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Adolescents' perceptions of the transition process from parental management to self-management of type 1 diabetes.

AIM: The aim of this study was to describe how adolescents perceive the transition from being dependent on their parents to managing their own type 1 diabetes.

DESIGN: An explorative design with a phenomenographic approach was used.

METHODS: Semistructured interviews took place during 2016-2017 with 18 strategically sampled adolescents (7 boys and 11 girls, aged 16-18 years) with type 1 diabetes from five Norwegian paediatric diabetes centres.

FINDINGS: Three descriptive categories, each comprising three perceptions, emerged: (1) Taking responsibility for own diabetes is a process comprised 'It is natural to take over responsibility for own diabetes', 'Expectations from parents and healthcare personnel', and 'The adolescents want more independence'. (2) Taking responsibility for own diabetes was dependent on coping comprised 'Feeling proud to handle their own diabetes', 'The transition is like a roller coaster', and 'Taking responsibility means that it is your fault if you make mistakes'. (3) It is demanding to take responsibility for own diabetes comprised 'Taking responsibility for own diabetes requires knowledge and skills', 'It is time-consuming to take responsibility for own diabetes', and 'Having responsibility for own diabetes is like being examined every day'.

CONCLUSIONS: Adolescents want to take over the responsibility for their diabetes treatment from their parents, but they need knowledge, experience and skills to succeed. Parents, friends and health professionals are important supporters during the transition.

RELEVANCE TO CLINICAL PRACTICE: Health professionals need to know their patients to identify the adolescents' need for support. Self-care is considered essential in the management of diabetes. Education sessions are an important part of the transition to control own diabetes. Such education should also include parents and friends.

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