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Kandyla B, Tsitsika A, Soldatou A, Tzavara C, Karanasios S, Karavanaki K. Sexual Risk Behaviors of Adolescents with Type 1 Diabetes in Comparison with Their Peers. CHILDREN (BASEL, SWITZERLAND) 2021; 9:20. [PMID: 35053645 PMCID: PMC8774407 DOI: 10.3390/children9010020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/19/2021] [Accepted: 12/22/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Adolescents with type 1 diabetes mellitus (T1D) may differ from peers regarding sexual risk behaviors. OBJECTIVES To explore sexual risk behaviors of adolescents with T1D in comparison with peers. MATERIALS AND METHODS The subjects were 174 adolescents, 58 adolescents with T1D (mean ± SD age 16.3 ± 2.0 yrs, disease duration 6.7 ± 3.5 yrs and HbA1c:8.0 ± 1.3%) and 116 without (matched 1:2). Anonymous, self-reported questionnaires were used to evaluate sexual education and behaviors. RESULTS Fewer adolescents with T1D than those without had a sexual experience (74.1% vs. 87.4%, p = 0.033), with similar age of sexual debut. Among adolescents with T1D, ≥2 risky behaviors were observed less frequently than adolescents without T1D (8.62% vs. 23.27%, p = NS respectively) and in fewer girls than boys in both adolescents with T1D (0% vs. 18.5%, p = NS) and adolescents without T1D (11% vs. 44%, p = 0.022). Adolescents with T1D with ≥2 risky behaviors were older (p = 0.031), younger at first sexual intercourse (p = 0.031), with higher maternal education (p = 0.039). Early sexual debut was associated with higher maternal education (p = 0.014) and HbA1c (p = 0.049). Most adolescents without T1D with ≥2 risky behaviors were boys and older than peers. CONCLUSIONS Adolescents with T1D and females were more cautious than adolescents without T1D regarding sex. The associations of increased risky behaviors with male gender, older age, younger age at sexual debut and higher maternal education in adolescents with T1D merit further investigation.
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Affiliation(s)
- Betina Kandyla
- Diabetes and Metabolism Clinic, Second University Department of Pediatrics, “P. & A. Kyriakou” Children’s Hospital, National and Kapodistrian University of Athens School of Medicine, 115 27 Athens, Greece; (A.S.); (S.K.); (K.K.)
| | - Artemis Tsitsika
- Adolescent Health Unit (A.H.U.), Second University Department of Pediatrics, “P. & A. Kyriakou” Children’s Hospital, National and Kapodistrian University of Athens School of Medicine, 115 27 Athens, Greece; (A.T.); (C.T.)
| | - Alexandra Soldatou
- Diabetes and Metabolism Clinic, Second University Department of Pediatrics, “P. & A. Kyriakou” Children’s Hospital, National and Kapodistrian University of Athens School of Medicine, 115 27 Athens, Greece; (A.S.); (S.K.); (K.K.)
| | - Chara Tzavara
- Adolescent Health Unit (A.H.U.), Second University Department of Pediatrics, “P. & A. Kyriakou” Children’s Hospital, National and Kapodistrian University of Athens School of Medicine, 115 27 Athens, Greece; (A.T.); (C.T.)
| | - Spyridon Karanasios
- Diabetes and Metabolism Clinic, Second University Department of Pediatrics, “P. & A. Kyriakou” Children’s Hospital, National and Kapodistrian University of Athens School of Medicine, 115 27 Athens, Greece; (A.S.); (S.K.); (K.K.)
| | - Kyriaki Karavanaki
- Diabetes and Metabolism Clinic, Second University Department of Pediatrics, “P. & A. Kyriakou” Children’s Hospital, National and Kapodistrian University of Athens School of Medicine, 115 27 Athens, Greece; (A.S.); (S.K.); (K.K.)
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Taş D, Mengen E, Kocaay P, Uçaktürk SA. The Effects of Risk Behaviors and Orthorexic Behavior on Glycemic Control in Adolescents with Type 1 Diabetes. J Clin Res Pediatr Endocrinol 2020; 12:233-240. [PMID: 31722516 PMCID: PMC7499139 DOI: 10.4274/jcrpe.galenos.2019.2019.0128] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 11/14/2019] [Indexed: 12/15/2022] Open
Abstract
Objective Adolescents with chronic disease are as likely to exhibit risk-taking behavior as their peers. The aim was to investigate the risk behaviors of adolescents with type 1 diabetes (T1D) and the effect of orthorexic eating behaviors (OEB) on glycemic control (GC). Methods This cross-sectional study was conducted with 107 adolescents with T1D, aged between 13-18 years and attending high school. The Risk Behavior Scale (RBS) and Orthorexic Behavior Scale (ORTO-11) were administered. A high RBS score indicates risky behavior; a low ORTO-11 score suggests a tendency to OEB. Participants hemoglobin A1c (HbA1c) status was used to assess GC: optimal GC (HbA1c ≤7%); or poor GC (HbA1c >7%). Results Among females, those with poor GC had significantly lower (p=0.031) ORTO-11 scores than those with optimal GC, which was not the case in males. A significant correlation (r=0.358, p<0.001) was found between HbA1c and total RBS, eating habits subscale, and suicidal tendency subscale scores. Participants with poor GC had significantly higher eating habits subscale, alcohol use, and tobacco use subscale scores (p<0.05). Among females, total RBS and suicidal tendency subscale score was found to be significantly higher in those with poor GC; among males, alcohol subscale score was found to be significantly higher in those with poor GC. Conclusion This study is the first to show the effect of the tendency for OEB on GC among female adolescents with T1D. The study showed that, along with inappropriate eating behaviors, adolescents with T1D should also be assessed for other risk behaviors to help achieve optimal GC.
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Affiliation(s)
- Demet Taş
- Ankara City Hospital, Children’s Hospital, Clinic of Pediatrics, Ankara, Turkey
| | - Eda Mengen
- Ankara City Hospital, Children’s Hospital, Department of Pediatric Endocrinology, Ankara, Turkey
| | - Pınar Kocaay
- Ankara City Hospital, Children’s Hospital, Department of Pediatric Endocrinology, Ankara, Turkey
| | - Seyit Ahmet Uçaktürk
- Ankara City Hospital, Children’s Hospital, Department of Pediatric Endocrinology, Ankara, Turkey
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Pancer J, Dasgupta K. Effects of Cannabis Use in Youth and Young Adults With Type 1 Diabetes: The Highs, the Lows, the Don't Knows. Can J Diabetes 2019; 44:121-127. [PMID: 31401053 DOI: 10.1016/j.jcjd.2019.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 04/04/2019] [Accepted: 05/06/2019] [Indexed: 12/25/2022]
Abstract
Our objective was to address the request by our Diabetes Canada/Canadian Institutes of Health Research-funded Virtual Patient Network (VPN) of youth and young adults with type 1 diabetes for information on the impact of cannabis use on type 1 diabetes. To respond to this patient-initiated request, we conducted a literature search in PubMed, with search terms relevant to the following: cannabis use in youth with type 1 diabetes, effects of cannabis use on glycemic control and diabetic emergencies and immune-modulating properties of cannabis. These were synthesized in a narrative review. The number of studies is limited and is based largely on self-report and cross-sectional assessment. The existing literature indicates that 10% to 30% of youth and young adults with type 1 diabetes report ever using cannabis, similarly to the general population. Use appears to be associated with higher glycated hemoglobin and greater diabetic ketoacidosis incidence. There is some evidence of poorer self-management during episodes of use. Cannabis has been shown to be protective against type 1 diabetes in animal models, but such findings have yet to be replicated in humans. Existing cross-sectional studies suggest adverse effects of cannabis use on glycemic control and self-management. However, it is not clear if the associations identified are due to use itself or other patient or contextual factors. Nonetheless, given high use rates, health-care providers should query use, discuss its potential impact on diabetes management and outcomes, and codevelop an action plan.
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Affiliation(s)
- Jill Pancer
- Division of Endocrinology and Metabolism, Department of Medicine, McGill University Health Centre, Montréal, Québec, Canada; Centre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - Kaberi Dasgupta
- Centre for Outcomes Research and Evaluation (CORE), Research Institute of the McGill University Health Centre, Montréal, Québec, Canada; Department of Medicine, McGill University Health Centre, Montréal, Québec, Canada.
