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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
Main Authors: 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
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container_title Journal of adolescent health
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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. 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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. 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source Applied Social Sciences Index & Abstracts (ASSIA); ScienceDirect Freedom Collection
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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