Adolescent Perceptions of Peer Responses to Diabetes Self-Management: A Qualitative Study

Background Type 1 diabetes (T1D) is more prevalent in adolescents than in adults, and the self-management of insulin-dependent diabetes is complex. T1D requires injections of insulin, self-management of blood testing, regular physical activity, and diet monitoring, which are challenging for growing and developing adolescents. Adolescents are often more concerned with how they are perceived by their peers than how they perceive themselves. Positive peer responses influence the self-care management of adolescents with T1D in school settings. By contrast, negative peer responses and avoidance behaviors threaten to negatively affect the health outcomes of adolescents with T1D. Evidence indicates that peer influence is crucial to the successful self-management of diabetes in adolescents. However, very few studies have investigated the effect of peer influence on adolescents with T1D. Purpose This article describes how adolescents with T1D perceive the responses of their peers to their diabetes self-management in school settings. Methods Ten 12- to 17-year-old adolescents with diabetes were recruited from a pediatric endocrinology clinic at a university hospital in Taiwan. Audio-recorded interview data were transcribed verbatim and reviewed for accuracy. A thematic analysis approach was used to analyze the narrative content of semistructured interviews with participants. The rigor of the data collection and analysis was emphasized. Results Analysis of peer responses to the diabetes care practices of the participants revealed six themes: knowledge seeking, curiosity, enthusiasm, empathy, fearfulness, and isolation and bullying. Subthemes were categorized to illustrate how adolescents with T1D balance the challenge of diabetes self-care regimens and normal peer interactions. They were coping with the requirements of their T1D regimen and hoping to determine the perceptions of their peers toward this regimen and themselves. Conclusions/implications for practice Understanding the perception of peer identity for adolescents with T1D provides information for diabetes education and assists school nurses to facilitate successful T1D management in adolescents.