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Potter K, Virtanen H, Luca P, Pacaud D, Nettel-Aguirre A, Kaminsky L, Ho J. Knowledge and practice of harm-reduction behaviours for alcohol and other illicit substance use in adolescents with type 1 diabetes. Paediatr Child Health 2018; 24:e51-e56. [PMID: 30833824 DOI: 10.1093/pch/pxy075] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Objective To survey adolescents with type 1 diabetes mellitus (T1DM) about their knowledge and application of harm-reduction recommendations when they engage in alcohol and other illicit substance use. Methods Cross-sectional survey and chart review of adolescents with T1DM aged 13 to 18 years. Results One hundred and ninety patients were approached and 164 were included in the analysis. Mean age was 15.6 years (standard deviation [SD]=1.5). Fifty-one per cent were male. Of those who reported consuming alcohol, 95% knew that they should have a friend or parent check their blood glucose in the middle of the night after drinking but only 62% reported actually doing this in practice. Similarly, 98% reported knowing that they should wear a medic alert identification but only 79% reported actually doing this. Of those who reported consuming cannabis, 14% reported forgetting to check blood glucose and 14% reported forgetting insulin when using cannabis. From the chart review, a significantly lower proportion of adolescents reported substance use during their clinic visits (alcohol 26%, tobacco 19%, illicit substance 25%) compared to the self report in the survey (alcohol 55%, tobacco 30%, illicit substance 32%). Conclusions Adolescents' knowledge of harm-reduction practices for the use of alcohol and other illicit substances is not always put to practice. Motivating adolescents to use their knowledge in practice is an important area to improve in diabetes self-management. Those who reported engaging in substance use in the survey had not always reported use during interactions with health care providers. This emphasizes the need for unbiased, universal education of all adolescents in the clinic.
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Affiliation(s)
- Kathryn Potter
- Department of Pediatrics, Alberta Children's Hospital, Calgary, Alberta
| | - Heidi Virtanen
- Department of Pediatrics, Alberta Children's Hospital, Calgary, Alberta
| | - Paola Luca
- Department of Pediatrics, Alberta Children's Hospital, Calgary, Alberta
| | - Danièle Pacaud
- Department of Pediatrics, Alberta Children's Hospital, Calgary, Alberta
| | | | - Laura Kaminsky
- Department of Pediatrics, Alberta Children's Hospital, Calgary, Alberta
| | - Josephine Ho
- Department of Pediatrics, Alberta Children's Hospital, Calgary, Alberta
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Ssewanyana D, Nyongesa MK, van Baar A, Newton CR, Abubakar A. Health risk behavior among chronically ill adolescents: a systematic review of assessment tools. Child Adolesc Psychiatry Ment Health 2017; 11:32. [PMID: 28725261 PMCID: PMC5512752 DOI: 10.1186/s13034-017-0172-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 06/18/2017] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Adolescents living with chronic illnesses engage in health risk behaviors (HRB) which pose challenges for optimizing care and management of their ill health. Frequent monitoring of HRB is recommended, however little is known about which are the most useful tools to detect HRB among chronically ill adolescents. AIMS This systematic review was conducted to address important knowledge gaps on the assessment of HRB among chronically ill adolescents. Its specific aims were to: identify HRB assessment tools, the geographical location of the studies, their means of administration, the psychometric properties of the tools and the commonest forms of HRB assessed among adolescents living with chronic illnesses globally. METHODS We searched in four bibliographic databases of PubMed, Embase, PsycINFO and Applied Social Sciences Index and Abstracts for empirical studies published until April 2017 on HRB among chronically ill adolescents aged 10-17 years. RESULTS This review indicates a major dearth of research on HRB among chronically ill adolescents especially in low income settings. The Youth Risk Behavior Surveillance System and Health Behavior in School-aged Children were the commonest HRB assessment tools. Only 21% of the eligible studies reported psychometric properties of the HRB tools or items. Internal consistency was good and varied from 0.73 to 0.98 whereas test-retest reliability varied from unacceptable (0.58) to good (0.85). Numerous methods of tool administration were also identified. Alcohol, tobacco and other drug use and physical inactivity are the commonest forms of HRB assessed. CONCLUSION Evidence on the suitability of the majority of the HRB assessment tools has so far been documented in high income settings where most of them have been developed. The utility of such tools in low resource settings is often hampered by the cultural and contextual variations across regions. The psychometric qualities were good but only reported in a minority of studies from high income settings. This result points to the need for more resources and capacity building for tool adaptation and validation, so as to enhance research on HRB among chronically ill adolescents in low resource settings.
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Affiliation(s)
- Derrick Ssewanyana
- 0000 0001 0155 5938grid.33058.3dCentre for Geographic Medicine Research Coast, Kenya Medical Research Institute, Kilifi, Kenya ,0000000120346234grid.5477.1Utrecht Centre for Child and Adolescent Studies, Utrecht University, Utrecht, The Netherlands
| | - Moses Kachama Nyongesa
- 0000 0001 0155 5938grid.33058.3dCentre for Geographic Medicine Research Coast, Kenya Medical Research Institute, Kilifi, Kenya
| | - Anneloes van Baar
- 0000000120346234grid.5477.1Utrecht Centre for Child and Adolescent Studies, Utrecht University, Utrecht, The Netherlands
| | - Charles R. Newton
- 0000 0001 0155 5938grid.33058.3dCentre for Geographic Medicine Research Coast, Kenya Medical Research Institute, Kilifi, Kenya ,0000 0004 1936 8948grid.4991.5Department of Psychiatry, University of Oxford, Oxford, UK ,grid.449370.dDepartment of Public Health, Pwani University, Kilifi, Kenya
| | - Amina Abubakar
- 0000 0001 0155 5938grid.33058.3dCentre for Geographic Medicine Research Coast, Kenya Medical Research Institute, Kilifi, Kenya ,0000000120346234grid.5477.1Utrecht Centre for Child and Adolescent Studies, Utrecht University, Utrecht, The Netherlands ,0000 0004 1936 8948grid.4991.5Department of Psychiatry, University of Oxford, Oxford, UK ,grid.449370.dDepartment of Public Health, Pwani University, Kilifi, Kenya
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Daniilidou K, Triantafyllou P, Resta M, Dimitriadou M, Christoforidis A. Level of Internet use among Greek adolescents with type 1 diabetes. Int J Adolesc Med Health 2017; 31:ijamh-2016-0140. [PMID: 28598798 DOI: 10.1515/ijamh-2016-0140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Accepted: 02/12/2017] [Indexed: 06/07/2023]
Abstract
Background Compulsive Internet use has emerged as a contemporary addictive behavior. Our aim was to investigate the reasons for Greek adolescents with type 1 diabetes mellitus (T1DM) and their families to use the Internet and additionally to investigate the level of Internet use and its associations to demographic, socio-economic parameters and glycemic control. Methods Patients with T1DM, aged >12 years and their parents were recruited during their regular visits to the Pediatric Diabetes Clinic. A similar group of healthy children, age- and sex-matched served as a control group. All participants were asked to fill out the Greek translated version of the Internet Addiction Test (IAT). Caregivers of patients with T1DM were asked to complete a second questionnaire consisting of questions regarding demographic and socio-economic data of the family and data concerning disease management. Results Thirty-five patients with T1DM (mean decimal age of 14.95 ± 1.90 years) and 35 controls participated in the study. Nine patients were on an insulin pump whereas the rest were on multiple daily injections. The mean total score of the patients' IAT questionnaires was significantly lower compared to the controls (26.26 ± 12.67 vs. 39.91 ± 18.55, p = 0.003). Controls were characterized as exhibiting moderate addictive behavior at a significantly higher percentage than patients (31.43% vs. 2.86%, p = 0.002). All patients on insulin pumps demonstrated normal Internet use. Mild addictive behavior was associated with a lower parental educational level. Finally, level of Internet use (IAT score) was positively associated to glycemic control (HbA1c value) with a correlation that was approaching significance (r = 0.315, p = 0.065). Conclusions Adolescents with T1DM and especially those on an insulin pump exhibit normal Internet use compared to their healthy peers. Time consumed on Internet correlates reversibly with glycemic control.
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Affiliation(s)
- Katerina Daniilidou
- 1st Department of Pediatrics, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Maria Resta
- 1st Department of Pediatrics, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Meropi Dimitriadou
- 1st Department of Pediatrics, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Athanasios Christoforidis
- 1st Department of Pediatrics, Aristotle University of Thessaloniki, 49 Konstantinoupoleos str, 54642, Thessaloniki, Greece, Phone/Fax: +30230892491
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Wasserman R, Anderson BJ, Schwartz DD. Illness-Specific Risk-Taking in Adolescence: A Missing Piece of the Nonadherence Puzzle for Youth With Type 1 Diabetes? Diabetes Spectr 2017; 30:3-10. [PMID: 28270709 PMCID: PMC5309908 DOI: 10.2337/ds15-0060] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Risky behavior is often at its lifetime peak in adolescence. Chronic illness creates additional opportunities for risk because nonadherence behaviors can jeopardize adolescents' health. Adolescents with type 1 diabetes could engage in risky behavior around insulin administration that would put them in danger of severe health consequences. It is possible that some nonadherence behaviors observed in adolescents with type 1 diabetes may result from youth taking risks with their medical treatment. Illness-specific risk-taking behaviors are not captured in most assessments of adherence, which primarily focus on frequency of adherence behaviors. This article reviews current models of general risk-taking and their implications for diabetes management. The authors argue that illness-specific risk-taking may be an important, understudied aspect of illness management that can inform future studies and treatment of nonadherence in adolescents with type 1 diabetes.
