A Qualitative Exploration of Self-Care Behaviors for Disease and Symptom Management Among College Students with Type 1 Diabetes Mellitus
Although only 2.5% of college students have been diagnosed with Type 1 Diabetes Mellitus (T1DM), the effects of inadequate management can lead to hospitalizations, additional development of chronic health conditions, and early mortality. Therefore, T1DM self-care behaviors (e.g., administering insulin, monitoring blood glucose) must be performed to minimize disease exacerbations. Previous research has shown that college students with T1DM are improperly administering insulin and infrequently monitoring their blood glucose levels. Though previous research has utilized quantitative and qualitative methods to examine T1DM self-care behaviors among college students with T1DM, the literature is limited on disease and symptom management experiences among college students with T1DM. Therefore, this qualitative study used the middle-range theory of self-care of chronic illness integration of symptoms as a theoretical framework to conceptualize and explore T1DM self-care behaviors utilized for disease and symptom management. Participants engaged in self-care maintenance through carrying supplies, inserting consumed carbohydrates into their medical device, checking blood glucose, administering insulin, and engaging in physical activity. Self-care monitoring behaviors included recording and tracking changes to their blood glucose. Self-care management behaviors consisted of adjusting insulin rates, changing pump/pod sites, and consulting with their provider. Symptom management findings were physiological awareness and technology alerts to determine that symptoms were present (i.e., symptom detection). Symptom interpretation experiences included analyzing blood glucose trends and examining the situational causes of their blood glucose changing. Symptom response experiences consisted of immediately responding to hypoglycemia and situational responses to hyperglycemia. Barriers and facilitators that impacted T1DM self-care behaviors included barriers such as 1) diabetes burnout, 2) college lifestyle, 3) difficulty receiving medical supplies, 4) insurance limitations, and the facilitators consisted of 1) years of experience, 2) tangible support with supplies, 3) emotional support for disease and symptom management, 4) informational support for disease management, and 5) technology assistance for disease and symptom management. Findings from this study can be used for future interventions for college students with T1DM, and can guide healthcare professionals, health education and promotion practitioners, and family, friends, and romantic partners on how to support disease and symptom management among full-time college students.
Chronic Disease Self-Management, College Students, Health Education/Promotion, Qualitative Research, Self-Care Behaviors, Type 1 Diabetes Mellitus
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