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Balatoni I. Parental Attitude Toward the Engagement in Physical Activity of Their Children with Type 1 Diabetes Mellitus in Hungary. CHILDREN (BASEL, SWITZERLAND) 2025; 12:612. [PMID: 40426791 PMCID: PMC12110388 DOI: 10.3390/children12050612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2025] [Revised: 05/03/2025] [Accepted: 05/04/2025] [Indexed: 05/29/2025]
Abstract
BACKGROUND/OBJECTIVES Physical activity plays an essential role in a healthy lifestyle. For children, the development of an encouraging attitude toward exercise can define a positive life-long behaviour. Type 1 diabetes mellitus (T1DM) is a metabolic disorder that usually develops in early childhood and severely affects glucose metabolism. Associated hypo- and hyperglycaemic conditions can dramatically interfere with the patient's everyday life. Since exercise significantly alters the glucose consumption of the body, this might influence how T1DM patients view physical activity. As parental guidance is critical in their children's behaviour, we investigate how parents of T1DM children relate to the engagement in physical activity of their children as compared to parents of healthy children. METHODS A self-reported survey was conducted among those parents whose T1DM children were cared for at the Paediatric Clinic of the University of Debrecen, Hungary. All together, 318 children, 140 with T1DM and 178 healthy peers, participated in the study. RESULTS We found no significant difference in the body mass index of healthy and T1DM children and, furthermore, no significant difference was observed in HbA1c levels in exercising and non-exercising T1DM children. Nevertheless, while 67.6% of the healthy children regularly engage in physical activity, only 57.5% of T1DM children do so (p = 0.044). Importantly, parents whose T1DM child exercised regularly believed that daily PhysEd classes improved their children's health and had positive effects on their attitude toward exercise. In contrast, parents of children who did not regularly exercise were significantly less convinced. CONCLUSIONS These findings highlight the importance of targeted educational efforts to foster positive attitudes toward physical activity among families with T1DM children and contribute valuable insights into how parental perceptions may influence children's engagement in exercise.
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Affiliation(s)
- Ildikó Balatoni
- Clinical Center, University of Debrecen, H-4032 Debrecen, Hungary
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Goldstein S, Chow O, Schwartz J, Pais V, Wright S, Gucciardi E. Assessing the Feasibility and Acceptability of a Virtual Food Skills and Food Sustainability Program Designed for Children Living With Type 1 Diabetes. Pediatr Diabetes 2024; 2024:3821265. [PMID: 40302974 PMCID: PMC12016876 DOI: 10.1155/2024/3821265] [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: 02/15/2024] [Revised: 08/06/2024] [Accepted: 09/14/2024] [Indexed: 05/02/2025] Open
Abstract
Objective: To assess the feasibility and acceptability of a virtual food skills program for children with type 1 diabetes. Methods: Forty-three patients, aged 6-14 years with type 1 diabetes, participated in an 8-week online programme, summerlunch+ At Home, that included weekly live cooking classes, asynchronous learning modules, and quizzes accessed through Google Classroom. Grocery delivery or gift cards were provided to all participants to support equitable access to participation. Descriptive results were summarized, and thematic analysis was performed on answers to a post-intervention questionnaire, parent/caregivers interview transcripts, and facilitators' field notes. Results: Participants reported having a positive experience and would recommend the programme to others. Acceptable elements included the online format, the cooking class demonstrations, and the well-organized content. Families enjoyed the recipes, expressed an improvement in the families' cooking skills and nutrition knowledge, and noted the program as a way to improve family bonding and reduce participants' sense of social isolation given the opportunity of meeting peers with diabetes. The intervention also appears to increase participants' independence, confidence, and self-esteem. While grocery cards were easier to coordinate compared with meal kits, both were deemed acceptable by caregivers. Barriers to participation include a distracting home environment and not feeling comfortable on camera. Factors that negatively impacted satisfaction were the large age range of participants and the class timing and duration. Caregivers noted a desire for more diabetes education, enhanced peer-to-peer interaction, and incorporation of animal-based protein recipes in future programmes. Conclusion: The current study demonstrates the feasibility and acceptability of the virtual summerlunch+ At Home cooking and nutrition program that was adapted for children with diabetes. Similar food skills programmes may support the development of food skills imperative to diabetes self-management long-term. Further research can continue to assess food literacy skills, glycemic management, and the social benefits of such interventions.
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Affiliation(s)
- Sarah Goldstein
- School of Nutrition, Toronto Metropolitan University, M5B 2K3, Toronto, Canada
| | - Olivia Chow
- School of Nutrition, Toronto Metropolitan University, M5B 2K3, Toronto, Canada
| | | | - Vanita Pais
- The Hospital for Sick Children (SickKids), M5G 1X8, Toronto, Canada
| | | | - Enza Gucciardi
- School of Nutrition, Toronto Metropolitan University, M5B 2K3, Toronto, Canada
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Luo J, Li Q, Whittemore R, Välimäki M, Guo J. The Associating Factors of Parent-Teen and Peer Relationships Among Chinese Adolescents with Type 1 Diabetes Mellitus. Psychol Res Behav Manag 2024; 17:3611-3623. [PMID: 39435368 PMCID: PMC11492902 DOI: 10.2147/prbm.s474339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 10/13/2024] [Indexed: 10/23/2024] Open
Abstract
Background Positive parent-teen and peer relationships are crucial support resources for adolescents with type 1 diabetes mellitus (T1DM). There is quite a bit of research on parent-teen relationships in Western countries, less so with peer relationships. Additionally, information on these relationships and their influencing factors among adolescents from other regions with different family culture and peer cohesion is limited, which impedes the development of targeted interventions. Methods This study analyzed baseline data from a randomized controlled trial in China involving 122 adolescents with T1DM aged 12-18 years. Data were collected using established questionnaires on social-demographic and clinical characteristics, perceived stress, general self-efficacy, coping styles, diabetes self-management, and parent-teen and peer relationships. Multivariate linear regression analysis was conducted to determine the associating factors of parent-teen relationships and peer relationships respectively. Results The total score of the parent-teen relationships subscale was 11.02 ± 2.77, within a theoretical range of 4-16. The total score of the peer relationships subscale was 16.51 ± 2.42, within a theoretical range of 5-20. Positive coping styles, less negative coping styles, and more collaboration with parents in diabetes self-management were associated with better parent-teen relationships. Younger age, positive coping styles, less negative coping styles, and higher goals for diabetes self-management were associated with better peer relationships. Conclusion There is room to improve parent-teen relationships, maybe via encouraging more collaboration between parents and adolescents for diabetes management. The coping styles training is indicated to improve both relationships.