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King KM, King PJ, Nayar R, Wilkes S. Perceptions of Adolescent Patients of the "Lived Experience" of Type 1 Diabetes. Diabetes Spectr 2017; 30:23-35. [PMID: 28270712 PMCID: PMC5309904 DOI: 10.2337/ds15-0041] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The care and management of adolescents with type 1 diabetes presents numerous challenges that are inherent to the fears, attitudes, and perceptions of their illness. This qualitative study aimed to explore the "lived experience" of individuals with type 1 diabetes. In-depth interviews were conducted with 20 patients diagnosed with type 1 diabetes in their adolescent years to elicit their views, perceptions, and concerns regarding living with diabetes. All interviews were conducted and analyzed using the principles of grounded theory. Five categories defining the patients' lived experience were elicited: Barriers, Develop Skills, Manage Emotion, Social World, and Health Care Professionals. The problems experienced by adolescents with type 1 diabetes are multifactorial. Existentially, type 1 diabetes affects their daily activities and impinges on their academic achievement and personal aspirations. They have great difficulty coping with their health status and highlight a lack of empathy from health care professionals (HCPs). Their major fear is of hypoglycemia, resulting in their subsequent focus of preventing hypoglycemic episodes. Indeed, regardless of consequence, blood glucose levels are often deliberately kept above recommended levels, which serves to decrease the effectiveness of their health care management. This study shows that the quality of care provided for adolescent patients with type 1 diabetes is failing to meet their expectations and falls short of the essential standards commensurate with current health care policy. Improvements in long-term care management for these patients require changes in both patients' and professionals' understanding of the disease and of the ways it is managed.
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Affiliation(s)
| | | | - Rahul Nayar
- Sunderland Royal Hospital, Sunderland, Tyne and Wear, UK
| | - Scott Wilkes
- University of Sunderland, Sunderland, Tyne and Wear, UK
- Coquet Medical Group, Amble Health Centre, Amble, Northumberland, UK
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Michel B, Charron-Prochownik D. Diabetes Nurse Educators and Preconception Counseling. DIABETES EDUCATOR 2016; 32:108-16. [PMID: 16439499 DOI: 10.1177/0145721705284371] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: The purpose of this study was to examine the diabetes nurse educator’s role, practice, and training in preconception counseling (PC) when caring for adolescents with diabetes. Methods: A descriptive, correlational research design, using a cross-sectional survey technique, was used. Subjects were 2003 registered nurse members of the American Association of Diabetes Educators. A survey instrument was developed by the investigator and placed on the World Wide Web. Results: Although most of the diabetes nurse educators were aware of PC, most reported not having received any training in PC and would benefit from this education. Thirty percent of the respondents did not routinely provide PC to their adult female clients, and 40% did not provide this to adolescents. Conclusions: Results of this study suggest that the diabetes nurse educators in this sample would benefit from receiving instruction about PC. The diabetes nurse educators should be trained to provide PC to all female clients with diabetes of childbearing age starting at puberty.
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Affiliation(s)
- Brenda Michel
- Lincoln Land Community College, Nursing Department, Springfield, Illinois
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Snyder LL, Truong YKN, Law JR. Evaluating Substance Use and Insulin Misuse in Adolescents With Type 1 Diabetes. DIABETES EDUCATOR 2016; 42:529-37. [PMID: 27480524 DOI: 10.1177/0145721716659149] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Substance use behaviors often emerge during adolescence, and adolescents with type 1 diabetes (T1D) may be at risk for engaging in traditional substance use (eg, alcohol, tobacco, and illicit substances) as well as a unique form of substance use: insulin misuse. The purpose of this exploratory study was to examine substance use and insulin misuse in adolescents with T1D. METHODS Sixty adolescents aged 12 to 20 years with T1D (n = 60) completed surveys on substance use, insulin misuse, and diabetes self-management during a routine diabetes appointment. Demographic measures were summarized by mean (SD) or percentage. Prevalence of substance use and insulin misuse was calculated and stratified by demographic and clinical characteristics. Two-sample t test (continuous variables) and chi-square analysis (categorical variables) determined statistically significant differences. RESULTS The prevalence of ever using substances was 36.7%, and that for ever misusing insulin was 19%. Older participants (17.1 ± 1.8 vs 15.6 ± 1.9 years; P < .01) and those with depression (31.8% vs 7.9%; P = .02) were more likely to use substances. Disordered eating behaviors were the most frequently reported reason for insulin misuse. Self-harm intent was reported by one-third of insulin misusers. Substance use and insulin misuse were not related to glycemic control or diabetes self-management behaviors. CONCLUSIONS The diabetes care team should be aware that substance use and insulin misuse are common in adolescents with T1D. Screening for these risky behaviors is critical in those who are older or have mental health disorders. Effective education, prevention, and treatment strategies targeted at these behaviors are needed to improve the overall health of this population.
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Affiliation(s)
- Lydia L Snyder
- Division of Pediatric Endocrinology, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA (Dr Snyder, Dr Law)
| | - Young Kinh-Nhue Truong
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA (Dr Truong)
| | - Jennifer R Law
- Division of Pediatric Endocrinology, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA (Dr Snyder, Dr Law)
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Hogendorf AM, Fendler W, Sieroslawski J, Bobeff K, Wegrewicz K, Malewska KI, Przudzik MW, Szmigiero-Kawko M, Sztangierska B, Mysliwiec M, Szadkowska A, Mlynarski W. Breaking the Taboo: Illicit Drug Use among Adolescents with Type 1 Diabetes Mellitus. J Diabetes Res 2016; 2016:4153278. [PMID: 26858959 PMCID: PMC4709623 DOI: 10.1155/2016/4153278] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 10/11/2015] [Accepted: 10/18/2015] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The aim of the study was to explore the prevalence of illicit drug use in a group of Polish adolescents with type 1 diabetes (DM1) in comparison with a national cohort of their healthy peers. METHODS Two hundred and nine adolescents with DM1, aged 15-18 years, were studied in 2013 with an anonymous questionnaire prepared for the European School Survey Project on Alcohol and Other Drugs (ESPAD). The control group was a representative sample of 12114 students at the same age who took part in ESPAD in 2011. Metabolic control was regarded as good if self-reported HbA1c was <8% or poor if HbA1c was ≥8%. RESULTS Lifetime prevalence of illicit drug use was lower among adolescents with DM1 than in the control group [58 (28%) versus 5524 (46%), p = 10(-5)]. Cannabis preparations were the most frequently used substances [38 (18.3%) versus 3976 (33.1%), p = 10(-5)], followed by tranquilizers, sedatives, and amphetamine. Lifetime and last 12-month use of cannabis were associated with poorer glycemic control (HbA1c ≥ 8%), p < 0.01 and 0.02, respectively. CONCLUSIONS Adolescents with DM1 report using illicit drugs to a lesser extent than their healthy peers. The use of cannabis is associated with a poorer metabolic control in teens with DM1.
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Affiliation(s)
- Anna M. Hogendorf
- Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Lodz, 91-738 Lodz, Poland
- *Anna M. Hogendorf:
| | - Wojciech Fendler
- Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Lodz, 91-738 Lodz, Poland
| | - Janusz Sieroslawski
- Department of Studies on Alcoholism and Other Dependencies, Institute of Psychiatry and Neurology, 02-957 Warsaw, Poland
| | - Katarzyna Bobeff
- Students' Scientific Circle at the Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Lodz, 91-738 Lodz, Poland
| | - Krzysztof Wegrewicz
- Students' Scientific Circle at the Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Lodz, 91-738 Lodz, Poland
| | - Kamila I. Malewska
- Students' Scientific Circle at the Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Lodz, 91-738 Lodz, Poland
| | - Maciej W. Przudzik
- Students' Scientific Circle at the Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Lodz, 91-738 Lodz, Poland
| | - Malgorzata Szmigiero-Kawko
- Department of Pediatrics, Diabetology and Endocrinology, Medical University of Gdańsk, 80-211 Gdańsk, Poland
| | - Beata Sztangierska
- Department of Pediatrics, Diabetology and Endocrinology, Medical University of Gdańsk, 80-211 Gdańsk, Poland
| | - Malgorzata Mysliwiec
- Department of Pediatrics, Diabetology and Endocrinology, Medical University of Gdańsk, 80-211 Gdańsk, Poland
| | - Agnieszka Szadkowska
- Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Lodz, 91-738 Lodz, Poland
| | - Wojciech Mlynarski
- Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Lodz, 91-738 Lodz, Poland
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McDonagh JE, Gleeson H. Getting transition right for young people with diabetes. ACTA ACUST UNITED AC 2015. [DOI: 10.1002/edn.170] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Sivertsen B, Petrie KJ, Wilhelmsen-Langeland A, Hysing M. Mental health in adolescents with Type 1 diabetes: results from a large population-based study. BMC Endocr Disord 2014; 14:83. [PMID: 25303963 PMCID: PMC4197324 DOI: 10.1186/1472-6823-14-83] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 10/03/2014] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Diabetes has previously been linked to mental health problems in adolescents, but more recent studies have yielded mixed findings. The aim of the current study was to compare symptoms of mental health problems, sleep and eating disturbances in adolescents with and without Type 1 diabetes in a population based sample. METHODS Data were taken from the youth@hordaland study, a large population based study in Hordaland County in Norway conducted in 2012. In all, 9883 adolescents aged 16-19 years (53% girls) provided self-reported data on both diabetes and a range of instruments assessing mental health symptoms, including depression, anxiety, obsessive-compulsive behaviours, hyperactivity, impulsivity, inattention, perfectionism, resilience, sleep problems and eating behaviour. RESULTS 40 adolescents were classified as having Type 1 diabetes (prevalence 0.4%). We found that adolescents with Type 1 diabetes did not differ from their peers on any of the mental health measures. CONCLUSIONS This is one of the first population-based studies to examine mental health of adolescents with Type 1 diabetes. There was no evidence of increased psychopathology across a wide range of mental health measures. These findings contradict previous studies, and suggest that Type 1 diabetes is not associated with an increased risk of psychosocial problems.
