The Lived Experience of Adolescents With Type 1 Diabetes Mellitus in Bahir Dar, Ethiopia: Phenomenological Study

Abstract

Background: Type 1 diabetes mellitus (T1DM) is one of the most common chronic diseases among adolescents and is posing a threat to health and potentially endangering life. It can have a significant impact on the physical, social, and emotional development of adolescents. Understanding the lived experiences of adolescents with T1DM is crucial for improving their health outcomes and future aspirations. However, there is currently limited research, and existing studies on psychosocial and self-care perspectives do not highlight their lived experiences in Ethiopia. Objective: This study aimed to explore the lived experiences of adolescents living with T1DM in Bahir Dar, Ethiopia. Methods: A descriptive phenomenological design was used. The study was conducted at Felege Hiwot Comprehensive Specialized Hospital in Bahir Dar from March to May 2023. Ten adolescents aged 10-19 years receiving follow-up care at the hospital were selected using purposive sampling. Data were collected through face-to-face, in-depth interviews using a semistructured guide translated into Amharic. All interviews were conducted by the principal investigator, audio-recorded, transcribed verbatim, and translated conceptually. Thematic analysis was conducted using ATLAS.ti (8.4.24; ATLAS.ti Scientific Software Development GmbH) software, guided by the Colaizzi phenomenological method. Results: The study included 10 participants (7 female and 3 male), aged 13-18 years, with the duration of living with T1DM ranging from 6 months to 11 years. It identified 4 key themes in adolescents managing insulin dependence. First, psychoemotional factors were significant, with participants experiencing stress, anxiety, low self-esteem, and negative emotions such as fear and hopelessness, although some also reported positive feelings from strong social support. Second, supportive factors were crucial, as family, friends, teachers, health care providers, and community health insurance offered essential emotional and practical help. Third, significant challenges included insulin unavailability, financial issues, fasting-related nonadherence, fear of hypoglycemia, and sleep disturbances, all impacting their well-being. Finally, adolescents used various coping strategies, such as avoidance, acceptance, prayer, and social engagement, to manage emotional distress and maintain daily functioning. Conclusions: Adolescents with T1DM in Bahir Dar face multifaceted challenges that affect their emotional well-being and diabetes management. Despite these difficulties, they demonstrate resilience through various coping strategies and benefit from strong support systems. These findings underscore the need for adolescent-centered diabetes care, improved insulin access, and psychosocial support in both clinical and community settings.