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Affiliation(s)
- Jiaxin Luo
- Xiangya School of Nursing, Central South University, Changsha, Hunan, People’s Republic of China
| | - Qingting Li
- Xiangya School of Nursing, Central South University, Changsha, Hunan, People’s Republic of China
- Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, People’s Republic of China
| | | | - Maritta Välimäki
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Jia Guo
- Xiangya School of Nursing, Central South University, Changsha, Hunan, People’s Republic of China
- Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, People’s Republic of China
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Straton E, Bryant BL, Kang L, Wang C, Barber J, Perkins A, Gallant L, Marks B, Agarwal S, Majidi S, Monaghan M, Streisand R. ROUTE-T1D: A behavioral intervention to promote optimal continuous glucose monitor use among racially minoritized youth with type 1 diabetes: Design and development. Contemp Clin Trials 2024; 140:107493. [PMID: 38460913 PMCID: PMC11065587 DOI: 10.1016/j.cct.2024.107493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 02/13/2024] [Accepted: 03/05/2024] [Indexed: 03/11/2024]
Abstract
BACKGROUND Type 1 diabetes management is often challenging during adolescence, and many youth with type 1 diabetes struggle with sustained and optimal continuous glucose monitor (CGM) use. Due to racial oppression and racially discriminatory policies leading to inequitable access to quality healthcare and life necessities, racially minoritized youth are significantly less likely to use CGM. METHODS ROUTE-T1D: Research on Optimizing the Use of Technology with Education is a pilot behavioral intervention designed to promote optimal CGM use among racially minoritized youth with type 1 diabetes. Intervention strategies include problem solving CGM challenges and promoting positive caregiver-youth communication related to CGM data. RESULTS This randomized waitlist intervention provides participants with access to three telemedicine sessions with a Certified Diabetes Care and Education Specialist. Caregiver participants are also connected with a peer-parent coach. CONCLUSION Hypothesized findings and anticipated challenges are discussed. Future directions regarding sustaining and optimizing the use of diabetes technology among racially minoritized pediatric populations are reviewed.
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Affiliation(s)
- Emma Straton
- Children's National Hospital, Washington DC, United States of America
| | - Breana L Bryant
- Children's National Hospital, Washington DC, United States of America
| | - Leyi Kang
- Children's National Hospital, Washington DC, United States of America
| | - Christine Wang
- Children's National Hospital, Washington DC, United States of America
| | - John Barber
- Children's National Hospital, Washington DC, United States of America
| | - Amanda Perkins
- Children's National Hospital, Washington DC, United States of America
| | - Letitia Gallant
- Children's National Hospital, Washington DC, United States of America
| | - Brynn Marks
- Children's Hospital of Philadelphia, Philadelphia, PA, United States of America
| | - Shivani Agarwal
- Albert Einstein College of Medicine, Bronx, NY, United States of America
| | - Shideh Majidi
- Children's National Hospital, Washington DC, United States of America; The George Washington University School of Medicine, Washington, DC, United States of America
| | - Maureen Monaghan
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, United States of America
| | - Randi Streisand
- Children's National Hospital, Washington DC, United States of America; The George Washington University School of Medicine, Washington, DC, United States of America.
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Canela SM, Allen NA, Henderson M, Lee S, Miller NA, Howes Z, Litchman ML. Care Partner Experiences in Supporting Deaf and Hard of Hearing Adults With Diabetes. Diabetes Spectr 2024; 37:335-341. [PMID: 39649697 PMCID: PMC11623034 DOI: 10.2337/ds22-0088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2024]
Abstract
Objective Care partners play an important role in diabetes management of people with diabetes. Although deaf and hard of hearing (DHH) adults experience diabetes at a higher rate than their hearing counterparts, there is a lack of information regarding the experience of care partners assisting those in the DHH community. There is a need to identify intentional support for this population. The purpose of this study was to explore how care partners of DHH people with diabetes provide helpful and unhelpful support, the care partner experience of providing support, and care partners' perceived diabetes self-management education, support needs, and recommendations. Research Design and Methods We engaged a community advisory board of care partners to DHH people with diabetes to explore how care partners provide support, their individual experiences in providing support, and their suggestions for diabetes self-management education. We used thematic analysis to analyze individual and collective responses. Results Three emergent themes were identified suggesting that care partners give support in a variety of ways, are often overwhelmed in meeting the demanding and ongoing needs of DHH people with diabetes, and have a multitude of suggestions for implementing a future diabetes care partner education program. We also identified some DHH population-specific challenges to diabetes care, including communication barriers with health care providers, inability to use hearing cues if a person with diabetes experiences a fall, and limited access to diabetes care education in sign language. Conclusion These findings highlight a need to provide more support for care partners of DHH people with diabetes and to address the needs of DHH populations to ensure more equitable diabetes care. Further research is needed to adequately inform successful interventions for DHH people with diabetes and their care partners.
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Affiliation(s)
- Sierra M. Canela
- University of Utah Department of Educational Leadership and Policy, Salt Lake City, UT
| | - Nancy A. Allen
- University of Utah College of Nursing, Salt Lake City, UT
| | | | - Shinduk Lee
- University of Utah College of Nursing, Salt Lake City, UT
| | | | - Zach Howes
- University of Utah College of Nursing, Salt Lake City, UT
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Seiffge-Krenke I, Volz M. Effectiveness of psychodynamic treatment: Comparing trajectories of internalizing and externalizing psychopathology of adolescents in treatment, healthy and physically ill adolescents. Dev Psychopathol 2024; 36:478-493. [PMID: 36744527 DOI: 10.1017/s0954579422001341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Effectiveness of psychodynamic therapy for adolescents in reducing internalizing and externalizing psychopathology was determined by comparing treated adolescents (86 sessions) with the normative developmental progression in two groups without treatment: healthy and diabetic adolescents. In a three-wave longitudinal study, n = 531 adolescents (n = 303 patients, n = 119 healthy, n = 109 diabetics) and their mothers filled out psychopathology questionnaires (Youth Self-Report and Child Behavior Checklist). Latent growth curve modeling and multilevel modeling were used to analyze and compare within-person symptoms changes across groups. Analyses showed a significant reduction over the course of treatment for internalizing (Cohen's d = .90-.92) and externalizing (d = .58-.72) symptoms, also when the developmental progression of both control groups was accounted for (d = .48-.76). Mothers reported lower levels than their children in internalizing symptoms (p ≤ .01) while this discrepancy increased over time for treated adolescents (p = .02). Results established the effectiveness of psychodynamic treatment for adolescents both with externalizing and internalizing symptoms in comparison with growth and change in nonclinical samples. Cross-informant differences and age-specific trajectories require attention in psychotherapy treatment and research.