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Affiliation(s)
- Børge Sivertsen
- />Division of Mental Health, Norwegian Institute of Public Health, Kalfarveien 31, 5018 Bergen, Norway
- />Uni Research Health, P.O.Box 7810, N-5020 Bergen, Norway
- />Department of Psychiatry, Helse Fonna HF, P.O.Box 2170, N-5504 Haugesund, Norway
| | - Keith J Petrie
- />Department of Psychological Medicine, University of Auckland, Auckland, 1142 New Zealand
| | | | - Mari Hysing
- />The Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, P.O.Box 7810, N-5020 Bergen, Norway
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Santos T, Ferreira M, Simões MC, Machado MC, de Matos MG. Chronic condition and risk behaviours in Portuguese adolescents. Glob J Health Sci 2014; 6:227-36. [PMID: 24576385 PMCID: PMC4825360 DOI: 10.5539/gjhs.v6n2p227] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Revised: 11/23/2013] [Accepted: 12/07/2013] [Indexed: 11/18/2022] Open
Abstract
Living with a chronic condition (CC) in adolescence has been historically considered protective for risk behaviours. However, research from the last decade suggest that when compared with healthy peers, adolescents living with a chronic condition can engage in risky behaviours in a similar if not higher rate than their counterparts living with out a CC. This study aims to characterize and evaluate the impact of 1) living with a chronic condition (CC), and 2) how the perception of living with a CC affects school participation, and its association with risk/protective behaviours (drunkenness, physical fight, sadness and self-harm). For this purpose 4 groups were identified: adolescents with mostly healthy behaviours, adolescents with mostly risk behaviours, adolescents with mostly risk-internalizing behaviours and adolescents with mostly risk-externalizing behaviours. A large sample was included in this study, composed by 3494 Portuguese adolescents with an average age of 15 years, who participated in the Portuguese Survey of Health Behaviour in School-aged Children/WHO (HBSC). Main results show that adolescents living with a CC have more risk-internalizing behaviours when compared to adolescents without CC, who present more healthy behaviors. Furthermore, adolescents that report that having a CC affects school participation show more risky behaviours than those not affected by a CC who present more healthy behaviours. Boys with a CC show more healthy behaviours, and those who feel that the CC affects school participation present more risky behaviours. On the other hand, girls with a CC have more risk-internalizing behaviours and less healthy behaviours It is important to point out that dolescents living with a CC represent a vulnerable group, and may engage in experimental/risky behaviours as likely as their non CC peers. Thus, potential benefits can arise from reinforcing interventions within protective contexts (family/peers/school setting). Health/education professionals, more than considering risk behaviours as dangerous in themselves, should offer adolescents with a CC an opportunity to reflect on their own decisions. Educational programs would benefit from looking at risk behaviors more from an experimentation perspective, focusing on constructive ways to help adolescents with CC to proceed into adulthood in a more appropriate developmental way.
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Affiliation(s)
- Teresa Santos
- Faculdade de Motricidade Humana/Universidade de Lisboa (FMH/UL); Centro de Malária e Doenças Tropicais/Instituto de Medicina Tropical/Universidade Nova de Lisboa (CMDT/IHMT/UNL).
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15
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Bae J. Differences in cigarette use behaviors by age at the time of diagnosis with diabetes from young adulthood to adulthood: results from the National Longitudinal Study of Adolescent Health. J Prev Med Public Health 2013; 46:249-60. [PMID: 24137527 PMCID: PMC3796650 DOI: 10.3961/jpmph.2013.46.5.249] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 08/07/2013] [Indexed: 11/09/2022] Open
Abstract
Objectives Previous observations propose that risk-taking behaviors such as cigarette smoking are prevailing among young people with chronic conditions including diabetes. The purpose of this study was to examine whether cigarette smoking is more prevalent among diabetics than non-diabetics and whether it differs by age at the time of diagnosis with diabetes from young adulthood (YAH) to adulthood (AH). Methods We used US panel data from the National Longitudinal Study of Adolescent Health (Add Health Study) during the years 2001 to 2002 (Wave III, YAH) and 2007 to 2008 (Wave IV, AH). Multivariate logistic regression models were applied to estimate odds ratios (ORs) and 95% confidence intervals (CIs) of cigarette use behaviors according to age at the time of diagnosis with diabetes, after adjusting for demographic and selected behavioral factors. Results Of 12 175 study participants, 2.6% reported having been diagnosed with diabetes up to AH. Early-onset diabetics (age at diagnosis <13 years) were more likely than non-diabetics to report frequent cigarette smoking (smoking on ≥20 days during the previous 30 days) in YAH (OR, 3.34; 95% CI, 1.27 to 8.79). On the other hand, late-onset diabetics (age at diagnosis ≥13 years) were more likely than non-diabetics to report heavy cigarette smoking (smoking ≥10 cigarettes per day during the previous 30 days) in AH (OR, 1.54; 95% CI, 1.03 to 2.30). Conclusions The current study indicated that diabetics are more likely than non-diabetics to smoke cigarettes frequently and heavily in YAH and AH. Effective smoking prevention and cessation programs uniquely focused on diabetics need to be designed and implemented.
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Affiliation(s)
- Jisuk Bae
- Department of Preventive Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
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16
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Neylon OM, O'Connell MA, Skinner TC, Cameron FJ. Demographic and personal factors associated with metabolic control and self-care in youth with type 1 diabetes: a systematic review. Diabetes Metab Res Rev 2013; 29:257-72. [PMID: 23364787 DOI: 10.1002/dmrr.2392] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2012] [Revised: 12/02/2012] [Accepted: 01/02/2013] [Indexed: 11/11/2022]
Abstract
Optimal use of recent technological advances in insulin delivery and glucose monitoring remain limited by the impact of behaviour on self-care. In recent years, there has been a resurgence of interest in psychosocial methods of optimizing care in youth with type 1 diabetes. We therefore sought to examine the literature for demographic, interpersonal and intrapersonal correlates of self-care and/or metabolic control. Studies for this systematic review were obtained via an electronic search of Medline, Embase, Cumulative Index to Nursing and Allied Health Literature and PsycINFO databases. Seventy studies fulfilled the inclusion criteria. These studies have indicated that identifiable individual characteristics in each domain are robustly associated with metabolic control and/or self-care in children and adolescents. We present these characteristics and propose a theoretical model of their interactions and effect on diabetes outcomes. There is currently no consensus regarding patient selection for insulin pump therapy. In this era of scarce healthcare resources, it may be prudent to identify youth requiring increased psychosocial support prior to regimen intensification. The importance of this review lies in its potential to create a framework for rationally utilizing resources by stratifying costly therapeutic options to those who, in the first instance, will be most likely to benefit from them.
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Affiliation(s)
- Orla M Neylon
- University of Tasmania, Burnie, Tasmania, Australia.
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Isidro ML, Jorge S. Recreational drug abuse in patients hospitalized for diabetic ketosis or diabetic ketoacidosis. Acta Diabetol 2013; 50:183-7. [PMID: 21136122 DOI: 10.1007/s00592-010-0243-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2010] [Accepted: 11/25/2010] [Indexed: 11/25/2022]
Abstract
To evaluate the association between recreational drug use and diabetic ketosis (DK) and diabetic ketoacidosis (DKA) in our area. Retrospective examination of records from a 1,450 bed urban teaching hospital in Spain. All adult admissions for DK or DKA from January 1, 2005, to December 31, 2009 in our hospital were included. Demographic, exploratory (blood pressure, heart rate, respiratory rate), and analytical data (glucose, urea, creatinine, corrected Na(+), K(+), pH, HCO3(-) and HbA1c) at admittance were recorded. In 152 patients, 253 episodes of DK or DKA occurred. Screening for drug use was performed in 40.3% of the events; 20.6% of the episodes (n = 52) were shown to be substance abuse. Cocaine, followed by cannabis and alcohol, was the most frequently involved drug. Poly-substance abuse occurred in 67.3% of them. Comorbidities were present in 11.5 and 39.8% of the cases shown and not shown to be related to drug use (P = 0.00). Seventy percent of the patients who were at least once shown to have consumed drugs, and 15.9% of those who were never shown to have done so, were admitted more than once (P = 0.00). The frequency of recent drug misuse in patients presenting with DK or DKA was high. Substance abuse screening was frequently neglected. Adverse profile, most significantly in readmission to hospital, was found in the patients with positive drug findings. History taking in this context should routinely include questions on substance abuse, and toxicology screening may be worthwhile, particularly in those with the history of frequent readmissions.
