The education and information needs of young adults with type 2 diabetes : a qualitative study

Aims and objectives. To identify the preferred content and delivery mode of education information for people aged 25 to 45 with type 2 diabetes to enable them to effectively self-manage their diabetes.

Background. People with type 2 diabetes are required to manage their own health and initiate behavioural changes. Self-management education and resources have typically been targeted at people aged 50 years and older. Little is known about the concerns and needs of younger people in managing type 2 diabetes, which are likely to be different from those of older people.

Design. A qualitative design was considered the most appropriate to elicit participants' views and perceptions of their type 2 diabetes information needs.

Methods. Data were obtained from one focus group (n = 9) and telephone interviews (n = 4) with people aged 25 to 45 with type 2 diabetes conducted in 2008.

Results. Implicit in participants' responses was their need to be active partners in managing their diabetes. Participants wanted information that is easy to understand, brief, consistent, age-specific and about a number of topics that are not adequately covered at present. They wanted a centralised source of information and a range of delivery mode options. Participants expressed some ambivalence about the Internet as a source of information. Participants also wanted age-specific group sessions, support from peers, psychological support, increased understanding of type 2 diabetes in the community, and a focus on preventing diabetes.

Conclusions. Young people with type 2 diabetes have specific diabetes needs and preferred information delivery modes. Participants felt current diabetes education programs do not cater specifically to their age group. Education and information resources need to be developed for the target group, addressing their content and format preferences.

Relevance to clinical practice. Health professionals need to utilise appropriate delivery modes and include information relevant to younger people when providing education information to young adults with type 2 diabetes.

Development of a model to explain the sexual beliefs, intentions and behaviours of adolescents and young adults

In the last thirty years there have been many research studies which have examined the reasons why adolescents and young adults engage in sexual behaviours. Most of these studies have lacked a theoretical basis, Consequently there are many links made between variables, but no consistency across studies, or attempts to develop an underlying theory to explain the results. However, there have been theoretical models developed to explain adolescents’ and young adults’ sexual decision making. Unfortunately, many of these models have not been empirically validated. This thesis attempts to address these deficiencies in the literature by utilising a theory of behaviour and applying it to adolescent and young adult sexual decision making. This theory is the Theory of Planned Behaviour (TPB). Two longitudinal studies were conducted to examine the utility of an adaptation of the TPB to sexual decision making among adolescents and young adults. In the first study 58 adolescent males, aged between 14 years and 18 years participated in a longitudinal study using a questionnaire adapted from the Depth of Sexual Involvement Scale. In the second study, 194 young adults (156 female, 38 male) aged between 18 years and 21 years participated in a similar study. The first study found that intention to engage in behaviour was well predicted, although some of the variables in the model, did not in fact, contribute significantly to the prediction. The prediction of behaviour was less strong than that of intention. Study two found that intention to engage in behaviours was well predicted by the model. However, the degree to which intention led to behaviour was not well predicted. Overall, the results of these studies suggest that the TPB is a good theoretical basis from which to launch a systematic and theoretically informed explanation of adolescent and young adult sexual decision making. However, other factors may need to be added to the model to fully describe the decision making process and accurately predict behaviour. Suggestions are made for future research, as well as interventions that may arise as more knowledge is gathered using this paradigm.

Spirituality and coping in young adults with diabetes : a cross-sectional study

Aim: Spirituality is an important aspect of wellbeing in people with diabetes. The current study aimed to explore how young adults with diabetes define spirituality, and the relationship between spirituality and coping in young adults with diabetes.

Methods: An exploratory study was conducted in 100 young adults with diabetes aged 18–30 years. Participants completed the Coping Questionnaire for Young Adults with Diabetes and the Spirituality Questionnaire.

Results: Young adults with diabetes defined spirituality as a sense of finding inner self and meaning in life, which is enriched by connections with other people and the universal whole. There was no significant difference in spirituality between religious and non-religious young adults with diabetes. People with a shorter duration of diabetes had higher scores on spiritual needs and engaged in more spiritual practices. Coping was correlated with spirituality (p<0.002) and self-awareness (p<0.000). Lower levels of glycosylated haemoglobin were associated with overall spirituality (p<0.04) and self-awareness (p<0.01).

Conclusions: Young adults with diabetes defined spirituality as a sense of being in touch with the inner self, meaning in life, and connecting with people, nature and a higher being. Spirituality is important to young adults with diabetes and helps them cope with stressful situations.

Bereaved young adults

This qualitative study examined the social experiences of twenty-five young adults, each bereaved of a sibling in the last ten years. The outcomes emphasised the importance of 'meaningful' support, the value of gender sensitive approaches toward studying bereavement, and the need for a wider social acknowledgement of the ongoing nature of grief.

