Promoting health in children and adolescents with – or at risk of – Type 2 diabetes mellitus in the United States: An interview – study of nurses’ experiences of their role


  • Samuel Jara Josefsson
  • Minna Allar
  • Kajsa Landgren
  • Irén Tiberg



Type 2 diabetes, Professional role, Paediatric obesity, Health promotion, Prevention


Introduction: Type 2 diabetes mellitus (T2DM) in children and adolescents is increasing throughout the world and the USA. Previous research has shown that the nurses have an important role in the management of T2DM in children and adolescents, but few studies have covered how the nurses perceive and experience their role.

Aim: This paper aims to describe how nurses experience their role in the care of children and adolescents with T2DM and their families.

Methods: Semi-structured interviews were used to collect the data from eight registered nurses and nurse practitioners who worked in an American university hospital area participated in the study. An inductive qualitative approach was used and the data were analysed through the content analysis. The findings were described in four categories: overcoming challenges; improving life quality; being cooperative and being committed to one’s role as a diabetes nurse forming the theme Promoting health.

Conclusions: The diabetes nurse has a key role in the work of promoting health and the results elucidate the complexity of the role. To be able to plan for and to implement an evidence-based approach based on theoretical models of behaviour and consideration of the child’s needs, not only requires a commitment from health professionals but also involves education and discussions that require both commitment and managerial and economic support from leaders in children’s healthcare and managers of health services.


Download data is not yet available.


International Diabetes Federation. Key findings, 2014. Retrieved 2015 Mar 5, from International Diabetes Federation. Available from

Dabelea D, Mayor-Davids E, Saydah S, Imperatore G, Linder B, Divers J, et al. Prevalence of type 1 and type 2 diabetes among children and adolescents from 2001 to 2009. JAMA 2014;311(17):1778–86. doi: 10.1001/jama.2014.3201

Nader N, Kumar S. Type 2 diabetes mellitus in children and adolescents: where do we stand with drug treatment and behavioral management? Curr Diabetes Rep. 2008;8(5):383–88. doi: 10.1007/s11892-008-0066-2

Reinehr T Type 2 diabetes mellitus in children and adolescents. World J Diabetes. 2013;4(6):270–81. doi: 10.4239/wjd.v4.i6.270

American Diabetes Association. Complications. Retrieved 2015 Mar 5, from American Diabetes Association. Available from

Tryggestad J, Willi S. Complications and comorbidities of T2DM in adolescents: findings from the TODAY clinical trial. J Diabetes Complicat. 2015;29(2):307–12. doi: 10.1016/j.jdiacomp.2014.10.009

Jaser S. Psychological problems in adolescents with diabetes. Adolesc Med State Art Rev. 2010;21(1):138–51, x-xi.

Hannon T, Rao G, Arslanian S. Childhood obesity and type 2 diabetes mellitus. Pediatrics 2005;116(2):473–80. doi: 10.1542/peds.2004-2536

Zeitler P, Fu J, Tandon N, Nadeau K, Urakami T, Bartlett T, et al. Type 2 diabetes in the child and adolescent. Pediatr Diabetes 2014;15(20):26–46. doi: 10.1111/pedi.12179

International Diabetes Federation & International Society for Pediatric and Adolescent Diabetes. Global IDF/ISPAD Guideline for Diabetes in Childhood and Adolescence. Retrieved 2015 Nov, from International Diabetes Federation. Available from

Kenny J, Corkin D. A children’s nurse’s role in the global development of a child with diabetes mellitus. Nurs Child Young People. 2013;25(9):22–25. doi: 10.7748/ncyp2013.

Swift P. Diabetes education in children and adolescents. Pediatr Diabetes ISPAD Clinical Practice Consensus Guidelines 2009 Compendium. 2009;10(Suppl. 12):54–57.

McKnight-Menci H, Sababu S, Kelly S. The care of children and adolescents with type 2 diabetes. J Pediatr Nurs. 2005;20(2):96–106. doi: 10.1016/j.pedn.2004.12.012

Rabbitt A, Coyne I. Childhood obesity: nurses role in addressing the epidemic. Br J Nurs. 2012;21(12):731–35. doi: 10.12968/bjon.2012.21.12.731

Lange K, Swift P, Pankowska E, Danne T. Diabetes education in children and adolescents. Pediatr Diabetes 2014;15(20):77–85. doi: 10.1111/pedi.12187

Boström E, Isaksson U, Lundman B, Egan Sjölander A, Hörnsten A. Diabetes specialist nurses’ perceptions of their multifaceted role. Eur Diabetes Nurs. 2012;9(2):39–44. doi: 10.1002/edn.204

Granheim U, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Education Today 2004;24(2):105–12. doi: 10.1016/j.nedt.2003.10.001

Virginia Board of Nursing. Laws Governing Nursing, 2014. Retrieved 2015 Mar, from Virginia Board of Nursing – Laws and Regulations. Available from

American Association of Nurse Practitioners. What’s an NP? Retrieved 2015 Nov 16, from American Association of Nurse Practitioners. Available from

World Medical Association. WMA Declaration of Helsinki – Ethical Principles for Medical Research Involving Human Subjects. Retrieved 2015, from World Medical Association. Available from[page]/[toPage].

West E, Barron D, Reeves R. Overcoming the barriers to patient-centred care: time, tools and training. J Clin Nurs. 2005;14(4):435–43. doi: 10.1111/j.1365-2702.2004.01091.x

Greenwood S, Wright T, Nielsen H. Conversations in context: cultural safety and reflexivity in child and family health nursing. J Fam Nurs. 2006;12(2):201–24. doi: 10.1177/1074840706287405

Robinson J, Callister C, Berry A, Dearing A. Patient-centered care and adherence: definitions and applications to improve outcomes. J Am Assoc Nurse Prac. 2008;20(12):600–7. doi: 10.1111/j.1745-7599.2008.00360.x

Foster G, Taylor SJ, Eldridge SE, Ramsay J, Griffiths CJ. Self-management education programmes by lay leaders for people with chronic conditions. Cochrane DB Syst Rev. 2007;2007(4):CD005108. doi:10.1002/14651858.CD005108.pub2.

Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977;84(2):191–215. doi: 10.1037/0033-295X.84.2.191

Shields L, Zhou H, Pratt J, Taylor M, Hunter J, Pascoe E. Family-centred care for hospitalised children aged 0–12 years. Cochrane DB Syst Rev. 2012;10:CD004811. doi:10.1002/14651858.CD004811.pub3.

Coyne I, Hallström I, Söderbäck M. Reframing the focus from a family-centred to a childcentred care approach for children in healthcare. Child Health Care. 2016. doi:10.1177/1367493516642744.




How to Cite

Jara Josefsson, S., Allar, M., Landgren, K., & Tiberg, I. (2017). Promoting health in children and adolescents with – or at risk of – Type 2 diabetes mellitus in the United States: An interview – study of nurses’ experiences of their role. International Diabetes Nursing, 14(2), 40–45.



Original Articles

Most read articles by the same author(s)