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Affiliation(s)
- María L Isidro
- Endocrine Department, Complexo Hospitalario Universitario A Coruña, As Xubias 84, 15006, A Coruña, Spain.
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Kunz JH, Greenley RN, Mussatto KA, Roth-Wojcicki B, Miller T, Freeman ME, Lerand S. Personal attitudes, perceived social norms, and health-risk behavior among female adolescents with chronic medical conditions. J Health Psychol 2013; 19:877-86. [PMID: 23524992 DOI: 10.1177/1359105313481077] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
To examine whether perceived peer/parent norms or personal beliefs about adolescent substance use influence substance use among female adolescents with chronic medical conditions. Sixty-eight females reported on substance use, personal beliefs, and perceived peer/parent norms. Personal beliefs and perceived peer/parent norms were associated with adolescent's current and future substance use. Although perceived peer norms accounted for variance in current substance use, only personal beliefs accounted for variance in future alcohol use. Targeting perceived peer norms may be effective for intervention efforts among adolescents endorsing current substance use, whereas alcohol use prevention efforts should target personal beliefs.
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Tai YM, Gau SSF, Gau CS. Injury-proneness of youth with attention-deficit hyperactivity disorder: a national clinical data analysis in Taiwan. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:1100-1108. [PMID: 23340027 DOI: 10.1016/j.ridd.2012.11.027] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Revised: 11/28/2012] [Accepted: 11/28/2012] [Indexed: 06/01/2023]
Abstract
Limited literature documents injury-proneness of attention-deficit hyperactivity disorder in western population. However, only a few studies prospectively investigated the prediction of ADHD to injuries without considering other psychiatric and physical conditions and there is lack of such data in Asian population. To prospectively examine the prediction of ADHD to the risk of injury in a national sample of Taiwan, we conducted this study with samples including 1965 6-18-year-old youths with newly diagnosis of ADHD from 1999 to 2003, and 7860 sex-, age- and index day-matched non-ADHD controls from Taiwan's National Health Insurance Research Database (1997-2008). Relevant psychiatric and physical disorders, demographics, and medications were also included in the Cox proportional hazard models with injury as the outcome. Our results showed that ADHD cases had a roughly 2-fold and 5-fold higher risk of each injury, and overall injury than controls after considering all confounding factors, respectively. In addition to ADHD, use of anxiolytics, antidepressants, and antipsychotics, and comorbid physical illnesses also predicted the injury prospectively. Our findings strongly support that ADHD predicted injury risks and imply that physicians should take the risk of injury into consideration while prescribing medications other than stimulants to patients with ADHD, especially anxiolytics.
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Affiliation(s)
- Yueh-Ming Tai
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
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20
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Making a difference: Nursing scholarship and leadership in tobacco control. Nurs Outlook 2013; 61:31-42. [DOI: 10.1016/j.outlook.2012.05.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Revised: 04/30/2012] [Accepted: 05/29/2012] [Indexed: 11/18/2022]
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Hanna KM. A framework for the youth with type 1 diabetes during the emerging adulthood transition. Nurs Outlook 2012; 60:401-10. [PMID: 22226223 PMCID: PMC3324668 DOI: 10.1016/j.outlook.2011.10.005] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2011] [Revised: 10/03/2011] [Accepted: 10/30/2011] [Indexed: 10/14/2022]
Abstract
Emerging adulthood, a developmental period from late adolescence to the late twenties, is a critical transition for youths with type 1 diabetes. This article proposes a framework for emerging adults with diabetes during this transitional time, integrating theoretical writings on transitions and emerging adulthood with empirical findings from younger adolescents with diabetes, about whom more is known. Key health, developmental, and behavioral outcomes are proposed, as well as key influential personal and environmental characteristics. Influential transitional events for this age group are also discussed relative to these outcomes and to personal and environmental characteristics. This framework provides a guide for longitudinal studies on the transition to young adulthood among emerging adults with type 1 diabetes. Identifying key times and influential factors will provide information for designing future effective interventions to improve glycemic control and quality of life for these youths as they transition to adulthood.
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Affiliation(s)
- Kathleen M Hanna
- Indiana University School of Nursing, Indianapolis, IN 46202, USA.
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Scaramuzza A, De Palma A, Mameli C, Spiri D, Santoro L, Zuccotti GV. Adolescents with type 1 diabetes and risky behaviour. Acta Paediatr 2010; 99:1237-41. [PMID: 20377535 DOI: 10.1111/j.1651-2227.2010.01813.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM The aim of the student is to assess whether adolescents with type 1 diabetes mellitus (T1DM) in Italy differ from their healthy peers in regard to risky behaviour. METHODS Data were collected from 215 patients, aged 14 +/- 2 years with a mean disease duration of 7 +/- 5 years. The control group was comprised of 464 healthy adolescents recruited among high school students. Each patient completed an anonymous confidential questionnaire to determine the prevalence of sexual behaviour, alcohol and tobacco consumption, illicit drug use, and, among patients with diabetes and frequency of mismanagement related to diabetes care. RESULTS Compared with controls, subjects with diabetes showed a similar rate of sexual intercourse among males and lower rates among females (34.8% vs 35.5%, p NS and 29.4% vs 41.4%, p < 0.05, respectively). Males in the diabetes group reported a higher rate of tobacco use, whereas females showed similar or higher rates of use for every illicit drug studied. Among patients with diabetes, those who are engaged in risky behaviour showed a higher rate of treatment mismanagement (76% vs 34%, p < 0.01). CONCLUSION Adolescents with T1DM are as likely as their healthy peers to engage in risky behaviour, indicating the potential benefit of anticipatory guidance concerning glycaemic control and increased risk of acute and chronic complications.
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Affiliation(s)
- Ae Scaramuzza
- Department of Pediatrics, University of Milano, Luigi Sacco Hospital, Milan, Italy.
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Tercyak KP. Personal and Social Correlates of Tobacco Use Among Adolescents With Diabetes. CHILDRENS HEALTH CARE 2010. [DOI: 10.1207/s15326888chc3302_2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Radobuljac MD, Bratina NU, Battelino T, Tomori M. Lifetime prevalence of suicidal and self-injurious behaviors in a representative cohort of Slovenian adolescents with type 1 diabetes. Pediatr Diabetes 2009; 10:424-31. [PMID: 19490494 DOI: 10.1111/j.1399-5448.2009.00501.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To determine lifetime prevalence of suicidal and self-injurious behaviors in Slovenian adolescents with type 1 diabetes compared with healthy controls. RESEARCH DESIGN AND METHODS Adolescents (14-19 yr) with type 1 diabetes were compared with a normative control group of healthy secondary school students by means of a self-reported questionnaire (according to Kienhorst) containing questions on demographic and family characteristics, suicidal ideation, intended suicide, attempted suicide, possible future suicide, and self-injurious behavior. Patients received the questionnaires at regular outpatient visits to the pediatric diabetes clinic, completed them in private, and returned them by mail. Questionnaires for control subjects were administered in classrooms. RESULTS The responses of 126 eligible patients and 499 controls were analyzed. The control group trended toward higher lifetime prevalence of all suicidal behaviors and self-injurious behavior. The lowest prevalence of all suicidal behaviors and self-injurious behavior was reported by males with diabetes. Compared with male controls, the differences were statistically significant for suicidal ideation (p < 0.05) and intended suicide (p < 0.05). Compared with females with diabetes, the differences were statistically significant for suicidal ideation (p < 0.001), intended suicide (p < 0.01), attempted suicide (p < 0.05), and self-injurious behavior (p < 0.05). Females with diabetes reported highest prevalence of all suicidal but not self-injurious behaviors. More patients than controls reported receiving counseling the year preceding the study (p < 0.001). CONCLUSIONS In the study, type 1 diabetes showed a protective effect for suicidal behavior in adolescent males but not in adolescent females. Professionals working with adolescents with type 1 diabetes should be alert to possible suicidality, especially among females.
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Affiliation(s)
- Maja Drobnic Radobuljac
- Clinical Department for Mental Health, University Psychiatric Hospital Ljubljana, SI-1000 Ljubljana, Slovenia.
