校准逻辑:青少年如何在日常自我管理 1 型糖尿病的过程中校准经常相互竞争的逻辑。

IF 1.9 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Health Pub Date : 2024-01-01 Epub Date: 2022-07-15 DOI:10.1177/13634593221113211
Emilie Mølholm Kjærulff, Natasja Kingod, Mirjam Due Tiemensma, Ayo Wahlberg
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引用次数: 0

摘要

患有 1 型糖尿病的青少年和年轻人必须在日常生活中管理一种苛刻的慢性疾病,但适当的自我管理仍然是一项重大挑战。在本文中,我们探讨了青少年 1 型糖尿病患者在日常生活中进行自我管理的逻辑,并提出了一种将自我管理视为 "校准逻辑 "的分析观点。借鉴安妮玛丽-莫尔(Annemarie Mol)的 "逻辑 "概念,我们对 21 名 1 型糖尿病青少年患者的深入访谈分析表明,三大逻辑共同塑造了他们的自我管理:生物医学逻辑、体现逻辑和社会逻辑。生物医学逻辑表现为常规的胰岛素治疗、频繁的血糖检测和碳水化合物计算,所有这些都强调控制血糖水平。体现逻辑以 "思考胰岛素单位 "和 "倾听 "血糖波动等精细化实践的形式出现。最后,社会逻辑在谨慎或延迟的自我管理实践中发挥作用,以适应社会环境。虽然这些逻辑可能相辅相成,但研究参与者也提到了这些逻辑在日常生活中如何经常相互竞争,从而产生紧张关系。因此,我们建议把自我管理看作是一个调整逻辑的问题,在这个过程中,经常有相互竞争的逻辑在发挥作用。这可以让我们深入了解青少年和年轻人在日常自我管理 1 型糖尿病方面所做的努力和面临的挑战,与目前流行的坚持与不坚持处方治疗方案的二分法形成鲜明对比。
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Calibrating logics: How adolescents and young adults calibrate often-competing logics in their daily self-management of type 1 diabetes.

Adolescents and young adults with type 1 diabetes must manage a demanding chronic condition in their daily lives, but adequate self-management remains a major challenge. In this article, we explore the logics invoked in shaping daily type 1 diabetes self-management among adolescents and young adults and propose an analytical view of self-management as a matter of 'calibrating logics'. Drawing on Annemarie Mol's concept of logic, our analysis of in-depth interviews with 21 adolescents and young adults with type 1 diabetes suggested that three main logics collectively shaped their self-management: biomedical, embodied and social. Biomedical logics appeared in the form of routinised insulin therapy, frequent blood glucose testing, and carbohydrate counting, all of which emphasise controlling blood glucose levels. Embodied logics emerged as refined practices such as 'thinking insulin units' and 'listening' to blood glucose fluctuations. Finally, social logics were at play when discreet or postponed self-management practices were used to adjust to social situations. While these logics may complement each other, study participants invoked how these logics often competed in daily life, generating tensions. We therefore propose viewing self-management as a matter of calibrating logics in which often-competing logics are at play. This can provide nuanced insights into the effort and challenges related to the daily self-management of type 1 diabetes for adolescents and young adults, in contrast to the prevailing dichotomy of adherence versus nonadherence to prescribed treatment regimens.

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来源期刊
Health
Health Multiple-
CiteScore
4.90
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0.00%
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0
期刊介绍: Health: is published four times per year and attempts in each number to offer a mix of articles that inform or that provoke debate. The readership of the journal is wide and drawn from different disciplines and from workers both inside and outside the health care professions. Widely abstracted, Health: ensures authors an extensive and informed readership for their work. It also seeks to offer authors as short a delay as possible between submission and publication. Most articles are reviewed within 4-6 weeks of submission and those accepted are published within a year of that decision.
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