{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T01:37:10Z","timestamp":1777945030751,"version":"3.51.4"},"reference-count":37,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T00:00:00Z","timestamp":1741132800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T00:00:00Z","timestamp":1741132800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["U01DK135120"],"award-info":[{"award-number":["U01DK135120"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["T32DK007314"],"award-info":[{"award-number":["T32DK007314"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000056","name":"National Institute of Nursing Research","doi-asserted-by":"publisher","award":["F31NR020137"],"award-info":[{"award-number":["F31NR020137"]}],"id":[{"id":"10.13039\/100000056","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Advanced Nursing"],"published-print":{"date-parts":[[2025,12]]},"abstract":"ABSTRACT<\/jats:title>\n \n Aim<\/jats:title>\n The aim of this study was to explore self\u2010care among adults with type 1 diabetes (T1D) to (1) characterise possible self\u2010care profiles in adults with T1D; (2) explain self\u2010care maintenance, monitoring and management within the self\u2010care profiles; and (3) develop a typology of self\u2010care in adults with T1D.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Mixed\u2010methods study with explanatory sequential design.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Participants (\n n<\/jats:italic>\n \u2009=\u2009200) completed a validated self\u2010care survey. Cluster analysis of survey data was performed to identify self\u2010care profiles. Then, semi\u2010structured individual interviews were performed with a nested sample (\n n<\/jats:italic>\n \u2009=\u200920) stratified by these profiles. Directed content analysis was applied to transcript data to describe self\u2010care within profiles. Findings were integrated via joint display to develop a typology of self\u2010care in adults with T1D.\n <\/jats:p>\n <\/jats:sec>\n \n Data Sources<\/jats:title>\n \n A total of 200 adults with T1D were recruited from a diabetes centre in a large, urban US city from 6\/2022 to 11\/2022 (quantitative phase) and a nested sample (\n n<\/jats:italic>\n \u2009=\u200920) from 12\/2022 to 4\/2023 (qualitative phase).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n We identified three self\u2010care profiles:\n Expert, Inconsistent<\/jats:italic>\n and\n Novice<\/jats:italic>\n .\n Expert<\/jats:italic>\n self\u2010care was characterised by a steadfast and holistic approach to maintaining health, the use of internal and external cues to monitor for health changes and informed management decision\u2010making when health changes were detected.\n Inconsistent<\/jats:italic>\n self\u2010care was characterised by the capability to maintain health, often limited by low health prioritisation, a lack of perceived need for greater effort and compulsive management decision\u2010making.\n Novice<\/jats:italic>\n self\u2010care was characterised by difficulty maintaining health and limited skill development in more advanced self\u2010care processes, including monitoring for and managing health changes.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n This study identified an\n Expert\u2013Inconsistent\u2013Novice<\/jats:italic>\n typology of self\u2010care in adults with T1D, aligning with previous research and suggesting a stable typology across conditions.\n <\/jats:p>\n <\/jats:sec>\n \n Implications for the Profession and\/or Patient Care<\/jats:title>\n Characterising self\u2010care among adults with T1D may facilitate aligning support with individual needs.<\/jats:p>\n <\/jats:sec>\n \n Impact<\/jats:title>\n \n Progression towards\n Expert<\/jats:italic>\n self\u2010care may offer clinically meaningful improvements in glycaemic control and reduced risk for diabetes complications.\n <\/jats:p>\n <\/jats:sec>\n \n Reporting Method<\/jats:title>\n Good Reporting of A Mixed Methods Study (GRAMMS) Checklist.<\/jats:p>\n <\/jats:sec>\n \n Patient or Public Contribution<\/jats:title>\n No patient or public contribution.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jan.16868","type":"journal-article","created":{"date-parts":[[2025,3,8]],"date-time":"2025-03-08T13:01:15Z","timestamp":1741438875000},"page":"8914-8928","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Understanding Self\u2010Care Patterns in Adults With Type 1 Diabetes: Insights From a Mixed Methods Study"],"prefix":"10.1111","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7564-2524","authenticated-orcid":false,"given":"Austin M.","family":"Matus","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Diabetes & Metabolism, Department of Medicine University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania USA"},{"name":"Institute for Diabetes, Obesity & Metabolism University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania USA"},{"name":"University of Pennsylvania School of Nursing Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lea Ann","family":"Matura","sequence":"additional","affiliation":[{"name":"University of Pennsylvania School of Nursing Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter F.","family":"Cronholm","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Community Health and Center for Public Health, Leonard Davis Institute of Health Economics University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael R.","family":"Rickels","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes & Metabolism, Department of Medicine University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania USA"},{"name":"Institute for Diabetes, Obesity & Metabolism University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0970-136X","authenticated-orcid":false,"given":"Barbara","family":"Riegel","sequence":"additional","affiliation":[{"name":"University of Pennsylvania School of Nursing Philadelphia Pennsylvania USA"},{"name":"Center for Home Care Policy & Research at VNS Health New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,3,5]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc20\u20103063"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.2337\/cd22\u20100067"},{"key":"e_1_2_14_4_1","unstructured":"ATLAS.ti Scientific Software Development GmbH.2023.