I don't think either of us have really got over the diagnosis. Caregiver perspectives on medical trauma in adolescent type 1 diabetes; a trauma-informed qualitative investigation
Author Identifier (ORCID)
Karen Lombardi: https://orcid.org/0000-0001-8016-2197
Abstract
Purpose Type 1 Diabetes (T1D) is a ‘family illness’; diagnoses and management can be perceived as invasive or traumatic. Caregivers bear the brunt of the diagnostic shock, influencing their child's experience. Children and adolescents may grapple with the psychological effects of past/ongoing medical trauma. Additionally, adolescents may struggle with their mental health as they navigate tensions between caregiver involvement and their developmental need for autonomy. Despite this, limited research addresses the interplay between adolescent and caregiver mental health. This study sought to explore caregivers' perspectives of their adolescent's T1D-related mental health experience, using paediatric medical traumatic stress as a theoretical framework. Design and methods A descriptive qualitative approach using reflexive thematic analysis was implemented through online semi-structured focus groups and interviews with caregivers ( n = 9) of adolescents (aged 10–19 years) with T1D diagnosed before age 18. Results Four themes were identified: 1) perceived trauma, shock and adjustment in early stages; 2) support is important for healing; 3) caregiver difficulty relinquishing control; and 4) adolescent struggle with T1D. Caregivers reported their child's stoicism as characteristic of early stages, while adolescence was described as a period of waning resilience. Unresolved trauma often resurfaced during the transition of management responsibility, revealing caregiver hypervigilance and adolescent disengagement. Conclusions Findings highlight how medical trauma underpins a caregiver and adolescent's T1D-related mental health experience. Practice implications Findings support the application of a model of paediatric medical trauma to the caregiver and adolescent T1D experience, informing how trauma-sensitive care may be applied in this field.
Keywords
Adolescent, caregivers, diabetes mellitus, type 1, mental health, psychological trauma
Document Type
Journal Article
Date of Publication
5-1-2026
Volume
88
Publication Title
Journal of Pediatric Nursing
Publisher
Elsevier
School
School of Medical and Health Sciences
Funders
Embrace @ The Kids Research Institute Australia / Channel 7 Telethon Trust / Rio Tinto Embrace
Copyright
subscription content
First Page
22
Last Page
33
Comments
Coombs, S., Paciente, R., Lombardi, K., Milroy, H., Ohan, J., Bebbington, K., Roby, H. C., Taplin, C. E., Hanna, N., Rose, S., & Woolard, A. (2026). “I don’t think either of us have really got over the diagnosis.” Caregiver perspectives on medical trauma in adolescent type 1 diabetes; a trauma-informed qualitative investigation. Journal of Pediatric Nursing, 88, 22–33. https://doi.org/10.1016/j.pedn.2026.02.005