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Psychosocial problems in adolescents with type 1 diabetes mellitus. DIABETES & METABOLISM 2009; 35:339-50. [PMID: 19700362 DOI: 10.1016/j.diabet.2009.05.002] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2008] [Revised: 05/11/2009] [Accepted: 05/11/2009] [Indexed: 12/11/2022]
Abstract
Adolescents with diabetes are at increased risk of developing psychiatric (10-20%) or eating disorders (8-30%), as well as substance abuse (25-50%), leading to non-compliance with treatment and deterioration of diabetic control. At high risk are female adolescents with family problems and other comorbid disorders. Impaired cognitive function has also been reported among children with diabetes, mainly in boys, and especially in those with early diabetes diagnosis (< 5 years), or with episodes of severe hypoglycaemia or prolonged hyperglycaemia. Type 1 diabetes mellitus contributes to the development of problems in parent-child relationships and employment difficulties, and negatively affects the quality of life. However, insulin pumps appear to improve patients' metabolic control and lifestyle. The contributions of family and friends to the quality of metabolic control and emotional support are also crucial. In addition, the role of the primary-care provider is important in identifying patients at high risk of developing psychosocial disorders and referring them on to health specialists. At high risk are patients in mid-adolescence with comorbid disorders, low socioeconomic status or parental health problems. Multisystem therapy, involving the medical team, school personnel, family and peer group, is also essential. The present review focuses on the prevalence of nutritional and psychosocial problems among adolescents with diabetes, and the risk factors for its development, and emphasizes specific goals in their management and prevention.
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Zeitler PS, Klingensmith GJ. They're still kids. J Pediatr 2009; 154:7-9. [PMID: 19187730 DOI: 10.1016/j.jpeds.2008.09.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2008] [Accepted: 09/12/2008] [Indexed: 11/30/2022]
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Rhee H, Hollen PJ, Belyea MJ, Sutherland MA. Decision-making program for rural adolescents with asthma: a pilot study. J Pediatr Nurs 2008; 23:439-50. [PMID: 19026912 PMCID: PMC2676914 DOI: 10.1016/j.pedn.2008.01.079] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2007] [Revised: 01/06/2008] [Accepted: 01/20/2008] [Indexed: 10/21/2022]
Abstract
Although a high prevalence of substance use and its adverse effects on the course of the disease have been reported in adolescents with asthma, no studies have attempted to ameliorate the risk through adequate interventions. This pilot study evaluates and supports the feasibility and the effectiveness of a decision-making program in improving decision-making quality and reducing risk motivation over a 6-month study period. Differential effectiveness of the intervention was observed by race and gender. Although the improvement of decision-making quality was observed only in Whites, changes in risk motivation were detected only in non-Whites and girls. No significant reduction in actual substance use behavior was found. The intervention was favorably received by participants. An approach enhancing decision-making quality can be effective in addressing the risk of substance use in adolescent with asthma by altering motivations.
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Affiliation(s)
- Hyekyun Rhee
- University of Rochester, School of Nursing, Rochester, NY 14642, USA.
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Cha ES, Kim KH, Doswell WM. Influence of the parent-adolescent relationship on condom use among South Korean male college students. Nurs Health Sci 2008; 9:277-83. [PMID: 17958677 DOI: 10.1111/j.1442-2018.2007.00326.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This study examined the mediating role of condom self-efficacy between the parent-adolescent relationship and the intention to use condoms with a submodel based on the Theory of Planned Behavior. Male students aged 18-25 years (n = 176) were recruited from a university in Seoul, South Korea, using a flyer and self-referral in 2004. A sample of 170 male students was retained for the final data analyses as six subjects had incomplete data on more than one instrument. Condom self-efficacy completely mediated the prediction of intention to use condoms by the quality of the mother-son relationship. However, condom self-efficacy did not mediate the relationship between the quality of the father-son relationship and the intention to use condoms. Only an indirect effect between the quality of the father-son relationship and the intention to use condoms existed. The suggested sex education programs should develop culture-specific, theory-based, and family-based interventions in order to reduce risky sexual behavior among South Korean adolescents.
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Affiliation(s)
- Eun Seok Cha
- Department of Nursing, School of Medicine, Chung-Ang University, Seoul, South Korea.
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Martínez-Aguayo A, Araneda JC, Fernandez D, Gleisner A, Perez V, Codner E. Tobacco, alcohol, and illicit drug use in adolescents with diabetes mellitus. Pediatr Diabetes 2007; 8:265-71. [PMID: 17850469 DOI: 10.1111/j.1399-5448.2007.00307.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Substance abuse in adolescents with diabetes mellitus (DM) is associated with the development of acute and chronic complications. OBJECTIVE To determine the prevalence of alcohol, tobacco, and illicit drug consumption in adolescents with DM and compare it with the prevalence in a large contemporary control (C) group. METHODS Adolescents with and without DM, who were attending 8th-12th grades, answered a structured written questionnaire, which evaluates the voluntary declaration of tobacco, alcohol, and illicit drug consumption. Subjects with DM were recruited from free diabetes camps or public hospitals (n = 193). The C group was obtained from a nationwide study of prevalence of substance abuse (n = 58,489). For illicit drugs (marijuana, cocaine, or cocaine sulfate), results are shown as life prevalence (ever used the substance). For alcohol and tobacco, results are shown as last month prevalence (the substance was used during the last month). RESULTS Adolescents with DM showed a lower last month prevalence of tobacco and alcohol consumption than C (27.7 vs. 39.0%, p < 0.01 and 30.1 vs. 39.2%, p < 0.01, respectively). DM group had a lower life prevalence rate of illicit drugs than C group (9.6 vs. 22.2%, respectively; p < 0.01). A lower prevalence of tobacco, alcohol, and illicit drug use in DM group compared with C group was observed in grades 8, 9, and 10. However, a similar frequency of consumption was observed in 11th and 12th grades. CONCLUSION Compared with healthy youth, DM patients use less tobacco, alcohol, and illicit drugs during the first years of adolescence but not later.
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Rhee H, Hollen PJ, Sutherland M, Rakes G. A Pilot Study of Decision-Making Quality and Risk Behaviors in Rural Adolescents with Asthma. ACTA ACUST UNITED AC 2007. [DOI: 10.1089/pai.2007.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Roncević N, Stojadinović A, Odri I. [Chronic diseases in adolescence]. MEDICINSKI PREGLED 2006; 59:33-7. [PMID: 17068889 DOI: 10.2298/mpns0602033r] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The prevalence of chronic diseases in adolescence is constantly increasing, especially in the last two decades. Adolescence is a period of important changes: body growth and development, sexual development, development of cognitive abilities, change in family relations and between peers, formation of personal identity and personal system of values, making decisions on future occupation etc. CHRONIC DISEASES IN ADOLESENCE Chronic disorders affect all development issues and represent an additional burden for adolescents. The interaction between chronic disorders and various development issues is complex and two-way: the disease may affect development, and development may affect the disease. Developmental, psychosocial and family factors are of great importance in the treatment of adolescents with chronic disorders. Chronic disorders affect all aspects of adolescent life, including relations with peers, school, nutrition, learning, travelling, entertainment, choice of occupation, plans for the future. Physicians should keep in mind that chronic diseases and their treatment represent only one aspect of person's life. Adolescents with chronic diseases have other needs as well, personal priorities, social roles and they expect these needs to be recognised and respected. Adolescent health care should be adjusted to the life style of adolescents.
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Charron-Prochownik D, Sereika SM, Falsetti D, Wang SL, Becker D, Jacober S, Mansfield J, White NH. Knowledge, attitudes and behaviors related to sexuality and family planning in adolescent women with and without diabetes. Pediatr Diabetes 2006; 7:267-73. [PMID: 17054448 DOI: 10.1111/j.1399-5448.2006.00197.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Sexually active adolescents with diabetes are at high risk for unplanned pregnancies and reproductive complications. OBJECTIVE Knowledge, attitudes, intentions, and behaviors regarding diabetes and reproductive issues, sexuality, and contraception were examined in teens with diabetes in relation to a non-diabetic group. METHODS A multisite, case-control, theory-based structured telephone interview was conducted on adolescent women: 80 with diabetes mellitus (DM) and 37 matched controls without diabetes (non-DM). RESULTS Teens with diabetes appeared to lack an understanding of critical information that could prevent unplanned pregnancies and pregnancy-related complications. Although they scored significantly higher than the non-DM group on diabetes-related information, the DM group had their lowest mean average of 59% for the diabetes and pregnancy score. They did not appear to have greater protective attitudes regarding reproductive health issues than the non-DM group. The DM group felt that they were only moderately susceptible to becoming pregnant and that severe complications would not happen to them. The DM group perceived greater severity to sex-related outcomes (p = 0.001). The DM group did not report safer and more effective family planning behaviors (mean age coitus = 15.7 yr), which for them could be more detrimental. Similar trends were noted between groups regarding contraceptive methods; only a single method (e.g., pill only) rather than a dual method (e.g., pill and condom) was most frequently used. CONCLUSION Having diabetes did not appear to significantly decrease the risk-taking behavior of the teens. Early and some unsafe sexual practices may increase their risk for an unplanned pregnancy that could result in pregnancy-related complications. Enhancing awareness, knowledge, and attitudes through preconception counseling and reproductive health education may reduce these risks by empowering young women to plan healthy future pregnancies.
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Affiliation(s)
- Denise Charron-Prochownik
- Health Promotion & Development, School of Nursing, University of Pittsburgh, Pittsburgh, PA 15261, USA.
