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Caregiving, Parenting, Toddler/preschool, Type 1 diabetes



  1. Sullivan-Bolyai, Susan DNSc, CNS
  2. Knafl, Kathleen PhD, RN
  3. Deatrick, Janet PhD, RN, FAAN
  4. Grey, Margaret Dr PH, FAAN


Purpose: To describe the process that mothers raising young (0-4 years old) children who are newly diagnosed with type 1 diabetes move through to attain the necessary skills to care for their children.


Study Design and Methods: A mixed methods design was used, including qualitative interviews with 28 mothers of young children with type 1 diabetes. Principles of naturalistic inquiry were used to guide the data collection process, management, and analysis of the qualitative findings.


Results: The process paralleled two of three management approaches and associated behaviors previously described by Gallo and Knafl. Strict adherence behaviors included rigidly following the team recommendations and avoiding strange environments outside the home. Flexible adherence behaviors strove to bring spontaneity back into family life. Selective adherence was not used by this population.


Clinical Implications: Nurses working with these mothers can provide information and support to help them transition from using strict adherence to the more user-friendly flexible adherence, while avoiding the pitfalls of the possibly harmful third approach of selective adherence. Nurses need to remember to praise the parents' efforts at managing their children's diabetes, for our acknowledgment of their work is empowering and affirming.