A qualitative study of motivation to self-management in pediatric diabetes health care consultations with adolescents with type 1 diabetes.

Abstract

Background. The impact of health care professionals on the motivation for self-management in adolescents with type 1 diabetes has been highlighted as important. It is, however, not well understood how health care practitioners can help increasing motivation to self-management. The aim of the study was to investigate how practitioners can motivate their patients to self-management in consultation and how adolescents with type 1 diabetes experienced that consultation could facilitate motivation to self-management. Methods. The study triangulated participant observations of 11 consultations at a pediatric health care clinic and 10 interviews of the adolescents (age 15-17) about their experiences of consultations. The analysis showed five categories: 1. Consultation dialogue, 2. Roles in treatment, 3. Assuming consultation-facilitated responsibility for self-management, 4. Relationship in treatment, and 5. Consultation context. Results. Overall findings showed that the adolescent’s developmental process of becoming autonomous in relation to self-management was influenced by consultations, and that the need of feeling related was experienced as valued by the adolescents. Conclusions. The feeling of relatedness and development of autonomy were experienced as important for how consultations could facilitate motivation to self-management in 15-17-year-olds and may be fundamental to adolescents’ experience of competence in relation to self-management.