This thesis exploresfactors which may impact upon the diabetes-management and health-related outcomes of children and adolescents with diabetes. A literature reviewexamined the evidence regarding the association between parenting styles and the glycaemiccontrol, adherence, quality of life and mental health of children and adolescents with diabetes. Overall, the evidence regarding parenting and glycaemic control and adherence wasinconsistent. However, when parenting and outcome measures were completed bythe same informant (either parent or child) parenting characterised by responsiveness, acceptance and involvement was associated with better quality of life and mental health, whilst parenting characterised by psychological control, demandingness and low warmth was associated with worse quality of life and mental health.It is important to highlight thatwhen parenting and outcome measures were completed by different informants, no significant associationsbetween parenting and quality of life or mental health was found. The review therefore indicated that parents and children may experience their relationshipdifferently, andfuture studies need to explore the unique experiences of children and adolescentswith diabetes.
A qualitative exploration of the lived experiences of adolescents with diabetes and poor glycaemic control is also presented. The findings indicatethat participants grappled with intrapersonal and interpersonal conflicts as they struggled to accept and manage their diabetes. A cyclical pattern of glycaemic control was depicted as participants described feelings of guilt and shame when their poor glycaemic control and concealment of this was
1-3exposed. However, subsequent improvements in theirglycaemic control wereshort-lived as participants struggledwith the burdensomeness of adhering to their regimes.The final paper examines the contributions made to theory and clinical practice, whilst outlining areas requiring further research.