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Fathers' encounter of support from paediatric diabetes teams: the tension between general recommendations and personal experience
University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.ORCID iD: 0000-0003-3792-6600
Nordic School of Public Health NHV, Gothenburg.
University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.ORCID iD: 0000-0003-3702-8202
Department of Pediatrics, NU Hospital Group, Uddevalla Hospital, Uddevalla.
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2013 (English)In: Health & Social Care in the Community, ISSN 0966-0410, E-ISSN 1365-2524, Vol. 21, no 3, 263-270 p.Article in journal (Refereed) Published
Abstract [en]

The purpose of this grounded theory study was to explore and discuss how fathers involved in caring for a child with type 1 diabetes experienced support from Swedish paediatric diabetes teams (PDTs) in everyday life with their child. Eleven fathers of children with type 1 diabetes, living in Sweden and scoring high on involvement on the Parental Responsibility Questionnaire, participated. Data were collected from January 2011 to August 2011, initially through online focus group discussions in which 6 of 19 invited fathers participated. Due to high attrition, the data collection continued in eight individual interviews. A semi-structured interview guide was used, and the fathers were asked to share experiences of their PDT's support in everyday life with their child. A simultaneous and constant comparison approach to data collection and analysis allowed the core category to emerge: the tension between general recommendations and personal experience. This core category illuminates how the fathers experienced tension between managing their unique everyday life with their child and balancing this to meet their PDT's expectations with regard to blood glucose levels. The core category was supported by two categories: the tension between the fathers'and their PDT's knowledge, whereby fathers reported discrepancies between their PDT's medical knowledge and their own unique knowledge of their child; and the tension between the fathers'and their PDT's goals, whereby the fathers identified differences between the familys' and their PDT's goals. As a dimension of the core category, fathers felt trust or distrust in their PDT. We conclude that to achieve high-quality support for children with diabetes and to enhance their health and well-being, involved fathers' knowledge of their unique family situation needs to be integrated into the diabetes treatment.

Place, publisher, year, edition, pages
United Kingdom: Wiley-Blackwell, 2013. Vol. 21, no 3, 263-270 p.
Keyword [en]
family health practice, health promotion, involved fathers, paediatric diabetes team, type 1 diabetes
National Category
Medical and Health Sciences
Research subject
NURSING AND PUBLIC HEALTH SCIENCE, Public health science
Identifiers
URN: urn:nbn:se:hv:diva-4946DOI: 10.1111/hsc.12013ISI: 000317076400005Scopus ID: 2-s2.0-84875809888OAI: oai:DiVA.org:hv-4946DiVA: diva2:580764
Available from: 2012-12-26 Created: 2012-12-26 Last updated: 2015-03-04Bibliographically approved
In thesis
1. Fathers involved in children with type 1 diabetes: finding the balance between disease control and health promotion
Open this publication in new window or tab >>Fathers involved in children with type 1 diabetes: finding the balance between disease control and health promotion
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background:

Type I diabetes is a chronic disease that places great demands on the child and family. Parental involvement has been found to be essential for disease outcome. However, fathers’ involvement has been less studied, even though high paternal involvement has been correlated with less disease impact on the family and higher quality of life among adolescents.

Aim: The overall aim of the study was to explore and analyze constructions of fathers’ involvement in their child’s everyday life with type 1 diabetes from an ecological and health promotion perspective. Four specific aims were applied: 1) explore and describe discourses in health care guidelines for children with type 1 diabetes in Nordic countries, focusing on parents' positioning (I), 2) analyze how Swedish pediatric diabetes teams perceived and discussed fathers’ involvement in the care of their child with type 1 diabetes, and to discuss how the teams’ attitudes toward the fathers’ involvement developed during a focus group process (II), 3) explore and discuss how fathers involved in caring for their child with type 1 diabetes experience support from their pediatric diabetes team in everyday life with their child (III), and 4) analyze how involved fathers to children with type 1 diabetes understand their involvement in their child’s daily life and to discuss their perceptions from a health promotion perspective (IV).

Material and methods: A qualitative and inductive approach was applied. Data were collected and analyzed during 2010-2012. The sample consisted of three pediatric guidelines originating from Norway, Denmark and Sweden (I), three Swedish pediatric diabetes teams (PDTs) (II), and 11 (III) and 16 (IV) fathers of children with type 1 diabetes who scored high involvement on the Parental Responsibility Questionnaire. Data were collected through repeated focus group discussions with the PDTs (II), online focus group discussions (III) and individual interviews (III, IV) with the fathers. Three analysis methods were applied: analysis of discourses (I), Constructivist Grounded Theory (II, III) and content analysis (IV).

Findings: The findings illuminated the complex interaction between the pediatric guidelines, the PDTs and the fathers. Fathers highly involved in their child’s daily life experienced different levels of tension between the general recommendations and their personal experiences of living with a child with type 1 diabetes (III). The fathers regarded their involvement in their child’s diabetes care as additional to their general parenting, and a fine balance was identified between a health promotion perspective and a controlling involvement. The common denominator between the highly involved fathers was their use of parental leave (IV). The PDTs initially perceived fathers’ involvement as gendered and balanced on the mother’s agement, but as focus was set on fathers’ engagement the PDTs increased their awareness of this and started to identify and encourage their engagement II). At the macro-level, parents’ voices were diminished in Nordic pediatric diabetes guidelines in favor of an expert discourse (I).

Conclusions: Fathers’ involvement concerning a child with type 1diabetes is constructed in a complex way, based on an interaction between the fathers’ perceptions of their additional involvement and the support provided by the PDTs; the PDTs’ perceptions of the fathers’ involvement; and how parents/fathers are constructed in pediatric diabetes guidelines. In order to promote the health and well-being of children with type 1 diabetes, fathers’ involvement needs to be taken into account in the pediatric guidelines as well as in clinical practice. 

Place, publisher, year, edition, pages
Gothenburg: Nordic School of Public Health, 2013. 60 p.
Series
NHV rapporter, ISSN 0283-1961 ; 2013:1
Keyword
children, fathers’ involvement, health promotion, pediatric diabetes team, type 1
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
NURSING AND PUBLIC HEALTH SCIENCE, Public health science
Identifiers
urn:nbn:se:hv:diva-5808 (URN)978-91-86739-48-5 (ISBN)
Public defence
Nordic School of Public Health, Box 12133, 402 42 Göteborg (Swedish)
Opponent
Supervisors
Available from: 2014-01-16 Created: 2013-12-17 Last updated: 2015-03-04Bibliographically approved

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