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Carneiro MDNDL, Gomes DL, da Fonseca AA, Ripardo RC. Relationship between Quality of Life and Adult Attachment Factors in Mothers of Children with and without Type 1 Diabetes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7109. [PMID: 38063539 PMCID: PMC10706471 DOI: 10.3390/ijerph20237109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/27/2023] [Accepted: 11/02/2023] [Indexed: 12/18/2023]
Abstract
The mothers of children with a specific clinical situation such as type 1 diabetes mellitus may have a higher level of stress, causing a worse perception of their quality of life, greater anxiety, and greater avoidance (adult attachment factors). The objective of this research was to verify if there is a relationship between the adult attachment factors of mothers of children with and without type 1 diabetes mellitus and the perception of the quality of life of these mothers. This survey was carried out from July to September 2022, with mothers of children aged 5 to 10 years, with and without diabetes. The data were collected through an online questionnaire, with socioeconomic data from the attachment scale Experience in Close Relationship-(Reduced), and the questionnaire on the quality of life, the WHOQOL-abbreviated questionnaire. For statistical analysis, the Statistical Package for Social Science 24 was used. A total of 45 mothers of children with DM1 and 55 mothers of healthy children were evaluated. The mothers of children with DM1 had a worse perception of their quality of life when compared to the mothers of healthy children (p < 0.05), with no difference in terms of the attachment style. Therefore, it is understood that actions aimed at improving the quality of life of these mothers are necessary.
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Mathole SH, Deacon E, van Rensburg E. Are fathers involved in diabetes management? A rapid review. JOURNAL OF PSYCHOLOGY IN AFRICA 2022. [DOI: 10.1080/14330237.2022.2120702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Simphiwe Hope Mathole
- Optentia, School for Psychosocial Health, North-West University, Potchefstroom, South Africa
| | - Elmari Deacon
- Optentia, School for Psychosocial Health, North-West University, Potchefstroom, South Africa
| | - Esmé van Rensburg
- Compres, School for Psychosocial Health, North-West University, Potchefstroom, South Africa
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Saßmann H, Kim-Dorner SJ, Berndt V, Biester T, Dehn-Hindenberg A, Heidtmann B, Jorch N, Lilienthal E, Nellen-Hellmuth N, Neu A, Schaaf K, Ziegler R, Lange K. Understanding Daily, Emotional, and Physical Burdens and Needs of Parents Caring for Children with Type 1 Diabetes. J Diabetes Res 2022; 2022:9604115. [PMID: 36561282 PMCID: PMC9767735 DOI: 10.1155/2022/9604115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 11/07/2022] [Accepted: 11/12/2022] [Indexed: 12/15/2022] Open
Abstract
AIMS To investigate (1) daily, emotional, and physical caregiving burdens in parents of children with type 1 diabetes, (2) the sociodemographic and clinical predictors of three burdens, and (3) support measures that parents wish to receive. METHODS The study was a multicenter cross-sectional survey conducted in nine German pediatric diabetes centers. A questionnaire assessing three types of burdens and wishes for support was distributed to parents with a child with type 1 diabetes visiting one of the pediatric centers for a routine check-up. RESULTS Data from 1,107 parents (83% mothers) were analyzed. Parents reported significantly higher emotional burdens compared to daily and physical burdens (p < 0.0001). Mothers felt more burdened than fathers did. Parents of younger children reported higher daily and physical burdens compared to the parents of older children, and similarly, parents of technology users reported higher daily and physical burdens compared to the parents of nontechnology users. However, emotional burdens did not differ in both comparisons. Other demographic factors (i.e., parent's age, migration status, and single-parent family status) predicted high levels of daily or physical burdens, but only HbA1c level and the parent's gender (mother) predicted a high emotional burden. Independent of the level of burden, 78% of parents wanted additional diabetes training. CONCLUSION Despite parents reporting high emotional burdens in connection with diabetes care, HbA1c and the gender of the reporting parent were the only risk factors. As the child gets older, parents' daily and physical distress decrease but not the emotional burden. Diabetes training including regularly offered booster sessions as well as low-threshold interventions for mental health issues and practical self-care skills is recommended to provide continuous support for parents.
