Between gains and losses: A hermeneutic phenomenological study of meaning-making in adolescents with type 1 diabetes

To explore the lived experiences of adolescents with Type 1 diabetes and how they construct meaning around their illness.

This qualitative study was grounded in Van Manen's hermeneutic phenomenological approach and informed by Meaning-Making Theory. Conducted in the diabetes outpatient clinic of a university hospital between August 4 and November 28, 2025, data were collected through semi-structured interviews and drawing- and metaphor-based narratives. Using purposive sampling, twenty adolescents aged 9-18 who had been diagnosed for at least six months participated. The study followed COREQ reporting guidelines.

Three main themes, eight subthemes, and 26 categories emerged from the analysis. Adolescents described diabetes through metaphors that reflected how they understood and lived with their illness. Their accounts showed that diabetes affected everyday routines, relationships, and self-perception. Although many participants described positive changes, such as healthier habits and stronger family relationships, they also emphasized dietary restrictions, treatment burden, school disruptions, and feeling different from their peers. Their experiences reflected an ongoing balance between acceptance, resistance, and ambivalence.

For adolescents, Type 1 diabetes extends beyond a physiological condition and becomes integrated into identity development and adaptation processes.

Pediatric nurses should implement holistic, meaning-centered approaches that address psychosocial adaptation alongside glycemic management. Exploring adolescents' metaphors and perceptions of gains and losses may enhance therapeutic communication and individualized care.