Battling boundaries and conscience : a grounded theory of paediatric diabetes healthcare professionals’ experiences of safeguarding and child protection
type: CreativeWork
description: Introduction: Managing diabetes in children is complex, and in some families, overwhelming life circumstances hinder their capacity to meet diabetes care recommendations leading to safeguarding concerns for healthcare professionals. This study explores how healthcare professionals navigate safeguarding and child protection within paediatric diabetes services in England and Wales. Objectives: The study investigated how paediatric diabetes-specific safeguarding or child protection concerns are experienced, interpreted, and acted upon in clinical practice. Methods: A sample of 20 multidisciplinary participants was purposefully recruited through a professional network. Data from semi-structured interviews was analysed using a constructivist grounded theory methodology to develop a substantive theory. Results: Battling boundaries and Conscience is a grounded theory substantive to the area of paediatric diabetes in England and Wales. It is presented in the form of a conceptual model that presents the two interconnected conceptual categories and the relationships between them. It provides an understanding of how diabetes healthcare professionals navigate safeguarding or child protection concerns. Informing the ‘Battling Boundaries’ category. Participants described challenges in deciphering need, determining what constitutes “good enough care” when families appear unable, ambivalent, or overwhelmed in managing their child’s diabetes. However, systemic challenges, associated with institutional referral thresholds and a lack of diabetes literacy within children’s services, creates a divide between services, which hinders professionals enabling protective change for children and families often leaving professionals ‘filling the gap’, operating in a grey area “under the threshold.” The second category ‘Reconciling Professional Insecurity’, represents the battle of conscience. Participants revealed moral distress arising from personal doubt, fear of damaging therapeutic alliance…
abstract: Introduction: Managing diabetes in children is complex, and in some families, overwhelming life circumstances hinder their capacity to meet diabetes care recommendations leading to safeguarding concerns for healthcare professionals. This study explores how healthcare professionals navigate safeguarding and child protection within paediatric diabetes services in England and Wales. Objectives: The study investigated how paediatric diabetes-specific safeguarding or child protection concerns are experienced, interpreted, and acted upon in clinical practice. Methods: A sample of 20 multidisciplinary participants was purposefully recruited through a professional network. Data from semi-structured interviews was analysed using a constructivist grounded theory methodology to develop a substantive theory. Results: Battling boundaries and Conscience is a grounded theory substantive to the area of paediatric diabetes in England and Wales. It is presented in the form of a conceptual model that presents the two interconnected conceptual categories and the relationships between them. It provides an understanding of how diabetes healthcare professionals navigate safeguarding or child protection concerns. Informing the ‘Battling Boundaries’ category. Participants described challenges in deciphering need, determining what constitutes “good enough care” when families appear unable, ambivalent, or overwhelmed in managing their child’s diabetes. However, systemic challenges, associated with institutional referral thresholds and a lack of diabetes literacy within children’s services, creates a divide between services, which hinders professionals enabling protective change for children and families often leaving professionals ‘filling the gap’, operating in a grey area “under the threshold.” The second category ‘Reconciling Professional Insecurity’, represents the battle of conscience. Participants revealed moral distress arising from personal doubt, fear of damaging therapeutic alliance…
author: Yardley, Diana
language: en
date modified: 2026-07-24T03:42:07Z
provider: Oxford Brookes University
publisher: Networked Digital Library of Theses and Dissertations
type: WebPage
source organization: Oxford Brookes University

PropertyValue
property ID: DOI
value: 10.24384/n6xn-t440