Parents'and school-aged children's views on managing treatment adherence in asthma or diabetes

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Journal Article
Neonatal, Paediatric and Child Health Nursing, 2007, 10 (3), pp. 26 - 30
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Expectations that children with chronic illness will take over management of their treatment as they mature, and the factors that enable this shift in responsibility from parents to children, remain relatively unexplored within the treatment adherence literature. There is, however, an implicit assumption that establishing effective and efficient self-management skills in childhood improves the adherence behaviours of adolescents. The purpose of this study was to explore the views of children with asthma or diabetes and their parents on treatment adherence, and to suggest potential strategies to assist in the development of positive adherence behaviours. Fourteen children with diabetes, six children with asthma and 14 parents were interviewed or participated in focus groups to discuss treatment adherence. Data were analysed using a thematic approach. This paper discusses the challenging issues identified by parents and children attempting to adhere to treatment regimes. The most important of these challenges includes family dynamics regarding roles, the potential for conflict regarding who is in control of the treatment and difference in the expectations within each family concerning the child's management of their illness and associated treatments. Nurses working with school-aged children with chronic illness, and their families, are well placed to develop approaches for assisting this transfer of responsibility. These findings support the need for nurses to explicitly address the issue of self-management, and assist families to develop individualised plans to facilitate the transfer process as the child matures.
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