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Reasons for missed meal-time insulin boluses from the perspective of adolescents using insulin pumps: 'lost focus'
Sachs' Children's Hospital, Södersjukhuset, SE-118 83 Stockholm, Sweden / Department of Medical Sciences, Uppsala University Hospital, SE-752 37 Uppsala, Sweden.
University of Skövde, School of Life Sciences.
Department of Medical Sciences, Uppsala University Hospital, SE-752 37 Uppsala, Sweden.
2011 (English)In: Pediatric Diabetes, ISSN 1399-543X, E-ISSN 1399-5448, Vol. 12, no 4 part 2, 402-409 p.Article in journal (Refereed) Published
Abstract [en]

Objective: To investigate the reasons for missed bolus doses and strategies for avoiding this among adolescents using insulin pumps.

Methods: The grounded theory method was chosen as a model for the collection and analysis of data. Data were collected through interviews with 12 adolescents treated with an insulin pump (5 males and 7 females, mean age 14.4 yr) from different Swedish pediatric diabetes clinics. All interviews were tape-recorded and immediately transcribed.

Results: The core category ‘lost focus’ emerged as representing the main reason for missed bolus doses. Identified subcategories were delayed lost focus, directly lost focus, and totally lost focus. There was a risk of delayed lost focus when the adolescent used postprandial bolusing. Focus could also be lost directly in connection with the start of the meal. Totally lost focus could occur when the adolescent perceived the impact of diabetes as too high or tried to neglect that he or she had it. The category ‘agreements about reminders’ appeared to be the main strategy for avoiding missed bolus doses; subcategories were personal reminders and technical reminders. The adolescent needed to be involved in these agreements; otherwise, the reminding could be seen as nagging and did not work.

Conclusion: The results may help diabetes care teams understand the circumstances in which adolescents miss their bolus doses. This understanding may make it easier to discuss missed doses and strategies for avoiding this with adolescents and support negotiations over agreements about reminders between them and their parents.

Place, publisher, year, edition, pages
John Wiley & Sons, 2011. Vol. 12, no 4 part 2, 402-409 p.
Keyword [en]
adolescents, diabetes mellitus type 1, insulin infusion systems, insulin omission, qualitative research
National Category
Medical and Health Sciences
Research subject
Medical sciences
Identifiers
URN: urn:nbn:se:his:diva-5389DOI: 10.1111/j.1399-5448.2010.00688.xISI: 000290964000006PubMedID: 21129137Scopus ID: 2-s2.0-79957459988OAI: oai:DiVA.org:his-5389DiVA: diva2:477467
Available from: 2012-01-13 Created: 2012-01-13 Last updated: 2012-12-14Bibliographically approved

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CiteExportLink to record
Permanent link

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Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
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  • sv-SE
  • Other locale
More languages
Output format
  • html
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