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Affiliation(s)
- Heike Saßmann
- Hannover Medical School, Medical Psychology, Hannover, Germany
| | | | - Verena Berndt
- Sana Hospital Group Berlin-Brandenburg, Social-Pediatric Centre Lichtenberg, Berlin, Germany
| | - Torben Biester
- Children's Hospital AUF DER BULT, Diabetes-Centre for Children and Adolescents, Hannover, Germany
| | | | | | - Norbert Jorch
- Bielefeld University, University Clinic for Pediatrics, Evang. Klinikum Bethel, Bielefeld, Germany
| | - Eggert Lilienthal
- University Clinic Ruhr-University Bochum, University Children's Hospital, Bochum, Germany
| | | | - Andreas Neu
- Eberhard Karls University Tübingen, Pediatric Endocrinology and Diabetes, Tübingen, Germany
| | - Katja Schaaf
- Elisabeth-Hospital-Essen, Pediatrics, Essen, Germany
| | - Ralph Ziegler
- Diabetes Clinic for Children and Adolescents Münster, Münster, Germany
| | - Karin Lange
- Hannover Medical School, Medical Psychology, Hannover, Germany
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Teasdale A, Limbers CA. Online assessment of problem-solving skills among fathers of young and school-age children with type 1 diabetes: Associations with parent and child outcomes. J Child Health Care 2021; 25:379-392. [PMID: 32673074 DOI: 10.1177/1367493520942711] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Type 1 diabetes (T1D) is a pediatric chronic illness that is associated with significant parenting stress due to its lifelong course, burdensome disease management, and life-threatening complications. Although mothers of children with T1D have been studied extensively in relation to parenting stress, coping, and diabetes outcomes, there is a need to examine similar variables among fathers. The aim of the present study was to examine if fathers' use of problem-solving skills was related to parenting stress and diabetes regimen adherence and if problem-solving skills moderated the associations between paternal involvement in diabetes care and parenting stress in a national online sample of 215 fathers of children with T1D. Self-report measures completed by fathers through Qualtrics included a demographic and disease-related questionnaire, the Social Problem-Solving Inventory-Revised; Parenting Stress Index-Fourth Edition, Short Form; Pediatric Inventory for Parents; Dads' Active Disease Support Scale; and Self-Care Inventory-Revised. Pearson correlations were computed to assess associations among study variables. Four separate multiple linear regression analyses were conducted to determine the interactive effects of problem-solving skills and paternal involvement on parenting stress. Analyses revealed a large positive correlation between problem-solving skills and general parenting stress (r = .63), and a large negative correlation between problem-solving skills and pediatric parenting stress (r = -.52). The interaction between problem-solving skills and father involvement accounted for a significant amount of variance in a general parenting stress subscale (p < .01) and pediatric parenting stress (p < .05). These results highlight the importance of problem-solving skills for father outcomes in the context of T1D while implicating the potential benefit of a problem-solving intervention for this population.
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Affiliation(s)
- Ashley Teasdale
- Department of Psychology and Neuroscience, 14643Baylor University, TX, USA
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Schwartzman JM, Millan ME, Uljarevic M, Gengoux GW. Resilience Intervention for Parents of Children with Autism: Findings from a Randomized Controlled Trial of the AMOR Method. J Autism Dev Disord 2021; 52:738-757. [PMID: 33774741 DOI: 10.1007/s10803-021-04977-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2021] [Indexed: 01/11/2023]
Abstract
Parents of children with autism spectrum disorder (ASD) experience elevated stress, yet parent-specific interventions are sparse. Thirty-five parents of children with ASD were randomized to the novel 8-week AMOR (Acceptance, Mindfulness, Optimism, Resilience) Method parent group or waitlist control group. Significant gains in resilience were reported by AMOR parents only (d = 1.42, p < 0.001, 95% CI [2.152, 10.083]). AMOR parents exhibited significant gains in stress management and reductions in mental health symptoms, along with parent-reported improvements in martial, family, and child functioning. AMOR group follow-up data showed some maintenance of treatment gains. Findings demonstrate promise for resilience interventions in parents of children with ASD. The trial was registered (clinicaltrials.gov; NCT03513419; May 1, 2018) and approved by the Stanford University Institutional Review Board.