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Affiliation(s)
| | - Matthias Volz
- Department of Psychology, University of Kassel, Kassel, Germany
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Bristol AA, Litchman M, Berg C, Grigorian E, Small D, Glazener A, Jones C, Allen NA. Using Continuous Glucose Monitoring and Data Sharing to Encourage Collaboration Among Older Adults With Type 1 Diabetes and Their Care Partners: Qualitative Descriptive Study. JMIR Nurs 2023; 6:e46627. [PMID: 37494110 PMCID: PMC10413231 DOI: 10.2196/46627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 05/12/2023] [Accepted: 05/15/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Persons with diabetes use continuous glucose monitoring (CGM) to self-manage their diabetes. Care partners (CPs) frequently become involved in supporting persons with diabetes in the management of their diabetes. However, persons with diabetes and CP dyads may require more communication and problem-solving skills regarding how to share and respond to CGM data. OBJECTIVE The purpose of this study was to describe the experiences of persons with diabetes and CPs who participated in the Share "plus" intervention, which addresses dyadic communication strategies, problem-solving, and action planning to promote sharing of CGM data among the dyad. METHODS Ten dyads participated in the Share "plus" telehealth intervention. Participants were interviewed during and after the Share "plus" intervention. Thematic analysis was used to analyze interview data. RESULTS During postsession interviews, dyads described feeling a sense of shared responsibility yet viewed the persons with diabetes as ultimately responsible for the disease. Additionally, dyads shared that communication patterns improved and were able to recognize the negative aspects of previously established communication patterns. Dyads reported communication focused on hypoglycemia episodes while also differing in the frequency they reviewed CGM data and set alerts. Overall, dyads expressed positive reactions to the Share "plus" intervention. CONCLUSIONS Share "plus" was helpful in promoting positive CGM-related communication among dyads and encouraged more CP support. CPs play an important role in supporting older adults with type 1 diabetes. Communication strategies help support dyad involvement in CGM data sharing and self-management among persons with diabetes.
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Affiliation(s)
- Alycia A Bristol
- College of Nursing, University of Utah, Salt Lake City, UT, United States
| | - Michelle Litchman
- College of Nursing, University of Utah, Salt Lake City, UT, United States
| | - Cynthia Berg
- College of Social and Behavioral Science, University of Utah, Salt Lake City, UT, United States
| | - Ernest Grigorian
- College of Nursing, University of Utah, Salt Lake City, UT, United States
| | - Denise Small
- College of Pharmacy, Roseman University, South Jordan, UT, United States
| | - Ashley Glazener
- College of Pharmacy, Roseman University, South Jordan, UT, United States
| | - Christopher Jones
- Cottonwood Medical Clinic Endocrine and Diabetes, Intermountain Healthcare, Murray, UT, United States
| | - Nancy A Allen
- College of Nursing, University of Utah, Salt Lake City, UT, United States
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Rodriguez SA, Tiro JA, Baldwin AS, Hamilton-Bevil H, Bowen M. Measurement of Perceived Risk of Developing Diabetes Mellitus: A Systematic Literature Review. J Gen Intern Med 2023; 38:1928-1954. [PMID: 37037984 PMCID: PMC10272015 DOI: 10.1007/s11606-023-08164-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 03/10/2023] [Indexed: 04/12/2023]
Abstract
BACKGROUND This systematic review describes approaches to measuring perceived risk of developing type 2 diabetes among individuals without diagnoses and describes the use of theories, models, and frameworks in studies assessing perceived risk. While a systematic review has synthesized perceived risk of complications among individuals with diabetes, no reviews have systematically assessed how perceived risk is measured among those without a diagnosis. METHODS Medline, PubMed, PsycINFO, and CINAHAL databases were searched for studies conducted through October 2022 with measures of perceived risk among adults ≥ 18 years without a diabetes diagnosis. Extracted data included study characteristics, measures, and health behavior theories, models, or frameworks used. RESULTS Eighty-six studies met inclusion criteria. Six examined perceived risk scales' psychometric properties. Eighty measured perceived risk using (1) a single item; (2) a composite score from multiple items or subconstructs; and (3) multiple subconstructs but no composite score. Studies used items measuring "comparative risk," "absolute or lifetime risk," and "perceived risk" without defining how each differed. Sixty-four studies used cross-sectional designs. Twenty-eight studies mentioned use of health behavior theories in study design or selection of measures. DISCUSSION There was heterogeneity in how studies operationalized perceived risk; only one third of studies referenced a theory, model, or framework as guiding design or scale and item selection. Use of perceived lifetime risk, absolute risk, or comparative risk limits comparisons across studies. Consideration of context, target population, and how data are utilized is important when selecting measures; we present a series of questions to ask when selecting measures for use in research and clinical settings. This review is the first to categorize how perceived risk is measured in the diabetes prevention domain; most literature focuses on perceived risk among those with diabetes diagnoses. Limitations include exclusion of non-English and gray literature and single reviewer screening and data extraction.
