Illness perception in adolescents with controlled and uncontrolled diabetes: a rapid review
Type 1 diabetes mellitus (T1DM) is regarded as one of the most common endocrinological disorders found in adolescents. Several studies have reported an annual increase in the incidence of diabetes mellitus amongst children; however the prevalence rate for diabetes mellitus amongst adolescents in South Africa is unknown. T1DM can develop at any developmental stage of life. However, the peak onset for T1DM has been identified as being during puberty. In puberty, insulin resistance occurs, leaving adolescents particularly vulnerable. When adolescents are diagnosed with T1DM, they face the challenge of successfully integrating diabetes mellitus management into their lives, while concurrently struggling with the physiological and psychological changes that occur during this developmental phase. The strict treatment regime and the variety of distinct tasks that are required to manage diabetes effectively can increase emotional, social and physical stress. As less than one third of adolescents adhere to their treatment, it is important to identify psychosocial variables within adolescence. The aim of the current research was to conduct a rapid review, and to summarise the research findings on how illness perception of adolescents who successfully manage their T1DM differs from those who do not. The current research title refers to controlled and uncontrolled diabetes mellitus, whereas other research refers to it as metabolic control. A rapid review with a pragmatic approach was conducted in which a comprehensive and stepwise keyword search was done, using Boolean operators to combine keywords and the inclusion criteria. Quality assessment was done on the identified publications; in which three publications, published between 2016 and 2017, were used for the final inclusion. Initially, the current research found 11 unique publications, of which 6 publications met the following inclusion criteria; (1) published and peer reviewed article, specific to the research question; (2) studies that focused on illness perception amongst adolescents with type 1 diabetes; (3) studies that focused on illness perception amongst adolescents with controlled and uncontrolled management of their condition; (4) reviewed studies; (5) only ethically approved published and reviewed articles were be used; (6) studies done in English or in Afrikaans. After all duplicates were removed, a total of 3 studies were included that met the inclusion criteria. Of the 3 publications used, 1 publication found that illness perception does have an impact on metabolic control and that poor metabolic control tends to lead to more negative illness perception when compared to adolescents with good metabolic control; 1 publication pointed out that there is in fact a correlation between illness perception and metabolic control, but that this correlation could only be found in female adolescents. 1 publication pointed out that there is no correlation at all, however this might be due to the fact that this correlation could only be seen in girls and not in boys. The current research concluded that there is limited information available on how illness perception of adolescents diagnosed with T1DM may vary according to metabolic control levels. More research should be done in order to determine if adolescents who successfully manage their T1DM differ from those who do not, in terms of illness perception and whether or not gender plays a role.
- Health Sciences