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Affiliation(s)
- Jessica M Schwartzman
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA, 94305-5719, USA.
| | - Maria Estefania Millan
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA, 94305-5719, USA
| | - Mirko Uljarevic
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA, 94305-5719, USA.,Melbourne School of Psychological Sciences, The University of Melbourne, Redmond Barry Building, Parkville, VIC, 3010, Australia.,Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, Redmond Barry Building, Bundoora, VIC, 3086, Australia
| | - Grace W Gengoux
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA, 94305-5719, USA
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Jaser SS, Hamburger ER, Pagoto S, Williams R, Meyn A, Jones AC, Simmons JH. Communication and coping intervention for mothers of adolescents with type 1 diabetes: Rationale and trial design. Contemp Clin Trials 2019; 85:105844. [PMID: 31499228 DOI: 10.1016/j.cct.2019.105844] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 09/03/2019] [Accepted: 09/04/2019] [Indexed: 12/21/2022]
Abstract
Mothers of adolescents with type 1 diabetes (T1D) experience high rates of depressive symptoms and diabetes distress, which are established risk factors for deteriorating glycemic control, problems with adherence, increased depressive symptoms, and poor quality of life in adolescents. Given that adolescents are a high-risk population for suboptimal glycemic control, novel interventions to improve outcomes in adolescents with T1D are needed. Building on effective interventions to treat depression in adults, and our own pilot work in this population, we developed a cognitive behavioral intervention, Communication & Coping, to target maternal depressive symptoms and parenting behaviors. The randomized controlled trial compares the telephone and Facebook-delivered Communication & Coping intervention, which promotes the use of adaptive coping strategies and positive parenting practices, to a diabetes education control condition on diabetes outcomes and psychosocial outcomes in adolescents with T1D. This paper describes the study rationale, trial design, and methodology.
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7
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Goldberg A. Parents’ representations and glycemic control among adolescents with type 1 diabetes. J Public Health (Oxf) 2018. [DOI: 10.1007/s10389-018-1003-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Berg CA, Butner J, Wiebe DJ, Lansing AH, Osborn P, King PS, Palmer DL, Butler JM. Developmental model of parent-child coordination for self-regulation across childhood and into emerging adulthood: Type 1 diabetes management as an example. DEVELOPMENTAL REVIEW 2017; 46:1-26. [DOI: 10.1016/j.dr.2017.09.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Wong CA, Miller VA, Murphy K, Small D, Ford CA, Willi SM, Feingold J, Morris A, Ha YP, Zhu J, Wang W, Patel MS. Effect of Financial Incentives on Glucose Monitoring Adherence and Glycemic Control Among Adolescents and Young Adults With Type 1 Diabetes: A Randomized Clinical Trial. JAMA Pediatr 2017; 171:1176-1183. [PMID: 29059263 PMCID: PMC6583649 DOI: 10.1001/jamapediatrics.2017.3233] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
IMPORTANCE Glycemic control often deteriorates during adolescence and the transition to young adulthood for patients with type 1 diabetes. The inability to manage type 1 diabetes effectively during these years is associated with poor glycemic control and complications from diabetes in adult life. OBJECTIVE To determine the effect of daily financial incentives on glucose monitoring adherence and glycemic control in adolescents and young adults with type 1 diabetes. DESIGN, SETTING, AND PARTICIPANTS The Behavioral Economic Incentives to Improve Glycemic Control Among Adolescents and Young Adults With Type 1 Diabetes (BE IN CONTROL) study was an investigator-blinded, 6-month, 2-arm randomized clinical trial conducted between January 22 and November 2, 2016, with 3-month intervention and follow-up periods. Ninety participants (aged 14-20) with suboptimally controlled type 1 diabetes (hemoglobin A1c [HbA1c] >8.0%) were recruited from the Diabetes Center for Children at the Children's Hospital of Philadelphia. INTERVENTIONS All participants were given daily blood glucose monitoring goals of 4 or more checks per day with 1 or more level within the goal range (70-180 mg/dL) collected with a wireless glucometer. The 3-month intervention consisted of a $60 monthly incentive in a virtual account, from which $2 was subtracted for every day of nonadherence to the monitoring goals. During a 3-month follow-up period, the intervention was discontinued. MAIN OUTCOMES AND MEASURES The primary outcome was change in HbA1c levels at 3 months. Secondary outcomes included adherence to glucose monitoring and change in HbA1c levels at 6 months. All analyses were by intention to treat. RESULTS Of the 181 participants screened, 90 (52 [57.8%] girls) were randomized to the intervention (n = 45) or control (n = 45) arms. The mean (SD) age was 16.3 (1.9) years. The intervention group had significantly greater adherence to glucose monitoring goals in the incentive period (50.0% vs 18.9%; adjusted difference, 27.2%; 95% CI, 9.5% to 45.0%; P = .003) but not in the follow-up period (15.3% vs 8.7%; adjusted difference, 3.9%; 95% CI, -2.0% to 9.9%; P = .20). The change in HbA1c levels from baseline did not differ significantly between groups at 3 months (adjusted difference, -0.08%; 95% CI, -0.69% to 0.54%; P = .80) or 6 months (adjusted difference, 0.03%; 95% CI, -0.55% to 0.60%; P = .93). CONCLUSIONS AND RELEVANCE Among adolescents and young adults with type 1 diabetes, daily financial incentives improved glucose monitoring adherence during the incentive period but did not significantly improve glycemic control. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT02568501.