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Tyc VL, Throckmorton-Belzer L. Smoking rates and the state of smoking interventions for children and adolescents with chronic illness. Pediatrics 2006; 118:e471-87. [PMID: 16882787 DOI: 10.1542/peds.2004-2413] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Engaging in smoking is particularly risky for children and adolescents with chronic illness whose health status is already compromised because of disease- and treatment-related complications. Yet, some of these youngsters smoke at rates at least comparable to those of their healthy peers. To date, few randomized smoking-prevention and cessation trials have been conducted in children with chronic medical problems. In this review we report on the smoking rates among youngsters with chronic illness, identify specific disease- and treatment-related complications that can be exacerbated by smoking, examine risk factors associated with tobacco use among medically compromised youngsters, and review smoking interventions that have been conducted to date with pediatric populations in the health care setting. The following chronic illnesses are included in this review: asthma, cystic fibrosis, cancer, sickle cell disease, juvenile-onset diabetes, and juvenile rheumatoid arthritis. Objectives for a tobacco-control agenda and recommendations for future tobacco studies in chronically ill pediatric populations are provided. Finally, tobacco counseling strategies are suggested for clinicians who treat these youngsters in their practices.
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Affiliation(s)
- Vida L Tyc
- Division of Behavioral Medicine, St Jude Children's Research Hospital, 332 N Lauderdale, Memphis, Tennessee 38105-2794, USA.
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Ismail D, Gebert R, Vuillermin PJ, Fraser L, McDonnell CM, Donath SM, Cameron FJ. Social consumption of alcohol in adolescents with Type 1 diabetes is associated with increased glucose lability, but not hypoglycaemia. Diabet Med 2006; 23:830-3. [PMID: 16911618 DOI: 10.1111/j.1464-5491.2006.01868.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
AIM To determine the effects of social consumption of alcohol by diabetic adolescents on glycaemic control. METHODS Fourteen (five male) patients aged > 16 years were recruited from the diabetes clinic at the Royal Children's Hospital. The continuous glucose monitoring system (CGMS) was attached at a weekend when alcohol consumption was planned for one night only. For each patient, the 12-h period from 18.00 h to 06.00 h for the night with alcohol consumption (study period) was compared with the same period with non-alcohol consumption (control period) either 24 h before or after the alcohol study night. Thus, each subject was his/her own control. Glycaemic outcomes calculated from continuous glucose monitoring included mean blood glucose (MBG), percentage of time spent at low glucose levels (CGMS < 4.0 mmol/l), normal glucose levels (CGMS 4.0-10.0 mmol/l) and high glucose levels (> 10.0 mmol/l) and continuous overall net glycaemic action (CONGA). RESULTS The mean number of standard alcohol drinks consumed during the study period was 9.0 for males and 6.3 for females. There was no difference in percentage of time at high and normal glucose levels in the study and control periods. During the control period, there was a higher percentage of time with low glucose levels compared with the study period (P < 0.05). There was an increased level of glycaemic variation during the study time when compared with the control period. CONCLUSIONS In an uncontrolled, social context, moderately heavy alcohol consumption by adolescents with Type 1 diabetes appears to be associated with increased glycaemic variation, but not with low glucose levels.
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Affiliation(s)
- D Ismail
- Department of Endocrinology and Diabetes, Royal Children's Hospital, Melbourne, Australia
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Carroll AE, Marrero DG. The role of significant others in adolescent diabetes: a qualitative study. DIABETES EDUCATOR 2006; 32:243-52. [PMID: 16554428 DOI: 10.1177/0145721706286893] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this study was to explore perceptions of how diabetes influences adolescents' perceptions of quality of life in general and their relationships with parents, peers, school, and their physician. METHODS The authors recruited adolescents between the ages of 13 and 18 years living with type 1 diabetes mellitus from a midwestern metropolitan area. Qualitative analysis of the focus group data followed a set procedure: (1) audio review of the tapes, (2) reading through the transcriptions, (3) discussions among investigators, (4) determination of conceptual themes, and (5) assignment of relevant responses to appropriate thematic constructs. RESULTS The 5 focus groups involved 31 adolescents. From the discussions that occurred within the 5 focus groups, the following themes were identified: personal perceptions of living with diabetes (which included living with diabetes, testing and injections, and blood sugar fluctuations), impact on relationships (which included relationships with their parents, their friends/peers, and their physician), and impact on school. CONCLUSIONS Diabetes in adolescence is fraught with equal and opposite demands. One consequence of this internal push/pull is that adolescents become more afraid to do appropriate developmental activities. This can have a significant impact on their normal progression to independence and adulthood, ironically at odds with the increased responsibility they have had to assume throughout their lives to care for their disease. Much of the clinical time and research still focuses on the devices of diabetes care: testing and treatment. While these are important tools in improving the outcomes of people with diabetes, they will have little impact on the adolescent until the developmental consequences of diabetes on their lives are simultaneously addressed.
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Affiliation(s)
- Aaron E Carroll
- Riley Research 330, 699 West Drive, Indianapolis, IN 46074, USA.
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Abstract
The purpose of this study was to describe the universal and health deviation self-care of adolescents with Type 1 diabetes and the associations of basic conditioning factors with universal and health deviation self-care. Subjects for this study were 152 adolescents aged between 11 and 15 years with a diagnosis of Type 1 diabetes. Data were collected in the home setting of each adolescent and his or her family. The mean universal self-care scores ranged from 66.62% to 90%. The overall mean for this sample was 75.37, indicating that these adolescents took care of their self-care needs 75% of the time. Health deviation self-care was a mean of 27.26, indicating more positive self-care behaviors and treatment adherence. Health deviation and universal self-care were significantly and positively related (r = .36, p < .001). Ethnicity and adolescent sex were statistically significant in predicting universal self-care. Adolescent age was statistically significant in predicting health deviation self-care. Health deviation self-care decreases with age, suggesting that early adolescence or late school age is an appropriate time for interventions to strengthen self-care behaviors. Furthermore, the interrelationship of the two types of self-care supports the potential for a synergistic effect of intervention.
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Affiliation(s)
- Carol J Dashiff
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
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Suris JC, Parera N. Sex, drugs and chronic illness: health behaviours among chronically ill youth. Eur J Public Health 2005; 15:484-8. [PMID: 16162596 DOI: 10.1093/eurpub/cki001] [Citation(s) in RCA: 99] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND A growing body of literature indicates that adolescents with chronic conditions are as likely, or more likely, to take risky behaviours than their healthy peers. The objective of this research was to assess whether adolescents with chronic illness in Catalonia differ from their healthy peers in risk-taking behaviour. METHODS Data were drawn from the Catalonia Adolescent Health database, a survey including a random school-based sample of 6952 young people, aged 14-19 years. The index group (IG) included 665 adolescents (450 females) reporting several chronic conditions. The comparison group (CG) comprised 6287 healthy adolescents (3306 females). Personal, family and school-related variables were analysed to ensure comparability between groups. Sexual behaviour, drug use (tobacco, alcohol, cannabis, cocaine and synthetic drugs) and perception of drug use among peers and in school were compared. Analysis was carried out separately by gender. chi-square, Fisher's and Student's tests were used to compare categorical and continuous variables. RESULTS The prevalence of chronic conditions was 9.6%, with females showing a higher prevalence than males. The IG showed similar or higher rates of sexual intercourse and risky sexual behaviour. For most studied drugs, IG males reported slightly lower rates of use than CG males, while IG females showed higher rates for every drug studied. No differences were found in the perceptions of drug use among peers or in their school. CONCLUSIONS Similar to previous research, chronically ill adolescents in our sample are as likely, or more likely, to take risky behaviours than their healthy counterparts and should receive the same anticipatory guidance.
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Affiliation(s)
- Joan-Carles Suris
- Groupe de Recherche sur la Santé des Adolescents, Institut Universitaire de Médecine Sociale et Préventive, Lausanne, Switzerland.
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Erickson JD, Patterson JM, Wall M, Neumark-Sztainer D. Risk Behaviors and Emotional Well-Being in Youth With Chronic Health Conditions. CHILDRENS HEALTH CARE 2005. [DOI: 10.1207/s15326888chc3403_2] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Tercyak KP, Beville KW, Walker LR, Prahlad S, Cogen FR, Sobel DO, Streisand R. Health Attitudes, Beliefs, and Risk Behaviors Among Adolescents and Young Adults With Type 1 Diabetes. CHILDRENS HEALTH CARE 2005. [DOI: 10.1207/s15326888chc3403_1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Patino AM, Sanchez J, Eidson M, Delamater AM. Health beliefs and regimen adherence in minority adolescents with type 1 diabetes. J Pediatr Psychol 2005; 30:503-12. [PMID: 16055488 DOI: 10.1093/jpepsy/jsi075] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To examine the appraisal of short- and long-term diabetes health risk and adherence, determine whether health risk predicts adherence and glycemic control in an ethnic minority sample, and determine whether perceptions of personal risk differ from risk to others. METHODS Seventy-four youths with type 1 diabetes (ages 11-16) completed measures of risk perception and regimen adherence during their clinic visit; parents completed a measure of their children's adherence. Glycosylated hemoglobin A1c level was measured as part of the clinic visit. RESULTS Regression analyses predicting parental report and self-reported adherence from appraisal of risk yielded nonsignificant results; perceived short-term complications to self predicted glycemic control. Appraisal of risk was higher for short- and long-term complications occurring to someone else with diabetes than to self. Greater risk for short-term complications than for long-term complications to self and other was found. CONCLUSIONS The distinction between long-term and short-term complications and complications occurring to ones' self or someone else with diabetes was supported. Assessment of perceived risks for short-term complications is important for this age group and should be addressed in interventions to improve adherence.