Spirituality and coping in young adults with diabetes

This exploratory study with a combination of quantitative and qualitative methods addressed an important aspect of life that could help young adults with diabetes cope with stressful situations and manage their diabetes. The study aimed to explore young adults with diabetes' spirituality and how spirituality that focuses on inner-self and transformation can enhance their coping and diabetes management. The findings can also help health professionals integrate spirituality into diabetes care.

Post-disaster fiction for young adults : some trends and variations

In the forty years or so since it began to develop as a sub-genre of young adult fiction, post-disaster fiction has commented on a range of issues, including perceived social fears of the time, the nature of various types of society, and what people need in order to be truly human. This paper explores how young adult post-disaster fiction makes comment on these and other issues. It argues that within this genre there are three connected sub-genres, with the disaster having a different function in each, and the nature of the comments made by each of these sub-genres tending also to be different. As its title suggests, this paper includes texts in which the focus is on life after the disaster. The genre’s strong link with both the nature of young adult fiction and with adolescence itself suggests that it will continue to flourish as a sub-genre.

Tolerance of larger body sizes by young adults living in Australia and Hawaii

Identifying the barriers to achieving an appropriate body size is important for health. This study investigated young adults' tolerance of excess weight in other adults. Participants were 172 students (65 male, 107 female) with a mean age of 22.24 years (SD = 1.61). Half the participants resided in Australia, and half in Hawaii. Students from both countries were found to be tolerant of body sizes larger than those recommended for good health. These results help inform our understanding of the factors that may influence weight gain, and have important implications for the worldwide obesity problem and related health issues.

Self-assessed sexuality in young adults with High-Functioning Autism

The literature has revealed that autistic persons of all ages show an interest in sexuality and relationships, but the poor social and communication skills found among those with autism hinders the experience of this. Unfortunately, most research to date in this domain has relied exclusively upon parental or caregiver reports. Thus there remains a need for research to be undertaken in this area based on direct reports from autistic individuals. We hypothesised that compared to Typically Developing (TD) persons, persons with High-Functioning Autism (HFA) would reveal lesser levels of sexual experience, lower levels of sexual and social behaviour, and less understanding of privacy on various subscales of the Sexualised Behaviour Scale. The results of this present study supported the hypothesis on all scales except Privacy and Sexualised Behaviour. Overall, compared to TD individuals, HFA individuals engaged in fewer social behaviours, had less sex education and fewer sexual experiences, had more pronounced concerns for the future, and showed similar levels of privacy knowledge and public sexualised behaviour. These findings suggest a need for specialised sex education programs for autistic populations; further, since social behaviour was significantly lower for autistic individuals and future concerns were higher, this suggests that sex education programs need to incorporate education about social rules to enhance social communication and understanding.

Young adults’ management of Type 1 diabetes during life transitions

Aim. To identify life transitions likely to impact diabetes self-care among young adults with Type 1 diabetes and their coping strategies during transition events.
Background. Relationships among psychosocial stress, adjustment, coping and metabolic control affect clinical outcomes and mental health. Life transitions represent major change and are associated with stress that temporarily affects individuals’ problem-solving, coping abilities and blood glucose levels.
Design. A qualitative interpretive inquiry.
Method. Semi-structured interviews were conducted with 20 young adults with Type 1 diabetes and a constant comparative analysis method. Data and analysis was managed using QSR NVIVO 7 software.
Results. Participants identified two significant transition groups: life development associated with adolescence, going through the education system, entering new relationships, motherhood and the workforce and relocating. Diabetes-related transitions included being diagnosed, developing diabetes complications, commencing insulin pump treatment and going on diabetes camps. Participants managed transitions using ‘strategic thinking and planning’ with strategies of ‘self-negotiation to minimise risks’; ‘managing diabetes using previous experiences’; ‘connecting with others with diabetes’; ‘actively seeing information to ‘patch’ knowledge gaps’; and ‘putting diabetes into perspective’.
Conclusions. Several strategies are used to manage diabetes during transitions. Thinking and planning strategically was integral to glycaemic control and managing transitions. The impact of transitions on diabetes needs to be explored in larger and longitudinal studies to identify concrete strategies that assist diabetes care during life transitions.
Relevance to clinical practice. It is important for health professionals to understand the emotional, social and cognitive factors operating during transitions to assist young adults with Type 1 diabetes to achieve good health outcomes by prioritising goals and plan flexible, timely, individualised and collaborative treatment.