Managing the unmanageable through interdependence in adolescents living with type 1 diabetes and their parents: A constructivist grounded theory.

BACKGROUND: Management of T1D is complex and requires continuous care and monitoring that place many demands on adolescents with T1D and their parents. The purpose of this study was to explore the nature of interdependence with T1D management with adolescents and their parents. METHODS: Using a constructivist grounded theory methodology, 32 open-ended interviews were conducted, transcribed, and analyzed from 11 adolescents aged 10-18 years with T1D and eight parents. FINDINGS: The data were coded using three coding phases: initial, focused, and theroetical and this process continued until theroetical saturation was reached. The substantive theory that emerged from the data describing parents' and adolescents' main concern of Maintaining Optimal Glycemic Control was Managing the Unmanageable through Interdependence. Four related subprocesses were found: Completing T1D Tasks, Attaining Support, Balancing Independence, and Reconciling Reality. These subprocesses occurred within the context of the ever-changing, Nature of the Illness. DISCUSSION: There is a dynamic relationship associated with interdependence between adolescents with T1D and their parents that varied situationally and by age. Participants also indicated interdependence occurs or they would like it to occur, with others beyond themselves and the health-care team to others willing to be involved. APPLICATION TO PRACTICE: Interdependence is a dynamic process and requires ongoing evaluation by health-care professionals of its function in the daily management of T1D by parents and adolescents. Additional research into of the roles of health professionals and others in promoting interdependence is needed.

Lessons in media advocacy: a look back at Saskatchewan's nursing education debate.

Nurses are encouraged to exert their influence in the realm of public policy, particularly policies related to the nursing profession, the health care system and the health of their clients. Media advocacy can be used by nursing organizations to mobilize public support on policy issues in order to influence policy makers. This article retrospectively examined the media advocacy efforts of nursing stakeholders in Saskatchewan, Canada in response to a new government policy that would have impacted educational requirements for licensure as a registered nurse (RN) in that province. Print media sources from the period January to March, 2000 were examined to determine the specific media advocacy techniques used by nursing organizations within the framework of the policy cycle. The success of nursing stakeholders in reversing the government position highlights the effectiveness of media advocacy as a tool to disseminate messages from the nursing profession in order to impact policy.

Nurse retention strategies: advice from experienced registered nurses.

PURPOSE: The purpose of the paper is to explore the insights of experienced nurses regarding initiatives they believe would effectively retain nurses like themselves in the nursing profession. DESIGN/METHODOLOGY/APPROACH: As part of a qualitative investigation into the perceptions of nurses regarding issues affecting their profession, experienced nurses were asked to describe what retention strategies they would recommend to policy-makers. A total of 16 semi-structured interviews were conducted with long-term nurses in a health region in western Canada. FINDINGS: The paper found that seven retention strategies were commonly mentioned by the participants. The qualitative mode of inquiry allowed the nurses to convey the context, attitudes and feelings behind their recommendations. RESEARCH LIMITATIONS/IMPLICATIONS: The work environments and accompanying retention policies experienced by nurses vary widely according to the specific employment context As is typical with qualitative research, the findings of this study cannot be considered as generalizable to all nurses in all health care settings. PRACTICAL IMPLICATIONS: The results of this paper provide a deeper understanding of the attitudes, emotions and contextual issues behind the nurse retention strategies seen as most appropriate by the target audience of long-term nurses. ORIGINALITY/VALUE: While there is much literature advocating the implementation of nurse retention strategies, very little evidence has been presented from a qualitative lens. It is necessary to directly listen to the voices of those impacted by policies in order to better appreciate how such policies are perceived from a bottom-up perspective.