Self-Transcendence and Self-Care Behaviors in Emerging Adults with Type 1 Diabetes

Abstract

Emerging adults (age 18 to 25 years) with type 1 diabetes (T1D) represent a high risk, vulnerable population due to burdens they face in self-managing a daily regimen of diet, exercise, and glycemic control while simultaneously striving to meet developmental goals. Emerging adults are vulnerable to decreased diabetes self-care and well-being due to ongoing disruptions in the expected biography of their daily lives due to the burden and demands of T1D. Emerging adults with T1D also commonly experience diabetes distress. Ongoing vulnerability experienced by emerging adults with T1D can negatively affect their diabetes self-care and psychosocial well-being. Self-transcendence serves as a potent resource for well-being and transcending the negative effects of vulnerability to promote diabetes self-care and well-being outcomes. The purpose of this study was to explore and describe the perspectives and behaviors of emerging adults with T1D that reflected self-transcendence and how they positively influenced or facilitated their diabetes self-care. Factors (gender, work/university status, social support) that influenced diabetes self-care were also examined. The conceptual framework for this study was developed from the ‘Theory of Self-Transcendence’ and existing literature. Self-transcendence is expressed through life perspectives and behaviors that indicate expansion of personal boundaries through cognitive, introspective, creative, social, and spiritual pathways to influence a sense of well-being and personal growth. Qualitative description methodology was used. The purposive sample consisted of 29 emerging adults (age 18 to 25 years) who had lived with T1D for at least one year. Data were analyzed using thematic content analysis with the aim of presenting the key themes of participant narratives collected from interviews. The results suggest that self-transcendence promoted positive outcomes related to diabetes self-care and well-being. The findings also suggested that self-transcendence served to mitigate the negative effects of vulnerability among the participant group and was potentially the mechanism by which diabetes self-care occurred. Therefore, self-transcendence may help to sustain ongoing diabetes self-care behaviors and a sense of well-being. Based on the results, a revised theoretical framework was proposed to present the theoretical process of self-transcendence that emerged during data analysis among the participant group. The knowledge gained from this study will inform nurses who care for emerging adults with T1D of their important role in facilitating self-transcendence in this population to promote their diabetes self-care, sense of well-being, and positive outcomes. Implications for research include development and testing of innovative interventions to promote self-transcendence specifically tailored to meet the unique needs of emerging adults with chronic conditions, and thus supporting the holistic health of this vulnerable population.