Qualitative analysis of helpful and unhelpful aspects of social relationships among young adults with type 1 diabetes.

AIMS: Young adulthood is a high-risk time for type 1 diabetes management when individuals are managing diabetes within changing social contexts and new social relationships. This qualitative study examined helpful and unhelpful aspects of social relationships in the daily lives of young adults with type 1 diabetes. METHODS: Semi-structured qualitative interviews with 29 young adults with type 1 diabetes (ages 22-24, mean = 23 years; 55% female) explored: (a) who in the past week was present when diabetes management occurred; (b) what others did that was helpful or unhelpful for diabetes management; (c) what made helpful and unhelpful aspects of social relationships more or less likely; and (d) what young adults disclosed to others about diabetes. RESULTS: Romantic partners and parents were commonly present and helpful in giving reminders and offering instrumental support, but the presence of trusted individuals was also helpful to management. Co-workers and friends were present during episodes of diabetes management but were often unhelpful, especially when lacking knowledge about participants' diabetes or its management. Participants also discussed conflicting and spontaneous changes in schedules were unhelpful to management. Disclosing diabetes to others and planning for social context barriers were described as strategies to facilitate helpful and reduce unhelpful aspects of social relationships. CONCLUSIONS: Young adults face social barriers to management if they are unable to utilize their relationships effectively. Interventions to promote disclosure to trusted others and planning to avoid social context-related barriers to diabetes management may facilitate more effective self-management at this high-risk time of development.

Psychosocial Factors Related to Functional Restoration Treatment Completion and Return-to-Function for Patients With Chronic Disabling Occupational Musculoskeletal Disorders.

OBJECTIVE: The aim of this study was to identify demographic and psychosocial variables associated with successful completion of a functional restoration program and return-to-function within 3 months of treatment completion. METHODS: Three hundred seven patients admitted to the functional restoration program were evaluated for completion status and 200 patients with valid data were assessed for 3-month return-to-function status following completion. Psychosocial and functional status was assessed at baseline. RESULTS: Key factors associated with program completion included lower perceived disability, lower pain, lower functional impairment, and lower fear avoidance. Factors associated with 3-month return-to-function included lower perceived disability, lower depression, greater belief that pain is not associated with impairment, and higher quality of life. CONCLUSIONS: Psychosocial and functional factors contribute to both functional restoration completion and 3-month return-to-function outcomes.