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Affiliation(s)
- Serena A. Rodriguez
- Department of Health Promotion & Behavioral Sciences, The University of Texas Health Science Center Houston (UTHealth Houston) School of Public Health, Trinity Towers, 2777 N Stemmons Fwy, Ste 8400, TX 75207 Dallas, USA
- UTHealth Houston School of Public Health, Center for Health Promotion & Prevention Research, 7000 Fannin Street, Houston, TX 77030 USA
| | - Jasmin A. Tiro
- Department of Public Health Sciences, University of Chicago, 5841 S. Maryland Ave., Chicago, IL 60637 USA
- University of Chicago Medicine Comprehensive Cancer Center, 5841 S. Maryland Avenue, Chicago, IL 60637 USA
| | - Austin S. Baldwin
- Department of Psychology, Southern Methodist University, Expressway Tower, PO Box 750442, Dallas, TX 75275 USA
| | - Hayley Hamilton-Bevil
- University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr., San Antonio, TX 75229 USA
| | - Michael Bowen
- Department of Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390 USA
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Johansen SK, Kanstrup AM, Haseli K, Stenmo VH, Thomsen JL, Rathleff MS. Exploring User Visions for Modeling mHealth Apps Toward Supporting Patient-Parent-Clinician Collaboration and Shared Decision-making When Treating Adolescent Knee Pain in General Practice: Workshop Study. JMIR Hum Factors 2023; 10:e44462. [PMID: 37115609 PMCID: PMC10182461 DOI: 10.2196/44462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 03/07/2023] [Accepted: 03/09/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Long-standing knee pain is one of the most common reasons for adolescents (aged 10-19 years) to consult general practice. Generally, 1 in 2 adolescents will continue to experience pain after 2 years, but exercises and self-management education can improve the prognosis. However, adherence to exercises and self-management education interventions remains poor. Mobile health (mHealth) apps have the potential for supporting adolescents' self-management, enhancing treatment adherence, and fostering patient-centered approaches. However, it remains unclear how mHealth apps should be designed to act as tools for supporting individual and collaborative management of adolescents' knee pain in a general practice setting. OBJECTIVE The aim of the study was to extract design principles for designing mHealth core features, which were both sufficiently robust to support adolescents' everyday management of their knee pain and sufficiently flexible to act as enablers for enhancing patient-parent collaboration and shared decision-making. METHODS Overall, 3 future workshops were conducted with young adults with chronic knee pain since adolescence, parents, and general practitioners (GPs). Each workshop followed similar procedures, using case vignettes and design cards to stimulate discussions, shared construction of knowledge and elicit visions for mHealth designs. Young adults and parents were recruited via social media posts targeting individuals in Northern Jutland. GPs were recruited via email and cold calling. Data were transcribed and analyzed thematically using NVivo (QSR International) coding software. Extracted themes were synthesized in a matrix to map tensions in the collaborative space and inform a conceptual model for designing mHealth core-features to support individual and collaborative management of knee pain. RESULTS Overall, 38% (9/24) young adults with chronic knee pain since adolescence, 25% (6/24) parents, and 38% (9/24) GPs participated in the workshops. Data analysis revealed how adolescents, parents, and clinicians took on different roles within the collaborative space, with different tasks, challenges, and information needs. In total, 5 themes were identified: adolescents as explorers of pain and social rules; parents as supporters, advocates and enforcers of boundaries; and GPs as guides, gatekeepers, and navigators or systemic constraints described participants' roles; collaborative barriers and tensions referred to the contextual elements; and visions for an mHealth app identified beneficial core features. The synthesis informed a conceptual model, outlining 3 principles for consolidating mHealth core features as enablers for supporting role negotiation, limiting collaborative tensions, and facilitating shared decision-making. CONCLUSIONS An mHealth app for treating adolescents with knee pain should be designed to accommodate multiple users, enable them to shift between individual management decision-making, take charge, and engage in role negotiation to inform shared decision-making. We identified 3 silver-bullet principles for consolidating mHealth core features as enablers for negotiation by supporting patient-GP collaboration, supporting transitions, and cultivating the parent-GP alliance.
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Affiliation(s)
- Simon Kristoffer Johansen
- Center for General Practice (CAM-AAU), Department of Clinical Medicine, Aalborg University, Aalborg East, Denmark
| | | | - Kian Haseli
- Center for General Practice (CAM-AAU), Department of Clinical Medicine, Aalborg University, Aalborg East, Denmark
| | - Visti Hildebrandt Stenmo
- Center for General Practice (CAM-AAU), Department of Clinical Medicine, Aalborg University, Aalborg East, Denmark
| | - Janus Laust Thomsen
- Center for General Practice (CAM-AAU), Department of Clinical Medicine, Aalborg University, Aalborg East, Denmark
| | - Michael Skovdal Rathleff
- Center for General Practice (CAM-AAU), Department of Clinical Medicine, Aalborg University, Aalborg East, Denmark
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
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Matsumoto H, Nio K, Kawamura T, Obayashi Y, Hotta Y, Yuyama Y, Nishikawa N. Perceptions of diabetes management among adolescents with type 1 diabetes and their caregivers: development and validation of the Japanese version of the diabetes family responsibility questionnaire. Diabetol Int 2022; 14:155-164. [PMID: 36533089 PMCID: PMC9734505 DOI: 10.1007/s13340-022-00609-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 11/24/2022] [Indexed: 12/12/2022]
Abstract
The shift in diabetes management responsibility is critical for adolescents with type 1 diabetes (T1D). Currently, in Japan, there is insufficient progress in the development of scales for evaluating diabetes management responsibility. We developed the Japanese version of the Diabetes Family Responsibility Questionnaire (DFRQ), a scale to evaluate diabetes management responsibility, and verified its reliability and validity. We recruited 12-18-year-old adolescents with T1D and their caregivers. The DFRQ questionnaires (DFRQ-A for adolescents and DFRQ-C for caregivers) were distributed. The responses of 31 pairs were analyzed (adolescents: 9 males, 22 females; mean age: 14.8 ± 1.5 years). The median total DFRQ scores of adolescents (30.0) and caregivers (32.0) were not significantly different (p = 0.269). The internal consistencies (Cronbach's α) were 0.784 and 0.687 for DFRQ-A and DFRQ-C, respectively. DFRQ-A scores and adolescent age demonstrated a weak statistically significant negative correlation (r = - 0.397, p = 0.027), whereas DFRQ-C scores and adolescent age demonstrated a weak negative correlation not statistically significant (r = - 0.311, p = 0.089). Both scores were significantly negatively correlated with self-efficacy for diabetes self-management scores (r = - 0.390, p = 0.030; r = - 0.478, p = 0.006, respectively). Furthermore, a significantly moderate positive correlation was found between these scores (r = 0.624, p < 0.001). We confirmed the reliability and validity of the Japanese version of DFRQ. DFRQ is expected to be used as a dyadic scale to evaluate the status of diabetes management responsibility and its transition during adolescence in Japan.