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Affiliation(s)
- Charlene A. Wong
- Department of Pediatrics, Duke Clinical Research Institute, Duke-Margolis Center for Health Policy, Duke University, Durham, North Carolina,Leonard Davis Institute of Health Economics, Center for Health Incentives and Behavioral Economics at the University of Pennsylvania, Philadelphia
| | - Victoria A. Miller
- Division of Adolescent Medicine, The Children’s Hospital of Philadelphia, Perelman School of Medicine and University of Pennsylvania, Philadelphia
| | - Kathryn Murphy
- Division of Pediatric Endocrinology, The Children’s Hospital of Philadelphia, Philadelphia
| | - Dylan Small
- Leonard Davis Institute of Health Economics, Center for Health Incentives and Behavioral Economics at the University of Pennsylvania, Philadelphia,Department of Statistics, The Wharton School, University of Pennsylvania, Philadelphia
| | - Carol A. Ford
- Division of Adolescent Medicine, The Children’s Hospital of Philadelphia, Perelman School of Medicine and University of Pennsylvania, Philadelphia
| | - Steven M. Willi
- Division of Pediatric Endocrinology, The Children’s Hospital of Philadelphia and University of Pennsylvania, Philadelphia
| | - Jordyn Feingold
- medical student, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Alexander Morris
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Yoonhee P. Ha
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Jingsan Zhu
- Leonard Davis Institute of Health Economics, Center for Health Incentives and Behavioral Economics at the University of Pennsylvania, Philadelphia,Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Wenli Wang
- Leonard Davis Institute of Health Economics, Center for Health Incentives and Behavioral Economics at the University of Pennsylvania, Philadelphia,Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Mitesh S. Patel
- Leonard Davis Institute of Health Economics, Center for Health Incentives and Behavioral Economics at the University of Pennsylvania, Philadelphia,Perelman School of Medicine at the University of Pennsylvania, Philadelphia,Department of Medicine, Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania,Health Care Management, The Wharton School, University of Pennsylvania, Philadelphia
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10
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Akre C, Ramelet AS, Berchtold A, Suris JC. Educational intervention for parents of adolescents with chronic illness: a pre-post test pilot study. Int J Adolesc Med Health 2016; 27:261-9. [PMID: 25153554 DOI: 10.1515/ijamh-2014-0020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Accepted: 07/16/2014] [Indexed: 12/16/2022]
Abstract
OBJECTIVE This pilot experimental study tested the feasibility and intended effect of an educational intervention for parents to help them assist their adolescent child with chronic illness (CI) in becoming autonomous. METHODS A two-phase pre-post pilot intervention study targeting parents of adolescents with CI was conducted. Parents were allocated to group 1 and 2 and received the four-module intervention consecutively. Intended effect was measured through online questionnaires for parents and adolescents before, at 2 months after, and at 4-6 months after the intervention. Feasibility was assessed through an evaluation questionnaire for parents. RESULTS The most useful considered modules concerned the future of the adolescent and parents and social life. The most valued aspect was to exchange with other parents going through similar problems and receiving a new outlook on their relationship with their child. For parents, improvement trends appeared for shared management, parent protection, and self-efficacy, and worsening trends appeared for coping skills, parental perception of child vulnerability, and parental stress. For adolescents, improvement trends appeared for self-efficacy and parental bonding and worsening trends appeared for shared management and coping skills. CONCLUSION Parents could benefit from peer-to-peer support and education as they support the needed autonomy development of their child. Future studies should test an online platform for parents to find peer support at all times and places.
