Abstract
Using the theoretical framework of Guido Möllering conceptualising trust as a mental process composed of three elements—expectation, interpretation and suspension—we examined the role of trust in relation to young children’s (age ≤ 7 years) psychosocial needs when diagnosed with type 1 diabetes. Based on qualitative interviews with health care professionals (HPCs) from paediatric diabetes clinics in all regions of Denmark, we identified four main themes: trust through meaningful interaction, trust as a key factor at the time of diagnosis, trust in a long-term perspective and caregivers as the bridge to trust. We conclude that trust between young children and HCPs is central to children’s psychosocial experience, as well as a primary need, when children are diagnosed with type 1 diabetes. Trusting relationships counteract children’s experience of fear, anxiety and needle phobia and reinforce HCPs’ experience of providing good psychosocial as well as medical care. The present study offers insights into how trust can positively affect young children’s experience of diagnosis. This study also points out some key barriers to and facilitators of creating trusting relationships. This research is a first step towards a greater understanding that can inform collective future guidelines on the psychosocial care of young children.
Highlights
Type 1 diabetes is a chronic illness requiring daily treatment, which involves daily monitoring of blood glucose concentration and subcutaneous injection of insulin
The purpose of the present study was to gain insights into young children’s experiences and needs when they are diagnosed with type 1 diabetes, and to do so through the health care professionals (HCPs) caring for these children
The interviews were semi-structured, permitting an open conversation about young children’s psychosocial needs when they are diagnosed with type 1 diabetes
Summary
Type 1 diabetes is a chronic illness requiring daily treatment, which involves daily monitoring of blood glucose concentration and subcutaneous injection of insulin. The number of children diagnosed with type 1 diabetes has been steadily increasing [1], with the number under the age of 5 increasing most rapidly [2]. Research has consistently found a greater incidence of psychological distress among children and young people with type 1 diabetes compared to their peers [6]. The absence of guidelines reflect a lack of research and knowledge concerning this age group [8] and a tendency for the views of younger children to be excluded at the clinic level [9]. The available literature mainly explores the experiences, rather than the needs, of children diagnosed with type 1 diabetes. The authors of a recent review found it challenging to identify the need for support, knowledge that could inform the development of interventions for these children [10]
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