'It Makes a Difference, Coming Here': a Qualitative Exploration of Barriers and Facilitators to Clinic Attendance Among Young Adults With Type 1 Diabetes

Abstract

Background: Poor outpatient clinic attendance is common among young adults with Type 1 diabetes mellitus (DM). The aim of this qualitative study is to develop a theory, using Grounded Theory, of clinic attendance among young adults with Type 1 DM. Methods:Semi-structured interviews have been carried out with 18 young people with type 1 DM and 7 members of staff. Findings:Many young adults are motivated to attend the diabetes clinic in order to gain reassurance through contact with familiar, supportive staff, and testing and screening. Barriers to attendance include fear of deterioration of diabetes, work demands, and a lack of value associated with attending. Barriers prevent the development of Alliance, the core category in this theory. A collaborative relationship or Alliance between young adults and staff is developed through experience of attendance and major events (structured education programme or crisis of diabetes) and facilitates further attendance. Discussion:This substantive theory provides new insight into experiences of diabetes care which will inform the development of behavioural interventions to improve clinic attendance as well as improvements to services.