Purpose
We aimed to clarify how parent–child interactions influence the development of self-care among adolescents with chronic illnesses in Japan.
Methods
Eleven adolescent–guardian pairs were recruited from two hospitals in Japan. Adolescents, aged 16–24 years, were diagnosed with nephrotic syndrome or type 1 diabetes and were accompanied by one guardian. All participants were receiving treatment or outpatient follow-up care. Semi-structured interviews were conducted, and data were analyzed using grounded theory procedures described by Strauss and Corbin.
Results
Three major interactional processes and one sub-process- (1) Parent-Led Self-Care, (2) Challenges and Experimentation toward Autonomy, and (3) Realization of Self-Care Transition- and one sub-process, (2a) Disengaged Interaction under Attribution, were identified, underscoring the emotional functions within the parent–child subsystem. The findings revealed conflicts typical of adolescence—particularly within Interactional Process 2 and Sub-Interactional Process 2a—linked to poor disease control often seen during this developmental stage, as well as trial-and-error strategies of the parents to address these issues.
Conclusions
The results indicate that interventions for adolescents with chronic illnesses should consider the parent–child subsystem as a unit and strengthen emotional support for both parties. Such strategies may be beneficial across varied cultural and clinical contexts.
Implications to practice
Nurses can attend not only to adolescent patients but also to adolescent–guardian interactions, and guide guardians in adjusting their involvement according to adolescents' self-care development. Furthermore, nurses may support adolescents' emotional needs in collaboration with guardians, particularly during periods when emotional support is challenging.
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