Background: Type I diabetes is a chronic disease that places great demands on the child and family. Parental involvement has been found to be essential for disease outcome. However, fathers’ involvement has been less studied, even though high paternal involvement has been correlated with less disease impact on the family and higher quality of life among adolescents. Aim: The overall aim of the study was to explore and analyze constructions of fathers’ involvement in their child’s everyday life with type 1 diabetes from an ecological and health promotion perspective. Four specific aims were applied: 1) explore and describe discourses in health care guidelines for children with type 1 diabetes in Nordic countries, focusing on parents' positioning (I), 2) analyze how Swedish pediatric diabetes teams perceived and discussed fathers’ involvement in the care of their child with type 1 diabetes, and to discuss how the teams’ attitudes toward the fathers’ involvement developed during a focus group process (II), 3) explore and discuss how fathers involved in caring for their child with type 1 diabetes experience support from their pediatric diabetes team in everyday life with their child (III), and 4) analyze how involved fathers to children with type 1 diabetes understand their involvement in their child’s daily life and to discuss their perceptions from a health promotion perspective (IV). Material and methods: A qualitative and inductive approach was applied. Data were collected and analyzed during 2010-2012. The sample consisted of three pediatric guidelines originating from Norway, Denmark and Sweden (I), three Swedish pediatric diabetes teams (PDTs) (II), and 11 (III) and 16 (IV) fathers of children with type 1 diabetes who scored high involvement on the Parental Responsibility Questionnaire. Data were collected through repeated focus group discussions with the PDTs (II), online focus group discussions (III) and individual interviews (III, IV) with the fathers. Three analysis methods were applied: analysis of discourses (I), Constructivist Grounded Theory (II, III) and content analysis (IV). Findings: The findings illuminated the complex interaction between the pediatric guidelines, the PDTs and the fathers. Fathers highly involved in their child’s daily life experienced different levels of tension between the general recommendations and their personal experiences of living with a child with type 1 diabetes (III). The fathers regarded their involvement in their child’s diabetes care as additional to their general parenting, and a fine balance was identified between a health promotion perspective and a controlling involvement. The common denominator between the highly involved fathers was their use of parental leave (IV). The PDTs initially perceived fathers’ involvement as gendered and balanced on the mother’s agement, but as focus was set on fathers’ engagement the PDTs increased their awareness of this and started to identify and encourage their engagement II). At the macro-level, parents’ voices were diminished in Nordic pediatric diabetes guidelines in favor of an expert discourse (I). Conclusions: Fathers’ involvement concerning a child with type 1diabetes is constructed in a complex way, based on an interaction between the fathers’ perceptions of their additional involvement and the support provided by the PDTs; the PDTs’ perceptions of the fathers’ involvement; and how parents/fathers are constructed in pediatric diabetes guidelines. In order to promote the health and well-being of children with type 1 diabetes, fathers’ involvement needs to be taken into account in the pediatric guidelines as well as in clinical practice.

Bakgrund: Typ 1-diabetes en av de vanligaste, svåra kroniska sjukdomarna bland barn och ca 8000 barn i Sverige är drabbade. Vid insjuknande får barnen kontakt med tvärprofessionella diabetesteam, en kontakt de behåller till 18 årsdagen. Det finns flera fördelar med teamarbete och de tvärprofessionella teamen uppskattas av både personal, patienter och anhöriga. Teamets kompetens och sammansättning har en stor betydelse kring vården för familjerna. Motiv: Målet är att bidra med en ökad förståelse av det stöd tvärprofessionella team kan bidra med samt eventuellt finna förslag på utvecklings- och förbättringsarbete inom diabetesvården. Syfte: Syftet med studien är att belysa föräldrars upplevelse av stöd från tvärprofessionella diabetesteam. Metod: En kvalitativ intervjustudie. Resultat: Föräldrarnas erfarenheter av diabetesteamets stöd genomsyrades av positivitet, men visade även en viss brist på föräldrastöd. Intervjuernas resultat mynnade ut i 3 huvudkategorier; ”Stödjande relation”, ”Stöd i lidande” och ”Stöd i vardagen”. Konklusion: För att möta upp föräldrarnas behov av stöd krävs en förändring kring diabetesteamens arbete. En mer individanpassadomvårdad, där även föräldrars psykosociala behov inkluderas vilket gynnar hela familjen. / Background: Type 1-diabetes is one of the most common, severe chronic diseases among children and about 8000 children in Sweden are affected. When the children get sick, they get in touch with interprofessional diabetes team, a contact they keep until their 18th birthday. There are several benefits to teamwork and the interprofessional teams are appreciated by staff, patients, and relatives. The team’s competence and composition are of great importance in the care of the families. Motive: The goal is to contribute with an increased understanding of the support that interprofessional teams can contribute with and possibly find proposals for development and improvement work in diabetes care. Aim: The aim of the study is to find out parent’s experience of the support from the diabetes team.Methods: A qualitative interview study.Result: The parent´s experiences of the diabetes team´s support was permeated by positivity, but also showed a certain lack of parental support. The results of the interviews resulted in 3 main categories: “Supportive relationship”, “Support in suffering” and “Support in everyday life”.  Conclusion: To meet the parent´s need for support, a change in the work of the diabetes team is required. A more individualized care, where parent´s psychosocial needs are also including, which benefits the whole family. / <p>Presenationen genomfördes via zoom, anordnad av Instutionen för omvårdnad, Umeå Universitet</p>