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Rohan JM, Huang B, Pendley JS, Delamater A, Dolan L, Reeves G, Drotar D. Predicting Health Resilience in Pediatric Type 1 Diabetes: A Test of the Resilience Model Framework. J Pediatr Psychol 2015; 40:956-67. [PMID: 26152400 DOI: 10.1093/jpepsy/jsv061] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2014] [Accepted: 05/31/2015] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES This research examined whether individual and family-level factors during the transition from late childhood to early adolescence protected individuals from an increased risk of poor glycemic control across time, which is a predictor of future diabetes-related complications (i.e., health resilience). METHODS This longitudinal, multisite study included 239 patients with type 1 diabetes and their caregivers. Glycemic control was based on hemoglobin A1c. Individual and family-level factors included: demographic variables, youth behavioral regulation, adherence (frequency of blood glucose monitoring), diabetes self-management, level of parental support for diabetes autonomy, level of youth mastery and responsibility for diabetes management, and diabetes-related family conflict. RESULTS Longitudinal mixed-effects logistic regression indicated that testing blood glucose more frequently, better self-management, and less diabetes-related family conflict were indicators of health resilience. CONCLUSIONS Multiple individual and family-level factors predicted risk for future health complications. Future research should develop interventions targeting specific individual and family-level factors to sustain glycemic control within recommended targets, which reduces the risk of developing future health complications during the transition to adolescence and adulthood.
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Affiliation(s)
- Jennifer M Rohan
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Department of Psychology, University of Cincinnati,
| | - Bin Huang
- Division of Epidemiology and Biostatistics, Cincinnati Children's Hospital Medical Center
| | | | | | - Lawrence Dolan
- Division of Endocrinology, Cincinnati Children's Hospital Medical Center, and
| | - Grafton Reeves
- Division of Pediatric Endocrinology, Alfred I. duPont Hospital for Children
| | - Dennis Drotar
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Department of Psychology, University of Cincinnati
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Main A, Wiebe DJ, Van Bogart K, Turner SL, Tucker C, Butner JE, Berg CA. Secrecy From Parents and Type 1 Diabetes Management in Late Adolescence. J Pediatr Psychol 2015; 40:1075-84. [PMID: 26136405 DOI: 10.1093/jpepsy/jsv060] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Accepted: 05/28/2015] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES This study examined (a) associations of parent-adolescent relationship characteristics and adolescent problem behavior with late adolescents' secrecy from parents about type 1 diabetes management, and (b) whether secrecy was associated with diabetes and psychological outcomes independently of these factors. METHODS Adolescents (N = 247, Mage = 17.76 years) completed survey measures of diabetes-related secrecy from parents, disclosure, parental acceptance, parental knowledge, and conduct problems. Mothers and adolescents reported on adolescent adherence to diabetes regimens and adolescents reported their depressive symptoms. Glycemic control was obtained from HbA1c test kits. RESULTS Adolescent-reported disclosure to parents was uniquely negatively associated with secrecy from parents. Controlling for relationship variables, conduct problems, and sociodemographic and illness-related variables, secrecy from mothers was uniquely associated with poorer glycemic control and secrecy from both parents was associated with lower adherence. CONCLUSIONS Secrecy about type 1 diabetes management is uniquely associated with diabetes outcomes independent of other relationship characteristics and problem behaviors.