\u201cATLAS.ti Web (Version 23.0.0).\u201dhttps:\/\/atlasti.com."},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12902\u2010017\u20100218\u2010y"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.2337\/diaspect.26.3.172"},{"key":"e_1_2_14_7_1","unstructured":"Bhandari P.2023.\u201cTriangulation in Research|Guide Types Examples.\u201dhttps:\/\/www.scribbr.com\/methodology\/triangulation\/."},{"issue":"5","key":"e_1_2_14_8_1","first-page":"390","article-title":"Diabetic Kidney Disease","volume":"113","author":"Bouhairie V. E.","year":"2016","journal-title":"Missouri Medicine"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/1468794107085301"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475\u20106773.2006.00684.x"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1188\/14.ONF.545-547"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125\u2010018\u20104566\u20106"},{"key":"e_1_2_14_13_1","volume-title":"Research Design: Qualitative, Quantitative, and Mixed Methods Approaches","author":"Creswell J. W.","year":"2023"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare12030352"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcnurse.2007.11.005"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/0047287513496475"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2019.103208"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732305276687"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40662\u2010015\u20100026\u20102"},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc11\u20101360"},{"key":"e_1_2_14_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/0147-1767(85)90062-8"},{"key":"e_1_2_14_23_1","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa1408214"},{"key":"e_1_2_14_24_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc19\u20100573"},{"key":"e_1_2_14_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/jnu.12385"},{"key":"e_1_2_14_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/1558689818762576"},{"key":"e_1_2_14_27_1","doi-asserted-by":"publisher","DOI":"10.1177\/1525822x02239573"},{"key":"e_1_2_14_28_1","volume-title":"PRAPARE Risk Tally Scoring Methodology","author":"National Association of Community Health Centers","year":"2016"},{"key":"e_1_2_14_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/jcn.0000000000000999"},{"key":"e_1_2_14_30_1","unstructured":"R Core Team.2021.\u201cR: A Language and Environment for Statistical Computing [Mobile Application Software].\u201dhttps:\/\/www.R\u2010project.org\/."},{"key":"e_1_2_14_31_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2016\u20101649"},{"key":"e_1_2_14_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/JCN.0000000000001146"},{"key":"e_1_2_14_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/ans.0000000000000237"},{"key":"e_1_2_14_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/ans.0b013e318261b1ba"},{"key":"e_1_2_14_35_1","doi-asserted-by":"publisher","DOI":"10.1097\/NNR.0b013e31820978ec"},{"key":"e_1_2_14_36_1","volume-title":"Diabetes in America","author":"Stene L. C.","year":"2023"},{"key":"e_1_2_14_37_1","volume-title":"Qualitative Research: Analysis Types and Software Tools","author":"Tesch R.","year":"1990"},{"key":"e_1_2_14_38_1","doi-asserted-by":"publisher","DOI":"10.1161\/jaha.118.010150"}],"container-title":["Journal of Advanced Nursing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jan.16868","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jan.16868","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jan.16868","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T08:40:41Z","timestamp":1777711241000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jan.16868"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,5]]},"references-count":37,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1111\/jan.16868"],"URL":"https:\/\/doi.org\/10.1111\/jan.16868","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.1111\/JAN.16868\/v1\/review3","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JAN.16868\/v2\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JAN.16868\/v1\/review4","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JAN.16868\/v2\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JAN.16868\/v3\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JAN.16868\/v2\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JAN.16868\/v2\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JAN.16868\/v1\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JAN.16868\/v1\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JAN.16868\/v1\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/JAN.16868\/v3\/response1","asserted-by":"object"}]},"ISSN":["0309-2402","1365-2648"],"issn-type":[{"value":"0309-2402","type":"print"},{"value":"1365-2648","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,5]]},"assertion":[{"value":"2024-06-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}