Observing, ‘doing’ and ‘making’ gender in Dutch paediatric type 1 diabetes care, at home and in the clinic: Multiple-stakeholder perspectives

Abstract

Aim: To investigate the perspectives of Dutch care professionals, parents and experts by experience on gender dynamics in paediatric type 1 diabetes care. Design: Qualitative research design. Methods: Fifteen semi-structured interviews were held with care professionals, supplemented by two focus groups with parents of children with diabetes (n = 12 parents) and three semi-structured interviews with two experts by experience and a mother. Two respondent validation interviews were conducted, one with two care professionals and one with an expert by experience. Participant observations were conducted at three clinics, a diabetes sports day, weekend for young people and their families, and a high-school. An inductive framework analysis was done, informed by relational theory on gender. Results: Care professionals ‘did’ and ‘made’ gender differences together with young people, manifesting as communicative difficulties, in particular between female care professionals and young boys. Boys were considered less skilled in articulating their needs compared to girls. At home, care professionals and parents observed, ‘did’ and ‘made’ gender differences by perpetuating gendered divisions of labour. As traditional caretakers, mothers risk focusing excessively on the diabetes of their child whilst fathers remained more at a distance. Conclusion: Gender patterns have negative implications on those involved in paediatric type 1 diabetes. Leaving tacit the gendered communicative issues across child–parent and child-care professional dyads, can sustain invisible friction in a care system that normatively expects verbal participation and increased self-management. Implications for the Profession and Patient Care: Findings may encourage care professionals and parents to engage with the potential impact of gender dynamics on diabetes practices. Incorporating these dynamics as conversational tools would contribute to improving type 1 diabetes care for young people.