Date of Award


Degree Name

PhD Nursing

Dissertation Committee

Jane M. Georges, PhD, RN, Chairperson; Cynthia D. Connelly, PhD, RN, FAAN; Linda D. Urden, DNSc, RN, CNS, NE-BC, FAAN


children & youth, Diabetes management, HgA1c, nursing, parents & parenting, Type 1 Diabetes


Type 1 diabetes in school age children is a complex condition requiring continuous physical, nutritional, and therapeutic monitoring to prevent lifelong complications and maintain quality of life. In 2011, one in 400 children in the United States were affected by it. The purpose of this research study was to understand how parents achieve optimal HgA1c for their school age children with type-1 diabetes. Currently, there is very little research documenting how parents achieve this goal. Understanding this phenomenon more clearly can be used to inform future research, improve practice and provide information for development of effective health policy. Management of diabetes in school-age children is a challenge for parents because of the requirement for variable insulin regimes, and is complicated further by the child's ever-changing needs due to growth and development and inability to identify potentially harmful hypoglycemic episodes. Yin's case study methodology was utilized in this study with Parse's human/becoming theoretical framework as an analytic basis. Careful attention throughout the study was paid to demonstrating rigor. Data were triangulated using rival midrange theories, cross case comparison, observations and literature. The three cases used for the cross case comparison represented three distinct ethnic groups. The human/becoming theory most closely supported the outcome of the data analysis offering evidence of rhythmicity, co-transcendence and intentionality. Each case analyzed consistently communicated similar experiences in the various phases of pre-diagnosis, hospitalization and diagnosis, discharge, stabilization and preparing the child for independence.

Document Type

Dissertation: Open Access



Included in

Nursing Commons