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Affiliation(s)
- Hiro Matsumoto
- Course of Nursing Science, Graduate School of Medicine, Mie University, Tsu, Mie Japan
- Department of Pediatrics, Graduate School of Medicine, Osaka Metropolitan University, Abeno-Ku, Osaka, Japan
| | - Kaori Nio
- Graduate School of Nursing, Osaka Metropolitan University, Habikino, Osaka Japan
| | - Tomoyuki Kawamura
- Department of Pediatrics, Graduate School of Medicine, Osaka Metropolitan University, Abeno-Ku, Osaka, Japan
| | - Yoko Obayashi
- Department of Nursing, School of Health Sciences, Toyohashi Sozo University, Toyohashi, Aichi Japan
| | - Yuko Hotta
- Kashiwara Municipal Hospital, Kashiwara, Osaka Japan
| | - Yoshihiko Yuyama
- Department of Pediatrics, Graduate School of Medicine, Osaka Metropolitan University, Abeno-Ku, Osaka, Japan
| | - Naoko Nishikawa
- Department of Pediatrics, Graduate School of Medicine, Osaka Metropolitan University, Abeno-Ku, Osaka, Japan
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Socio-cognitive determinants affecting insulin adherence/non-adherence in late adolescents and young adults with type 1 diabetes: a systematic review protocol. J Diabetes Metab Disord 2022; 21:1207-1215. [PMID: 35673417 PMCID: PMC9167269 DOI: 10.1007/s40200-022-01054-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 05/09/2022] [Indexed: 11/04/2022]
Abstract
Objective This systematic review aims to investigate the key socio-cognitive determinants associated with adherence/non-adherence to insulin treatment in late adolescents and young adults in the age range of 17–24 years with T1D. Methods A pre-specified search strategy will be used to search for studies in the electronic databases and citation indexes: PubMed, EMBASE, Web of Science, and PsycINFO. Two researchers will screen the title and the abstract independently, then will read and critically appraise the full text of each included study. A third independent reviewer will resolve disagreements in data extraction until consensus. Data will be extracted using the Population, Exposure, Outcomes, Study characteristics framework. Study selection will follow the updated guideline for reporting systematic reviews (PRISMA 2020) and will take place from 15 October 2021 to 1 January 2022. The methodological quality and risk of bias of the observational studies will be assessed by the JBI Critical Appraisal Checklist for Cohort and JBI Critical Appraisal Checklist for Analytical Cross Sectional Studies. Results A qualitative narrative synthesis will present the characteristics and the quality of studies and the outcomes of concern. Conclusion Based on the contemporary literature, this review will synthesize the evidence on the socio-cognitive determinants associated with adherence/non-adherence to insulin treatment in late adolescents and young adults in the age range of 17–24 years with T1D. The findings will help design patient-centered interventions to promote adherence to insulin in this age group, guide patients’ consultations and diabetes self-management education (DSME) programs. Protocol registration: PROSPERO ID: CRD42021233074.
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12
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Rothman-Kabir Y, Gershy N, Pinhas-Hamiel O, Omer H. Supervising Without Controlling: A New Authority intervention for Adolescents with Type 1 Diabetes. JOURNAL OF CHILD AND FAMILY STUDIES 2022; 31:1045-1056. [DOI: 10.1007/s10826-021-02186-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/20/2021] [Indexed: 02/05/2023]
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13
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Yeo AJ, Halpern LF, Lin B, Riddick L, Sima D, Wohlfahrt KM, Jones N. Youth Temperament Moderates Associations Between Parental Involvement and Pediatric Type 1 Diabetes Treatment Outcome. J Pediatr Psychol 2022; 47:795-803. [DOI: 10.1093/jpepsy/jsac017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 11/12/2022] Open
Abstract
Abstract
Objective
Both youth self-regulation and quality of parental involvement have been associated with blood glucose levels (HbA1c) of youth with type 1 diabetes mellitus (T1DM). However, it is unclear whether and how youth and parental factors interact in their relation to youth HbA1c. The differential susceptibility hypothesis proposes that youth with high negative affectivity (NA) and low effortful control (EC) may be more susceptible to the deleterious impact of lower quality parenting behaviors but also reap greater benefit from higher quality parenting behaviors. This study investigated whether youth temperament would moderate the link between diabetes-specific parental assistance (e.g., checking blood sugar) or support (e.g., encouraging, praising) and HbA1c among youth with T1DM.
Methods
Primary caregivers of youth with T1DM (N = 101; M age = 12.02, SD = 2.43) completed surveys on diabetes-specific parental involvement and youth temperament. Medical information (i.e., HbA1c) was obtained from chart review.
Results
Multiple regression analyses indicated that youth NA and EC significantly interacted with parental assistance, but not support. Specifically, higher parental assistance was associated with higher HbA1c among youth with high NA or high EC. High assistance was only linked to lower HbA1c for youth with low NA.
Conclusions
Results suggest that optimal levels of parental involvement related to better T1DM outcomes depend on youth’s NA or EC. Consistent with the goodness-of-fit framework, when parenting approaches match youth’s temperament, youth with T1DM may be better able to maintain lower HbA1c. Family interventions for pediatric T1DM management may take into consideration youth temperament.
