The Health and Well-Being among Children with Diabetes and Low HbA1c—A Qualitative Study in Sweden

Aims and objectives: To examine health and well-being, as well as the need for support among children and parents where the child has T1DM with low HbA1c (Introduction: Studies have shown that children with diabetes type 1 (T1DM) rate their lives as worse than healthy peer ratings. In Sweden, views have been expressed that children, as well as their parents, feel pressurized by the diabetes teams to achieve low HbA1c values, which can lead to poorer mental health for the family. Design: A qualitative study. Methods: A consecutive sample of 11 children and their parents (one father, ten mothers) was interviewed together but individually guided by a semi structured interview guide. Interviews were analyzed using thematic content analysis. Results: Four main categories were consistent across children and their parents;1) attitude to the illness, 2) sadness about diabetes, 3) the importance of the social network, and 4) the importance of the diabetes team. Worries about hyperglycemia were more prominent than worries about hypoglycemia in both children and parents. A distinguishing feature of the interviewed children was that they were responsible, strict and targeted. Many of them were competitive and took part in various sports, even at a very advanced level. Conclusions: This study shows that children with low HbA1c values experience good health and good well-being. Family support, good planning, and high acceptance of their illness contributed to this.

The social environment is most important for not using snus or smoking among adolescents

Aims: To identify factors, which were related to being smoke-free and snus-free, respectively, among adolescents in relation to adolescents who were smoking and/or using snus, and determine if there were any sex differences. Methods: A questionnaire study was performed among students in year two in upper secondary schools (17-years-old) in southern Sweden in 2009. More than 2200 students completed the questionnaire regarding health and living habits anonymously. The variables were tested by χ2-test, before selection into the logistic model. Because of the salutogenic approach in the study, the results of the logistic regression analyses were expressed as Positive Odds Ratio (POR). Results: The prevalence of being smoke- free was 75.6 percent for girls and 70.2 percent for boys, whilst the prevalence of being snus- free was 95.1 percent for girls and 70.2 percent for boys. Having a tobacco-free best friend was the most important factor that correlated with being smoke- and snus-free as an adolescent, for both boys and girls. Good living habits, such as drinking less alcohol, were also central to being smoke-free and snus-free. Conclusions: The results show that a tobacco-free environment has a great influence on whether or not adolescents stay tobacco-free. As the environment has a big impact, the school has a big challenge to work with the school environment and policies but also with family responsibility, norms and attitudes to tobacco.

Experiences of Being Non-Smoking among Adolescents in a Smoking Context

Introduction: A study among Greenlandic 13-year-old showed that 68 percent for boys and 55 percent for girls, and at age 15, 46 percent of the boys and 32 percent of the girls were non-smokers. A literature review showed that the behaviour of parents and peers, attitudes and expectations were crucial factors for the smoking habits of adolescents. Young adults would more likely start smoking if their parents, older siblings and/or friends were smokers. Parental support has been proven to be a preventive factor against smoking, especially if the school and leisure centers get involved. Group pressure, directly or indirectly, is often described as the most important reason why adolescents start smoking. The purpose was to study why some adolescents choose to be smoke-free in a society where the norm is to smoke. Methods: Adolescents who were non-smokers were interviewed in focus groups. The material was analysed using content analysis. Results: The contents analysis of the text resulted in eleven categories. Based on these, four themes were developed. These themes covered areas on the reasons for being smoke-free;how the smoke-free adolescents generally felt about smokers from a society or environment perspective, and also specifically from an individual perspective, such as how smokers took up space and did not show any consideration. There was a feeling among non-smokers of not belonging and of ambivalence, as well as a perspective of the future for adolescents in Greenland and an uncertainty about what would be required for a smoke-free environment. Conclusions: In a context where the norm is to smoke, the adolescents need to make a conscious choice to be smoke-free, and there were different reasons for this choice. This choice means becoming an outsider in their group of peers as well as the overall social culture. Smokers were seen as taking up too much space, as their needs ruled and this was deemed inconsiderate.