Exploring blood glucose-related problem solving in at-risk emerging adults with type 1 diabetes

Abstract

Purpose: To investigate the problem-solving skills of emerging adults with diabetes following hospitalisation for diabetic ketoacidosis (DKA). Methods: An exploratory study design using the validated Diabetes Problem Solving Interview (DPSI) tool and taped interviews of responses to the DPSI. The DPSI score, covering two vignettes with six questions each coded zero to two, ranged from zero to 12. Scores were provided by two independent raters who analysed the transcribed interviews. Content analysis of the interviewed responses provided insights into self-care choices. Results: There was no difference between the volunteers (n=11) and non-participants (n=22) in the target group (N=33) in relation to gender distribution or number of DKA events. Mean age for the volunteer sample was 24.1 years and number of DKA events ranged from one to three. The median DPSI scores were 8.5 and 9.0 (max of 12) for hypoglycaemia and hyperglycaemia vignettes respectively. Conclusion: Participants had a reasonable understanding of what should be done but the qualitative results suggest their application of that knowledge was variable and perhaps contributed to their DKA risk. In seeking to improve services for emerging adults with diabetes when transferring to the adult health care system, the interpretative repertoires from this sample help to reveal the linguistically-expressed logic rules and intuition used.