - standards Ambulatory Care Facilities - statistics & numerical data Biological and medical sciences Child Chronic disease Confidentiality Confidentiality - legislation & jurisprudence Confidentiality - standards Consultation Diabetes Diabetes mellitus Diabetes Mellitus, Type 1 - psychology Diabetes Mellitus, Type 1 - therapy Diabetes. Impaired glucose tolerance Endocrine pancreas. Apud cells (diseases) Endocrinopathies Ethics Etiopathogenesis. Screening. Investigations. Target tissue resistance Female Humans Male Medical sciences Middle Aged Parent-Child Relations Parental participation Parents Parents - psychology Patient Compliance - psychology Patient Compliance - statistics & numerical data Pediatrics Physician-Patient Relations Practice Patterns, Physicians' - standards Practice Patterns, Physicians' - statistics & numerical data Professional-Family Relations Self Care - psychology Self Care - standards Self-management Surveys and Questionnaires Victoria Young Adult Young people |
title | Balancing Parental Involvement With Adolescent Friendly Health Care in Teenagers With Diabetes: Are We Getting It Right? |
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