Perceptions Related to Death in Adolescents and Their Parents During the Management of Type 1 Diabetes: A Thematic Analysis.

BACKGROUND: Type 1 diabetes (T1D) is associated with an increased risk of premature death compared to those without T1D, yet perceptions of dying have not been well studied. The purpose of this secondary analysis of existing data was to explore the fears of adolescents with T1D and their parents related to the possibility of death due to T1D. METHOD: A reflexive thematic analysis was used to examine data from interviews conducted with adolescents with T1D and their parents who participated in a primary grounded theory study of interdependence in T1D management. FINDINGS: Three themes were generated from the data including: (1) Facing the Reality of Death, (2) Fearing Highs and Lows, and (3) Finding a Way through Fears. Participants indicated they see death as a consequence of failing to optimally manage T1D. CONCLUSION: Additional investigation is needed to explore the fear of death in adolescents with T1D and any fear their parents may have of their adolescents' mortality.

Revolutionizing nursing education through Ai integration: A reflection on the disruptive impact of ChatGPT.

Artificial intelligence (AI) is driving global change. An AI language model like ChatGPT could revolutionize the delivery of nursing education in the future. ChatGPT is an AI-enabled text generator that has garnered significant attention due to its ability to engage in conversations and answer questions. Nurse educators play a crucial role in preparing nursing students for a technology-integrated healthcare system, and the emergence of ChatGPT presents both opportunities and challenges. While the technology has limitations and potential biases, it also has the potential to benefit students by facilitating learning, improving digital literacy, and encouraging critical thinking about AI integration in healthcare. Nurse educators can incorporate ChatGPT into their curriculum through formative or summative assessments and should prioritize faculty development to understand and use AI technologies effectively. Collaboration between educational institutions, regulatory bodies, and educators is crucial to establish provincial and national competencies and frameworks that reflect the increasing importance of AI in nursing education and practice. It is paramount that nurses and nurse educators be open to AI-enabled innovations as well as continue to critically think about their potential value to advance the profession so nurses are better prepared to lead the digital future.

Type 1 diabetes management responsibilities between adolescents with T1D and their parents: An integrative review.

PURPOSE: Diabetes self-management for adolescents with type 1 diabetes (T1D) is a complex and multifaceted process that requires careful consideration of a supportive or shared approach to care. The purpose of this review was to synthesize the qualitative and quantitative evidence regarding the nature of adolescent-parent interactions and relationships in the context of T1D management. Of particular interest was the role of interdependence in this relationship. METHODS: An integrative review of the literature was conducted between January 2021 and April 2021 using Whittemore and Knafl's (2005) methodological strategies. RESULTS: Eleven studies published between 2003 and 2018 met the review criteria. Thematic analysis identified the following three themes related to parent-adolescent relationships in care including the Effectiveness of Parental Involvement and T1D Management, Shared Responsibility and T1D Task Management, and Gaining Independence in T1D Management. This review highlights the importance of both parent and adolescent shared involvement in T1D management. In particular, parental involvement appears necessary for improved glycemic control, better adherence to the T1D management regime, and for practicing self-management in adolescents with T1D. PRACTICE IMPLICATIONS: Better understanding of the parent-child interaction in diabetes care will provide important information to aid family nurses to identify, support, and help maintain the sharing of T1D management responsibilities between parents and their adolescents.

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.

The association between farming activities and respiratory health in rural school age children.

This study assessed the prevalence of asthma in Canadian children living on and off farms and the risk of asthma and respiratory symptoms of children exposed to certain farming activities. A cross-sectional survey was sent to parents of school children ages 6 to 13 living in an agricultural community in rural Saskatchewan. History of asthma and respiratory symptoms (cough, phlegm, or wheeze), location of home, and exposure to farming activities including haying, harvesting, moving, or playing with hay bales, feeding livestock, cleaning or playing in barns, cleaning pens, and emptying or filling grain bins were assessed. The response rate was 90.6% (n = 553). The prevalence of asthma and respiratory symptoms were 18.8% and 39.8%, respectively, and did not differ by home location (farm/nonfarm). In the adjusted multivariable models conducted with each farming activity separately, children who were exposed to emptying and filling of grain bins had a higher odds of asthma (odds [OR] = 2.18, 95% confidence interval [CI]: 1.03-4.62]. Reports of playing on or near hay bales (OR = 1.89, 95% CI:1.19-3.01), (OR = 2.08, 95% CI:1.07-4.06), and cleaning pens (OR = 2.70, 95% CI:1.05-6.97) were associated with increased respiratory symptoms. Certain farming activities associated with dust and animals appear to be risk factors for asthma and respiratory symptoms in this study population and should be avoided.