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Affiliation(s)
- Anna J Yeo
- Department of Psychology, University at Albany, State University at New York, USA
| | | | - Betty Lin
- Department of Psychology, University at Albany, State University at New York, USA
| | - Linda Riddick
- Pediatric Endocrinology Division, Albany Medical Center, USA
| | - Daniela Sima
- Pediatric Endocrinology Division, Albany Medical Center, USA
| | | | - Nancy Jones
- Pediatric Endocrinology Division, Albany Medical Center, USA
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14
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Ingersgaard MV, Hoeeg D, Willaing I, Grabowski D. An exploratory study of how young people experience and perceive living with type 1 diabetes during late adolescence and emerging adulthood. Chronic Illn 2021; 17:475-492. [PMID: 31739683 DOI: 10.1177/1742395319886487] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Suboptimal glycemic control and psychosocial challenges are significant concerns for adolescents and emerging adults (collectively young people) with type 1 diabetes. Knowledge about young peoples' attitudes towards living with type 1 diabetes is inadequate, but the issue is important in the development of strategies to improve glycemic control and psychosocial well-being. This study explored young peoples' perceptions of living with type 1 diabetes. METHODS An exploratory, qualitative design was employed. Data were collected through five participatory workshops with 19 young people (age 15-25). Data were thematically analyzed. RESULTS The overall depiction of living with type 1 diabetes was paradoxical; it affected everything and nothing. Living with type 1 diabetes was a balancing act between accommodating a "normal" way of living and self-management tasks of the treatment regimen. Participants' perceptions reflected shifting accounts that could be divided into five themes: (1) special rules during youth, (2) striving for autonomy, (3) an uncertain future, (4) social support, and (5) stigma and disclosure. DISCUSSION It is important to probe for the multiple and interrelated social contexts that underlie young peoples' motives for adhering to and deviating from treatment regimens. Future studies should focus on relational aspects, including stigma mechanisms, the role of friends, and facilitation of balanced parental involvement.
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Affiliation(s)
| | | | | | - Dan Grabowski
- Steno Diabetes Center Copenhagen, Health Promotion, Gentofte, Denmark
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15
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Turin A, Drobnič Radobuljac M. Psychosocial factors affecting the etiology and management of type 1 diabetes mellitus: A narrative review. World J Diabetes 2021; 12:1518-1529. [PMID: 34630904 PMCID: PMC8472498 DOI: 10.4239/wjd.v12.i9.1518] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 05/26/2021] [Accepted: 07/26/2021] [Indexed: 02/06/2023] Open
Abstract
Type 1 diabetes (T1D) is one of the most common chronic diseases in children and adolescents worldwide. Its etiopathogenesis results from the interplay of genetic and environmental variables. Among the latter, psychological stress has been implicated in disease onset as well as disease management. Various studies, including large population-based studies, have highlighted the role of stressful life events in the etiopathogenesis of T1D. In this article, we also emphasize the importance of attachment in the early child-caregiver relationship, which can be seen as a measure of the quality of the relationship and is crucial for stress and emotional regulation. It serves as a model for all subsequent relationships in one's life. We summarize some of the few studies performed in the field of attachment and T1D etiopathogenesis or management. T1D management demands a lifelong therapeutic regimen to prevent acute and chronic complications. In addition to psychological stress, psychological factors such as family functioning, developmental adjustment, autonomy, mental health problems and other factors have been found to relate to metabolic control. Psychological factors need to be understood not as a single directional causality-based principle but as a dynamic bi- or multidirectional system that is affected by the normal developmental transitions of childhood and adolescence.
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Affiliation(s)
- Anja Turin
- Department for Child Psychiatry, University Children’s Hospital, University Medical Centre Ljubljana, Ljubljana 1000, Slovenia
- Department of Psychiatry, Faculty of Medicine, University of Ljubljana, Ljubljana 1000, Slovenia
| | - Maja Drobnič Radobuljac
- Department of Psychiatry, Faculty of Medicine, University of Ljubljana, Ljubljana 1000, Slovenia
- Unit for Intensive Child and Adolescent Psychiatry, University Psychiatric Clinic Ljubljana, Ljubljana 1000, Slovenia
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16
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Hickling A, Dingle GA, Barrett HL, Cobham VE. Systematic Review: Diabetes Family Conflict in Young People With Type 1 Diabetes. J Pediatr Psychol 2021; 46:1091-1109. [PMID: 34313769 DOI: 10.1093/jpepsy/jsab052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 04/27/2021] [Accepted: 04/28/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To investigate the relationships between diabetes-specific family conflict and health outcomes of young people with type 1 diabetes (T1D). METHODS A systematic review was performed according to the PRISMA statement (registration number: CRD42020164988). PubMed, Embase, PsycNET, reference lists of included studies, and other relevant reviews were searched (1990-2020). Two independent reviewers screened titles, abstracts, and full-texts. Studies were included if they sampled young people with T1D (mean age between 14 and 25 years) and examined the relationship between diabetes-specific family conflict and the following outcomes: glycated hemoglobin (HbA1c), treatment adherence, blood glucose monitoring, depression, anxiety, quality of life, and/or well-being. RESULTS A total of 20 studies met the predetermined inclusion criteria. Greater diabetes-specific family conflict was significantly related to higher HbA1c values in 17 studies. Seven studies reported a significant association between greater diabetes family conflict and suboptimal treatment adherence and/or less frequent blood glucose monitoring. However, significant relationships between conflict and HbA1c and/or treatment adherence were not found in four studies. Seven studies in total reported that greater diabetes family conflict was significantly related to poorer quality of life or well-being and greater depressive and/or anxiety symptoms in young people. CONCLUSIONS Diabetes-specific family conflict is associated with some adverse health outcomes for young people with T1D. However, more longitudinal studies of young people aged older than 16 years are needed. Screening for and addressing diabetes-specific family conflict is recommended, given the growing number of studies linking family conflict to various adverse health outcomes in young people with T1D.
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Affiliation(s)
- Anna Hickling
- School of Psychology, The University of Queensland.,Mater Research Institute, The University of Queensland.,Children's Hospital Foundation (Queensland)
| | | | - Helen L Barrett
- Mater Research Institute, The University of Queensland.,Department of Endocrinology, Mater Health Services, Mater Hospital
| | - Vanessa E Cobham
- School of Psychology, The University of Queensland.,Child and Youth Mental Health Service, Children's Health Queensland Hospital and Health Service
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17
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Klostermann S, Iskander J, Enlow P, Delamater AM, Dolan L, Pendley JS. Predicting healthcare utilization in youth with type 1 diabetes: The importance of family level variables. Pediatr Diabetes 2021; 22:294-302. [PMID: 33169899 DOI: 10.1111/pedi.13146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 10/29/2020] [Accepted: 11/06/2020] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE Little is known about how family factors impacting treatment adherence in type 1 diabetes are directly associated with unplanned healthcare utilization (e.g., emergency room visits and hospital admissions). Given the substantial financial burden of diabetes, understanding predictors of healthcare utilization in particular is important to inform behavioral interventions aimed toward improving adherence. RESEARCH DESIGN AND METHODS The current study examined the relationship between family-level variables and healthcare utilization in a sample of 239 youth with type 1 diabetes and their parents. Healthcare utilization was determined via parent report and chart review. Parent- and youth-reports regarding levels of family conflict, youth autonomy, and parent support related to diabetes management were obtained via questionnaire, and negative reciprocity was obtained by coding observations of parent and youth interactions. Generalized Estimating Equations were used to examine the longitudinal association between healthcare utilization and family-level factors. RESULTS Higher levels of observed negative reciprocity were associated with more frequent hospital admissions, while higher levels of youth-reported parent involvement in diabetes management were associated with fewer hospital admissions and ED visits. CONCLUSIONS These findings highlight how family-level factors are directly related to healthcare utilization and point to the continued importance of integrating family-focused behavioral interventions in routine medical care for improving type 1 diabetes outcomes and reducing healthcare costs.
