Jewell VD, Wise AC, Knezevich EL, Abbott AA, Feiten B, Dostal K. Type 1 Diabetes Management and Health Care Experiences Across Rural Nebraska.
J Pediatr Health Care 2023;
37:48-55. [PMID:
36064764 DOI:
10.1016/j.pedhc.2022.07.005]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 07/25/2022] [Indexed: 01/31/2023]
Abstract
INTRODUCTION
This study aimed to explore the unique health care needs of rural Nebraska families with a child with type 1 diabetes mellitus (T1DM).
METHOD
Using a phenomenological approach, the researchers conducted four focus groups across Nebraska. The focus groups gathered input from children, caregivers, and health care providers (n = 23). The researchers coded data and generated themes. Member checking, researcher triangulation, reflexivity, a thick description of the process, and an audit trail established trustworthiness.
RESULTS
Four themes emerged: dramatic family and lifestyle changes following diagnosis, lack of access to specialized care resulting in complications, isolation improved health management resourcefulness, and technology improved health management and flexibility.
DISCUSSION
Lifestyle changes persist after a child's diagnosis with T1DM. Rural families reported unpredictable health status of their child, reduced health care services, and limited information access. Conversely, limited specialty health care access, resources, and community support led to creative self-education, advocacy, and health care management strategies. Diabetes technology offered opportunities for improved provider-patient communication and continuous glucose monitoring.
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