Contextual Assessment of Problematic Situations Identified by Insulin Pump Using Adolescents and Their Parents

For youth with type 1 diabetes mellitus (T1DM) using insulin pumps, maintaining metabolic control through appropriate self-care is a complex biopsychosocial process reciprocally influenced by individual, familial, social, and technological variables. Adolescents (n = 20) with T1DM using insulin pumps and their parents (n = 34) were interviewed to determine (a) the most frequent and difficult situations faced by adolescents and their parents, (b) how the frequency and difficulty of these situations vary as a function of the respondent, the nature (content) of the problem, and the systemic context(s) in which problems occur, and (c) the relationship between the average difficulty rating and the youth's metabolic control. The most frequently reported problematic situations were T1DM self-care. For youth these problems were predominantly related to social and peer contexts; parents identified problems primarily related to the family context. Implications and additional analyses are reported.