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    ABSTRACT: Objective Hypoglycaemia Unawareness (HU) affects approximately 25% of people with type 1 diabetes. People with HU are often reliant on family to detect hypoglycaemia and treat severe episodes. We explored the impact of HU on family members’ lives; their involvement in preventing and managing hypoglycaemia; and, their information and support needs. Research Design and Methods Exploratory, qualitative design comprising in-depth interviews with 24 adult family members of people with type 1 diabetes and HU. Results Family members described restricting their lives so they could help the person with HU detect and treat hypoglycaemia. Some described being very physically afraid of their partner/relative when they had a hypoglycaemic episode due to their aggressive and argumentative behaviour and personality changes; this could also make treatment administration difficult. Family members also reported feeling anxious and worried about the safety of the person with HU, particularly when they were left unsupervised. These concerns were often precipitated by traumatic events, such as discovering the person with HU in a coma. Family members could neglect their own health and wellbeing to care for the person with HU and resentment could build up over time. Family members highlighted extensive, unmet needs for information and emotional support; however, some struggled to recognise and accept their own need for help. Conclusions Our findings reveal a caregiver group currently ‘in the shadow of the patient’ and in urgent need of information and emotional support. Raising awareness amongst healthcare professionals is essential and developing proactive support for family should be considered.
    Full-text · Article · Jan 2014 · Diabetes care
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    ABSTRACT: Reducing secondhand smoke exposure in the home is a key tobacco control goal, yet few studies have explored children's views and experiences of this. This study aimed to explore children's accounts of family members' smoking in the home and car and the impact of their socioeconomic circumstances on these. Individual and friendship group interviews using topic guides and visual stimulus methods. Two communities in Edinburgh, Scotland. One socioeconomically advantaged, one socioeconomically disadvantaged. Thirty-eight children aged 10-15 years who had a close family member who smoked. Focus group and interview topic guides FINDINGS: Participants in both communities expressed a strong dislike of family members' smoking and concern about the potential impact on the smoker's health. Participants described overt and covert acts of resistance including challenging relatives about their smoking, expressing disgust and concern, hiding or destroying cigarettes. Some acts were carried out in collusion with a non-smoking parent and/or sibling. Resistant acts were constrained by expectations of negative responses, which appeared to increase with age, wider social norms around smoking, and whether the young person smoked. Some children and young people in the UK, irrespective of socioeconomic status, may actively oppose parents' smoking in the home and car although their influence may be limited by their position in the family and social norms.
    Full-text · Article · Dec 2013 · Addiction
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    ABSTRACT: To explore the experiences of people who have hypoglycaemia unawareness and its impact on their everyday lives. In-depth interviews with 38 people with Type 1 diabetes who have hypoglycaemia unawareness. Data analysis used an inductive, thematic approach. Participants reported imposed and self-imposed changes to their lives following onset of hypoglycaemia unawareness including: leaving employment, curtailing pastimes and spending more time at home or being supervised by others. However, some reported getting on with life by downplaying the significance and impact of their condition, which could put their health and safety at risk. Many relied on frequent self-monitoring of blood glucose and/or prompting from others to detect hypoglycaemia. Some expressed concerns about becoming a burden on family and/or responding in irrational and aggressive ways to others' suggestions to test for and treat hypoglycaemia. Participants reported responding best to composed and directive prompts from family. Health professionals mainly advised on clinical aspects, and did not enquire about the emotional and psychosocial impact of hypoglycaemia unawareness. Hypoglycaemia unawareness can have a profound impact on people's confidence, careers and personal relationships. Healthcare professionals should pay more attention during consultations to the emotional and social aspects of living with hypoglycaemia unawareness.
    Full-text · Article · Dec 2013 · Chronic Illness
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