Family responsibility dynamics for young adults in transition to adult health care

Abstract

Aim: To explore family responsibility dynamics, metabolic control, clinic attendance, and emergency admissions when young adults (YA) with type 1 diabetes transition to an adult hospital. Method: A longitudinal mixed method design with two study groups (parents, n = 28; YA intervention group, n = 23) and a YA comparison group (n = 20). Sample recruited from an outpatient diabetes centre. Demographic, clinic at-tendance, emergency admissions, biodata, and the Diabetes Family Responsibility Questionnaire (DFRQ) were completed on entry and six- months later as part of an 18-month trial of a diabetes transition coordinator (DTC). The self- report DFRQ were analyzed using derived parent-child dyadic variables to explore differences at baseline and end of study using Wilcoxon Signed Rank Test. The relationship between metabolic control and the DFRQ patterns was explored using Spearman’s rho. Results: On completion of the study, the change in HBA1C for both adolescent groups was not significant but was less than ideal for 25% of adolescents in the study. The YA intervention group had significantly fewer missed appointments between them compared to the comparison group. The DFRQ indicated that the derived parent-child dyadic variable of task-discordance increased during the study. Conclusion: The clinically relevant diabetes-task dissonance between parents and young adults offers a challenge and a diagnostic opportunity for diabetes educators.