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Affiliation(s)
- Susan Klostermann
- Department of Pediatrics, Nemours Children's Health System, Wilmington, Delaware, USA.,Department of Pediatrics, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | | | - Paul Enlow
- Department of Pediatrics, Nemours Children's Health System, Wilmington, Delaware, USA.,Department of Pediatrics, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Alan M Delamater
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Lawrence Dolan
- Division of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Jennifer Shroff Pendley
- Department of Pediatrics, Nemours Children's Health System, Wilmington, Delaware, USA.,Department of Pediatrics, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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18
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Aalders J, Hartman E, Pouwer F, Winterdijk P, van Mil E, Roeleveld-Versteegh A, Mommertz-Mestrum E, Aanstoot HJ, Nefs G. The division and transfer of care responsibilities in paediatric type 1 diabetes: A qualitative study on parental perspectives. J Adv Nurs 2021; 77:1968-1979. [PMID: 33591623 PMCID: PMC8048668 DOI: 10.1111/jan.14781] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 01/04/2021] [Accepted: 01/27/2021] [Indexed: 12/17/2022]
Abstract
Aim To determine which factors other than child age play a role in the division and transfer of diabetes care responsibilities between parents and children with type 1 diabetes. Design Qualitative focus group study. Methods Across four sites in the Netherlands, 18 parents (13 mothers) of children (9–14 years) with type 1 diabetes participated in four focus groups in 2015–2016, as part of the research project 'Whose diabetes is it anyway?'. Qualitative content analysis and the constant comparison method were used to analyse the data. Results According to parents, the transfer process included both direct and indirect tasks, had different levels (remembering, deciding, performing), was at times a difficult and stressful process, and showed large variation between families. A large number of child, parent and context factors were identified that affected the division and transfer of diabetes care responsibilities according to parents. Both positive and negative consequences of the transfer process were described for parental and child health, behaviour and well‐being. Parental final evaluations of the division and transfer of diabetes care responsibilities appeared to be dependent on parenting values. Conclusion How families divide and transfer diabetes care tasks appeared to be affected by a complex interplay of child, parent and context characteristics, which had an impact on several parent and child domains. Impact Parents struggle with the right timing of transfer, which calls for more support from diabetes nurses. The identified factors can be used as input for integrating a more family‐based approach into current age‐based guidelines, to improve regular care.
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Affiliation(s)
- Jori Aalders
- Department of Medical and Clinical Psychology, Center of Research on Psychological and Somatic disorders [CoRPS], Tilburg University, Tilburg, The Netherlands.,Department of Psychology, University of Southern Denmark, Odense, Denmark.,Steno Diabetes Center Odense, Odense, Denmark
| | - Esther Hartman
- Department of Medical and Clinical Psychology, Center of Research on Psychological and Somatic disorders [CoRPS], Tilburg University, Tilburg, The Netherlands
| | - Frans Pouwer
- Department of Psychology, University of Southern Denmark, Odense, Denmark.,Steno Diabetes Center Odense, Odense, Denmark.,School of Psychology, Deakin University, Geelong, Australia
| | - Per Winterdijk
- Diabeter, Center for pediatric and adolescent diabetes care and research, Rotterdam, The Netherlands
| | - Edgar van Mil
- Kidz&Ko, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
| | | | | | - Henk-Jan Aanstoot
- Diabeter, Center for pediatric and adolescent diabetes care and research, Rotterdam, The Netherlands
| | - Giesje Nefs
- Department of Medical and Clinical Psychology, Center of Research on Psychological and Somatic disorders [CoRPS], Tilburg University, Tilburg, The Netherlands.,Diabeter, Center for pediatric and adolescent diabetes care and research, Rotterdam, The Netherlands.,Department of Medical Psychology, Radboud university medical center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
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19
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Sanjari M, Peyrovi H, Mehrdad N. The Process of Managing the Children with Type 1 Diabetes in the Family: A Grounded Theory Study. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2021; 26:25-33. [PMID: 33954095 PMCID: PMC8074732 DOI: 10.4103/ijnmr.ijnmr_5_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 08/02/2020] [Accepted: 08/23/2020] [Indexed: 11/04/2022]
Abstract
Background: Diabetes is a disease that affects all family members. Parents of children with type 1 diabetes are always concerned about all aspects of children's life. The aim of this study was to elucidate the process of managing children with diabetes in the family. Materials and Methods: This is a qualitative grounded theory of a doctoral dissertation, which was done on 2016. The 18 participants were selected through purposive and theoretical sampling until data saturation. The main participants in this study included parents, siblings, and children with type 1 diabetes. The data was gathered by semi-structured interviews as well as field notes and memos. Data analysis was done concurrently with data collection in four levels, including data analysis for concept and contex, bringing the process into the analysis, and integration of categories according to Corbin and Struss (2008). Core category appeared at the end of integrated categories. Results: “The family with diabetes in the child's diabetes orbit” as a core category contains the process of managing children with diabetes within the family, which included three main subcategories, including “entering into the diabetes orbit”, “movement into the diabetes orbit”, and “living into the diabetes orbit”. Conclusions: The family through the concept of “The family with diabetes in the child's diabetes orbit “as a main concern of families with diabetes suffering diabetes attempt to select and practicing appropriate strategies and manage diabetes and children with diabetes.