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Affiliation(s)
- Alexandra Main
- Psychological Sciences and Health Sciences Research Institute, University of California, Merced
| | - Deborah J Wiebe
- Psychological Sciences and Health Sciences Research Institute, University of California, Merced
| | - Karina Van Bogart
- Psychological Sciences and Health Sciences Research Institute, University of California, Merced
| | | | - Christy Tucker
- Division of Psychology, University of Texas Southwestern Medical Center
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Iskander JM, Rohan JM, Pendley JS, Delamater A, Drotar D. A 3-year prospective study of parent-child communication in early adolescents with type 1 diabetes: relationship to adherence and glycemic control. J Pediatr Psychol 2014; 40:109-20. [PMID: 24839292 DOI: 10.1093/jpepsy/jsu027] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To examine changes in parent-child communication patterns and their relation to glycemic control and treatment adherence using observational data in a 3-year prospective multisite study of youth with type 1 diabetes aged 9-11 years at baseline and their families (n = 217). METHODS Adolescents and caregivers participated in a diabetes problem-solving discussion. Families were rated on negative and positive communication and interactions using the Interaction Behavior Code. RESULTS Maternal and paternal negative communication decreased over time, whereas adolescent and maternal positive communication and positive reciprocity increased. Baseline preadolescent youth and maternal positive communication predicted adherence 3 years later. Changes in family communication did not predict changes in glycemic control or adherence. CONCLUSIONS During the transition to adolescence, family communication changed in unexpected and positive ways. Additionally, the relationship of baseline family communication to subsequent adherence suggests the need to assess family communication concerning diabetes-related management during preadolescence.
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Affiliation(s)
- Jeannette M Iskander
- Division of Behavioral Medicine and Clinical Psychology, Center for Treatment Adherence and Self-Management, Department of Psychology, University of Cincinnati, Department of Pediatrics, A. I. duPont Hospital for Children, and Department of Pediatrics, University of Miami School of Medicine
| | - Jennifer M Rohan
- Division of Behavioral Medicine and Clinical Psychology, Center for Treatment Adherence and Self-Management, Department of Psychology, University of Cincinnati, Department of Pediatrics, A. I. duPont Hospital for Children, and Department of Pediatrics, University of Miami School of Medicine Division of Behavioral Medicine and Clinical Psychology, Center for Treatment Adherence and Self-Management, Department of Psychology, University of Cincinnati, Department of Pediatrics, A. I. duPont Hospital for Children, and Department of Pediatrics, University of Miami School of Medicine
| | - Jennifer Shroff Pendley
- Division of Behavioral Medicine and Clinical Psychology, Center for Treatment Adherence and Self-Management, Department of Psychology, University of Cincinnati, Department of Pediatrics, A. I. duPont Hospital for Children, and Department of Pediatrics, University of Miami School of Medicine
| | - Alan Delamater
- Division of Behavioral Medicine and Clinical Psychology, Center for Treatment Adherence and Self-Management, Department of Psychology, University of Cincinnati, Department of Pediatrics, A. I. duPont Hospital for Children, and Department of Pediatrics, University of Miami School of Medicine
| | - Dennis Drotar
- Division of Behavioral Medicine and Clinical Psychology, Center for Treatment Adherence and Self-Management, Department of Psychology, University of Cincinnati, Department of Pediatrics, A. I. duPont Hospital for Children, and Department of Pediatrics, University of Miami School of Medicine Division of Behavioral Medicine and Clinical Psychology, Center for Treatment Adherence and Self-Management, Department of Psychology, University of Cincinnati, Department of Pediatrics, A. I. duPont Hospital for Children, and Department of Pediatrics, University of Miami School of Medicine
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Young MT, Lord JH, Patel NJ, Gruhn MA, Jaser SS. Good cop, bad cop: quality of parental involvement in type 1 diabetes management in youth. Curr Diab Rep 2014; 14:546. [PMID: 25212099 PMCID: PMC4283591 DOI: 10.1007/s11892-014-0546-5] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Sustained parental involvement in diabetes management has been generally advised to counteract the deteriorating adherence and glycemic control often seen during adolescence, yet until recently, little attention has been given to the optimal amount, type, and quality of parental involvement to promote the best health outcomes for adolescents with type 1 diabetes (T1D). This review synthesizes research regarding the involvement of caregivers-primarily mothers and fathers-of youth with T1D, with a focus on biopsychosocial outcomes. The recent literature on parental involvement in diabetes management highlights a shift in focus from not only amount but also the types (e.g., monitoring, problem-solving) and quality (e.g., warm, critical) of involvement in both mothers and fathers. We provide recommendations for ways that both parents can remain involved to facilitate greater collaboration in shared direct and indirect responsibility for diabetes care and improve outcomes in youth with T1D.
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