Research Summary and Ethical Considerations Guidelines (Essay Sample)

Topic: Research Summary and Ethical Considerations Guidelines
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Introduction
Type 1 diabetes in adolescents is associated with challenges due to the challenges related to prioritizing between diabetes management and meeting their psychosocial needs. This result into poor glycaemic control and parent-child conflicts that intern hamper the hospital caregiver’s attempts to involve the adolescent and parent in proper glycaemic control. Integrated visits involving the three parties are absent, and the Guided Self-Determined-Young (GSD-Y) method has been proven effective in pediatric diabetes within outpatient clinics. Hence, the paper aimed at testing the efficacy of GSD-Y in routine outpatient clinic visits. This is through the reduction of HbA1c concentration and promoting the development life skills (Husted, Thorsteinsson, Esbensen, Hommel, & Zoffmann, 2011).
Background of the Study
Adolescents that present with type 1 diabetes experience many challenges that are associated with the conflicting priorities between the managing their diabetes and meeting their psychosocial needs (Court, Cameron, Berg-Kelly, & Swift, 2009). Such a conflict consequently leads to poor glycaemic control and a discord in the parent-adolescent relationship. This conflict acts as a barrier among care providers as they attempt to integrate the adolescent and parent in improving the glycaemic control (Husted, Thorsteinsson, Esbensen, Hommel, & Zoffmann, 2011). Interventions that are based on evidence involving the adolescents, parents, and caregivers integration into routine outpatient visits are absent. The method of Guided Self-Determination has been effective in adult care settings. It has also been adopted in adolescent and parent Guided Self-Determination-Young (GSD-Y) in outpatient clinics for pediatric as diabetes patients (Husted, Thorsteinsson, Esbensen, Hommel, & Zoffmann, 2011).
Problem
The life years that are lost by ten-year-old children that have diabetes (type 1) has been 17 years for over four decades. Controlling blood-glucose levels in the early stages of the disease prevents or postpones diabetic complications later in life. Conflicts that develop between the adolescent and parent make it difficult for hospital caregivers to establish a collaborative approach to controlling the glucose levels hence hampering treatment (Weinger, O'Donnell, & Ritholz, 2001).
Purpose
The study’s purpose was to provide evidence on the effectiveness of incorporating the GSD-Y intervention approach with the three affected parties on HbA1c levels and life skills. In addition, the feasibility of integrating this treatment approach in routine visits to the outpatient clinic (Husted, Thorsteinsson, Esbensen, Hommel, & Zoffmann, 2011).
Objectives
1) To test the possibility of including GSD-Y in routine outpatient pediatric clinics for diabetic children in a collaborative manner, (adolescents, their parents and the interdisciplinary diabetes HCPs).
2) To test the ability of GSD-Y to reduce HbA1c levels and promote the development of life skills among diabetic adolescents.
3) To illustrate the influence of GSD-Y in life skills development through support from parents and their HCPs and diabetic adolescents.
Concepts
GSD is a method for problem-solving and decision-making designed to overcome any barriers to empowerment that may exist in the relationships between an adult patient and the caregiver. The barriers being addressed here are understood using the grounded theories and GSD is based on life skills, empowerment and motivational theories of self-determination (Husted, Thorsteinsson, Esbensen, Hommel, & Zoffmann, 2011).
Therefore, GDS-Y targets the improvement of glycaemic control and improving the life skills of the adolescent. Life skills here are the personal, social, cognitive and physical skills enabling individuals to have of their control lives and develop the capacity to survive and change the environment they inhabit. During the acquisition of these skills, the adolescent is intended to start accepting and integrating the diabetes into their lives. Therefore, he/she becomes autonomously motivated to handle the challenges and demands of teenage type 1 diabetes (Husted, Thorsteinsson, Esbensen, Hommel, & Zoffmann, 2011).
According to SDT, development of self-determined behavior to manage diabetes competence, autonomy and relatedness should be achieved. Environments supporting these needs promote the adolescents ability to manage the condition. However, parents and caregivers may obstruct the development of these needs in an adolescent unwillingly by applying pressure on the adolescent to control their glucose levels. They, therefore, unconsciously hamper the development of the adolescents need hence foster passivity, ill-being and a lack of motivation (Husted, Thorsteinsson, Esbensen, Hommel, & Zoffmann, 2011).
Methods of Study
The study employed a mixed method approach hence comprised of both quantitative (randomized controlled trial) and qualitative (nested evaluation) approaches. Sample selection was based on HbA1c as the primary outcome measure. Applying the power calculation, 1.0% HbA1C absolute difference between the GSD-Y group and the control group were detected. The calculation was on the basis of HbA1c standard deviation values of 1.3% and to compensate for an attrition rate of 25%, the study aimed at recruiting 68 patients. Therefore, the sample comprised of 68 adolescents that were aged between 13 – 18 years with type 1 diabetes and HbA1c > 8.0% and their parents that were randomized into GSD-Y or control groups. The GSD- Y group was required to complete eight outpatient GSD-Y visits in 8-12 months (Husted, Thorsteinsson, Esbensen, Hommel, & Zoffmann, 2011).
The control group was also required to complete the same number of standard visits during the same period. Evaluation of both the primary and secondary outcomes was done within and between both groups through the comparison of data from the baseline. This was done following the completion of visits and after the follow-up period of six months. The 10-12 GSD-Y visits were recorded during the intervention period. They were qualitatively analyzed with the individual interviews that were done during the follow-up. This was to highlight how glycaemic control and life-skills development are influenced by GSD-Y (Husted, Thorsteinsson, Esbensen, Hommel, & Zoffmann, 2011).
Results of the Study
The results highlighted the effectiveness of incorporating GSD-Y intervention approach with the three affected parties (the adolescents, parents, and caregivers) on HbA1c and life skills. The intervention group developed better control and lif...