Experiences of Healthcare Professionals in Home Based-Caring for Children With Type 1-Diabetes in Vulnerable Positions: A Qualitative Study.
7 affiliations
- 1Steno Diabetes Centre Odense, Odense University Hospital, Odense, Denmark.
- 2Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
- 3Department of Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark.
- 4The Children and Youth Department, Hospital of Lillebælt, Institute of Regional Healthcare Research, Kolding, Denmark.
- 5School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia.
- 6Centre for Quality and Patient Safety Research - Western Health Partnership, Deakin University, Geelong, Victoria, Australia.
- 7Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen.
Abstract
Introduction
Providing home-based care to children with type 1 diabetes (T1D) places healthcare professionals (HCPs) in complex and demanding practice contexts. Outside the clinic, HCPs must adapt their expertise to families' everyday lives, navigate shifting roles and manage emotional and relational challenges, particularly when working with vulnerable families. These situations often involve competing priorities, social constraints and complex family dynamics that challenge conventional care approaches and require additional competencies and support. Despite this, HCPs' perspectives remain underexplored. Therefore, this study aims to explore how HCPs experience, interpret and respond to the challenges and needs that arise when delivering diabetes care in the homes of children with T1D and their families in vulnerable positions.Methods
A qualitative study with a phenomenological-hermeneutical approach inspired by Paul Ricoeur's philosophy of interpretation and narrative was conducted using 75 h of field observations and two focus group interviews with 14 HCPs. Data were analysed through naïve reading, structural analysis and critical interpretation.Results
Home-based diabetes care was experienced as an ongoing process of learning and development, involving the expansion of competencies and the renegotiation of professional roles. Expert knowledge as the foundation for care provided stability but required adaptation to family contexts. Interpersonal work and emotional challenges involved building trust, managing relationships and coping with emotional strain and uncertainty. New and unfamiliar issues included encountering complex psychosocial problems, ethical dilemmas and role ambiguity, often beyond HCPs' expertise. Together, these dimensions illustrate how home-based care demands flexibility, emotional engagement and broader competencies, while increasing the need for supervision, peer support and organisational guidance.Conclusions
Home-based T1D care in vulnerable families is experienced as a complex, evolving practice requiring adaptable clinical and relational competencies, emotional engagement and role flexibility. Increased psychosocial demands highlight the need for structured education, supervision, organisational support and strengthened multidisciplinary and intersectoral collaboration.
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BibTeX
@article{jeppesen2026experiences,
title = {{Experiences of Healthcare Professionals in Home Based-Caring for Children With Type 1-Diabetes in Vulnerable Positions: A Qualitative Study.}},
author = {Marie Nedergaard Jeppesen and Jane Clemensen and Malene Søborg Heidemann and Birgitte Hertz and Bodil Rasmussen and Mette Juel Rothmann},
journal = {Scandinavian journal of caring sciences},
year = {2026},
month = oct,
doi = {10.1111/scs.70313},
url = {https://europepmc.org/article/MED/42904583},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Experiences of Healthcare Professionals in Home Based-Caring for Children With Type 1-Diabetes in Vulnerable Positions: A Qualitative Study.
AU - Marie Nedergaard Jeppesen
AU - Jane Clemensen
AU - Malene Søborg Heidemann
AU - Birgitte Hertz
AU - Bodil Rasmussen
AU - Mette Juel Rothmann
PY - 2026
DA - 2026/10/30
JO - Scandinavian journal of caring sciences
DO - 10.1111/scs.70313
UR - https://europepmc.org/article/MED/42904583
AB - Introduction Providing home-based care to children with type 1 diabetes (T1D) places healthcare professionals (HCPs) in complex and demanding practice contexts. Outside the clinic, HCPs must adapt their expertise to families' everyday lives, navigate shifting roles and manage emotional and relational challenges, particularly when working with vulnerable families. These situations often involve competing priorities, social constraints and complex family dynamics that challenge conventional care approaches and require additional competencies and support. Despite this, HCPs' perspectives remain underexplored. Therefore, this study aims to explore how HCPs experience, interpret and respond to the challenges and needs that arise when delivering diabetes care in the homes of children with T1D and their families in vulnerable positions.Methods A qualitative study with a phenomenological-hermeneutical approach inspired by Paul Ricoeur's philosophy of interpretation and narrative was conducted using 75 h of field observations and two focus group interviews with 14 HCPs. Data were analysed through naïve reading, structural analysis and critical interpretation.Results Home-based diabetes care was experienced as an ongoing process of learning and development, involving the expansion of competencies and the renegotiation of professional roles. Expert knowledge as the foundation for care provided stability but required adaptation to family contexts. Interpersonal work and emotional challenges involved building trust, managing relationships and coping with emotional strain and uncertainty. New and unfamiliar issues included encountering complex psychosocial problems, ethical dilemmas and role ambiguity, often beyond HCPs' expertise. Together, these dimensions illustrate how home-based care demands flexibility, emotional engagement and broader competencies, while increasing the need for supervision, peer support and organisational guidance.Conclusions Home-based T1D care in vulnerable families is experienced as a complex, evolving practice requiring adaptable clinical and relational competencies, emotional engagement and role flexibility. Increased psychosocial demands highlight the need for structured education, supervision, organisational support and strengthened multidisciplinary and intersectoral collaboration.
SN - 0283-9318
SN - 1471-6712
ER -