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Tercyak KP. Brief report: social risk factors predict cigarette smoking progression among adolescents with asthma. J Pediatr Psychol 2005; 31:246-51. [PMID: 16524960 DOI: 10.1093/jpepsy/jsj012] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To compare smoking progression in adolescents with and without asthma and to compare their psychosocial risk factors. METHODS Participants were 1,507 adolescents with asthma and 1,507 healthy matched controls from Waves I and II of the Add Health Project assessed at baseline and again 1 to 2 years later at follow-up. Three levels of smoking progression (defined as smoking more frequently and/or intensely over time) were identified: (a) Late Experimenters (never smokers at baseline, ever smokers at follow-up), (b) Early Experimenters (ever smokers at baseline, current/current frequent smokers at follow-up), and (c) Early Smokers (current smokers at baseline, current frequent smokers at follow-up). RESULTS Twenty percent of adolescents experienced progression in their smoking behavior; those with and without asthma were equally likely to progress. Among adolescents who progressed, 37% were Late Experimenters, 42% were Early Experimenters, and 21% were Early Smokers. Exposure to friends who smoked was a consistent and powerful social risk factor for smoking progression among adolescents with asthma-more so than among adolescents without asthma. This effect was intensified among Late Experimenters by the presence of a positive history of parent smoking. CONCLUSIONS Findings underscore the importance of addressing cigarette smoking behavior and its social risk factors among adolescents with asthma in both clinical and public health contexts, during early adolescence, and through research on this topic.
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Affiliation(s)
- Kenneth P Tercyak
- Cancer Control Program, Department of Oncology and Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, 2233 Wisconsin Avenue, NW, Suite 317, Washington, Federal District of Columbia 20007-4104, USA.
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Miauton L, Narring F, Michaud PA. Chronic illness, life style and emotional health in adolescence: results of a cross-sectional survey on the health of 15-20-year-olds in Switzerland. Eur J Pediatr 2003; 162:682-9. [PMID: 12915981 DOI: 10.1007/s00431-003-1179-x] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2002] [Revised: 01/13/2003] [Accepted: 01/21/2003] [Indexed: 11/30/2022]
Abstract
UNLABELLED The objective was to evaluate the prevalence of chronic conditions (CC) in adolescents in Switzerland; to describe their behaviour (leisure, sexuality, risk taking behaviour) and to compare them to those in adolescents who do not have CC in order to evaluate the impact of those conditions on their well-being. The data were obtained from the Swiss Multicentre Adolescent Survey on Health, targeting a sample of 9268 in-school adolescents aged 15 to 20 years, who answered a self-administered questionnaire. Some 11.4% of girls and 9.6% of boys declared themselves carriers of a CC. Of girls suffering from a CC, 25% (versus 13% of non carriers; P=0.007) and 38% of boys (versus 25%; P=0.002) proclaimed not to wear a seatbelt whilst driving. Of CC girls, 6.3% (versus 2.7%; P=0.000) reported within the last 12 months to have driven whilst drunk. Of the girls, 43% (versus 36%; P=0.004) and 47% (versus 39%; P=0.001) were cigarette smokers. Over 32% of boys (versus 27%; P=0.02) reported having ever used cannabis and 17% of girls (versus 13%; P=0.013) and 43% of boys (versus 36%; P=0.002) admitted drinking alcohol. The burden of their illness had important psychological consequences: 7.7% of girls (versus 3.4%; P=0.000) and 4.9% of boys (versus 2.0%; P=0.000) had attempted suicide during the previous 12 months. CONCLUSION experimental behaviours are not rarer in adolescents with a chronic condition and might be explained by a need to test their limits both in terms of consumption and behaviour. Prevention and specific attention from the health caring team is necessary.
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Affiliation(s)
- Lise Miauton
- Adolescent Health Research Unit, Institute of Social and Preventive Medicine, University of Lausanne, Bugnon 17, 1005, Lausanne, Switzerland
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Hanna KM, Guthrie DW. Health-compromising behavior and diabetes mismanagement among adolescents and young adults with diabetes. DIABETES EDUCATOR 2001; 27:223-30. [PMID: 11913004 DOI: 10.1177/014572170102700208] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE This study examined the relationship between health-compromising behavior, age, gender, and diabetes mismanagement. METHODS A total of 107 adolescents and young adults, 12 to 24 years old, with type 1 diabetes were asked to complete a health-compromising behavior scale and a diabetes mismanagement scale. RESULTS Based upon participants' responses, the study population was divided into 2 different groups: those involved in health-compromising behavior and those not involved in such behavior. A multiple regression analysis was performed using age, gender, and health-compromising behavior as predictor variables and diabetes mismanagement as the outcome variable. Variables that accounted for significant variance in diabetes mismanagement were being female and being involved in health-compromising behavior. CONCLUSIONS Adolescents and young adults with diabetes appear to be either involved or not involved in health-compromising behavior. Being female and being involved in health-compromising behavior were associated with diabetes mismanagement.
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Affiliation(s)
- K M Hanna
- Indiana University School of Nursing, Indianapolis (Dr Hanna)
| | - D W Guthrie
- University of Kansas School of Medicine Wichita (Dr Guthrie)
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Abstract
The transition from childhood through adolescence to adulthood is a difficult stage, particularly for patients with type 1 diabetes. The yearning for autonomy and independence, as well as the hormonal changes around the time of puberty, can manifest in poor glycaemic control. The focus on diet and weight increases the prevalence of eating disorders, compounding the difficulties in supervising diabetes patients. This can be exacerbated by the realisation that hyperglycaemia induces weight loss and the use of this knowledge to further manipulate diabetes control to gain a desired body image. The management of adolescents with type 1 diabetes is therefore challenging and requires close collaboration between psychological medicine and diabetes teams. This review describes the difficulties frequently encountered, with a description of four cases illustrating these points. Case 1 demonstrates the problem of needle phobia in a newly diagnosed patient with type 1 diabetes leading to persistent hyperglycaemia, the recognition of weight loss associated with this and the development of bulimia. The patient's overall management was further complicated by risk-taking behaviour. By the age of 24 years, she has developed diabetic retinopathy and autonomic neuropathy and continues to partake in risk-taking behaviour. Case 2 illustrates how the lack of parental support shortly after the development of type 1 diabetes led to poor glycaemic control and how teenagers often omit insulin to accommodate lifestyle and risk-taking behaviour. Case 3 further exemplifies the difficulty in managing patients with needle phobia and the fear of hypoglycaemia. Case 4 adds further weight to the need for parental support and the impact of deleterious life events on glycaemic control by manipulation of insulin dosage.
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Affiliation(s)
- E M McConnell
- Diabetes Unit, Ulster Hospital, 700 Upper Newtownards Road, Dundonald, Belfast, Northern Ireland BT16 1RH, UK
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Abstract
Treatment of children and adolescents with insulin-dependent diabetes mellitus (type 1) is different in many ways than it is for adults. Physical, cognitive, and emotional development changes affect therapeutic goals and modalities. Neonatal, early childhood, school-age, and adolescent patients all have unique needs. Further, diabetes can affect psychosocial maturation and the likelihood of difficulties with mood.
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Affiliation(s)
- M P Golden
- Interlake Psychiatric Associates, Bellevue, Washington 98004, USA
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Abstract
PURPOSE The purpose of this study was to examine involvement in a broad range of health behaviors among adolescents and young adults with diabetes. METHODS The sample consisted of 107 adolescents and young adults (12 to 24 years old) with Type 1 diabetes mellitus. Participants were asked to report involvement in health-enhancing, health-compromising, and diabetes mismanagement behaviors. RESULTS The participants reported low levels of health-compromising behaviors and high levels of health-enhancing behaviors. Females reported significantly higher levels of diabetes mismanagement than males. Males in late adolescence (18 to 24 years) reported significantly higher levels of health-compromising behaviors than males in early (12 to 14 years) and middle (15 to 17 years) adolescence. Females in late adolescence (18 to 24 years) reported significantly higher levels of health-compromising behaviors than females in early adolescence (12 to 14 years). CONCLUSIONS Diabetes educators who work with youth may want to assess all of these health behaviors, keeping in mind age and gender differences.
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Affiliation(s)
- K M Hanna
- The School of Nursing, University of Wyoming, Laramie, (Dr Hanna)
- Dr. Hanna also is a postdoctoral fellow at Indiana University Schools of Nursing and Medicine, Adolescent Section, Indianapolis
| | - D W Guthrie
- The Department of Pediatrics/Psychiatry, University of Kansas School of Medicine Wichita (Dr Guthrie)
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