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Affiliation(s)
- Mahnaz Sanjari
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Peyrovi
- Department of Critical Care Nursing, Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Neda Mehrdad
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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20
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Chen CY, Lo FS, Wang RH. Roles of Emotional Autonomy, Problem-Solving Ability and Parent-Adolescent Relationships on Self-Management of Adolescents with Type 1 Diabetes in Taiwan. J Pediatr Nurs 2020; 55:e263-e269. [PMID: 32493633 DOI: 10.1016/j.pedn.2020.05.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 05/19/2020] [Accepted: 05/19/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND High emotional autonomy has a negative association, whereas good problem-solving ability and parent-adolescent relationships have positive association with self-management in adolescents with type 1 diabetes (T1D). Exploring roles of these variables is crucial to design specific interventions to improve self-management in such afflicted adolescents. PURPOSE To explore the roles of emotional autonomy, problem-solving ability and parent-adolescent relationships on self-management in adolescents with T1D. DESIGN AND METHODS Cross-sectional design was used in this study. A total of 242 adolescents with T1D were recruited from an outpatient clinic of a medical center by convenience sampling in Taiwan. Self-reported questionnaires were used to collect personal characteristics, self-management, emotional autonomy, problem-solving ability, and parent-adolescent relationships. RESULTS Hierarchical multiple regressions indicated that body mass index, problem-solving ability, father-adolescent relationship, and emotional autonomy were significant factors associated with self-management. The interactions of emotional autonomy with problem-solving ability and with parent-adolescents relationship were not significantly associated with self-management. The overall model explained 47.5% variance of self-management. CONCLUSIONS High emotional autonomy was significantly associated with poor self-management. Problem-solving ability and father-adolescent relationships could not moderate, but were independently and significantly associated with self-management in adolescents with T1D. PRACTICE IMPLICATION Healthcare providers should evaluate emotional autonomy earlier and provide more timely help to reduce any negative impact on self-management in adolescents with T1D. Improving problem-solving ability and encouraging fathers to develop optimal father-adolescents relationship might be promising strategies to enhance self-management in adolescents with T1D.
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Affiliation(s)
- Chia-Ying Chen
- Administration Center of Research and Education, Ditmanson Medical Foundation Chai-Yi Christian Hospital, Taiwan.
| | - Fu-Sung Lo
- Division of Endocrinology, Department of Pediatrics, Chang Gung Memorial Hospital, College of Medicine, Chung Gung University, Taiwan.
| | - Ruey-Hsia Wang
- College of Nursing, Kaohsiung Medical University, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, Taiwan.
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21
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Moskowitz DA, Macapagal K, Mongrella M, Pérez-Cardona L, Newcomb ME, Mustanski B. What If My Dad Finds Out!?: Assessing Adolescent Men Who Have Sex with Men's Perceptions About Parents as Barriers to PrEP Uptake. AIDS Behav 2020; 24:2703-2719. [PMID: 32157491 PMCID: PMC7462124 DOI: 10.1007/s10461-020-02827-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Pre-exposure prophylaxis (PrEP) is an effective HIV prevention strategy for high-risk adults and recently was given US FDA approval for use among adolescents. Yet, the barriers to medication uptake for this population are unique when compared to adult populations, as parents may be just as likely as prescribers to be gatekeepers to access. To better understand the role of parents in adolescents' attitudes towards PrEP, we surveyed 491 adolescent men who have sex with men (AMSM) ages 13-18, using forced choice and open-ended response questions. We measured perceived parent-PrEP supportiveness, hypothetical parent reactions to a request to initiate PrEP, and perceived positive and negative aspects of taking PrEP without parents knowing. A mixed-methods approach was employed. Results indicated a majority of AMSM had heard of PrEP and most reported their parents would be unsupportive of their taking PrEP. Teens perceived their parents would likely be angry, accusatory, and punitive if PrEP use was discovered, and that accessing PrEP independent of parents might increase their health autonomy, agency, and prevent awkward conversations about sex. Furthermore, a path model revealed that fears of parental reaction and poor self-efficacy to communicate with parents about PrEP significantly contributed to participants feeling PrEP was not "right" for them, and as a corollary, less interest in starting PrEP. The study suggests that improving parental knowledge of PrEP and encouraging parents to begin the conversation about PrEP could help increase uptake in AMSM.
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Affiliation(s)
- David A Moskowitz
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Avenue, Floor 14, Chicago, IL, 60611, USA
- Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Kathryn Macapagal
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Avenue, Floor 14, Chicago, IL, 60611, USA
- Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Melissa Mongrella
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Avenue, Floor 14, Chicago, IL, 60611, USA
| | - Leishla Pérez-Cardona
- Mary Ann & J. Milburn Smith Child Health Research, Outreach and Advocacy Center, Chicago, IL, USA
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Michael E Newcomb
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Avenue, Floor 14, Chicago, IL, 60611, USA
- Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Brian Mustanski
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Avenue, Floor 14, Chicago, IL, 60611, USA.
- Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
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22
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Ayar D, Gürkan KP, Bektas M, Böber E, Abaci A. Psychometric properties of a Turkish version of the Collaborative Parent Involvement Scale for youths with type 1 diabetes. CURRENT PSYCHOLOGY 2020. [DOI: 10.1007/s12144-020-00868-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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23
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Silva K, Miller VA. Does Self-Efficacy Mediate the Link Between Impulse Control and Diabetes Adherence? J Pediatr Psychol 2020; 45:445-453. [PMID: 32106299 DOI: 10.1093/jpepsy/jsaa007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 01/30/2020] [Accepted: 01/31/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The goal of this study was to test the hypothesis that diabetes self-efficacy mediates the relationship between impulse control and type 1 diabetes (T1D) management from ages 8 to 18 years, using multilevel modeling. METHODS Participants included 117 youth with T1D and their parents. Youth (aged 8-16 years at baseline) and parents were assessed 5 times over 2 years. Using a cohort sequential design, we first estimated the growth trajectory of adherence from age 8 to 18 years, then specified a multilevel mediation model using impulse control as the main predictor, diabetes self-efficacy as the mediator, and changes in adherence (both within- and between-individuals) as the outcome. RESULTS According to youth-reported adherence only, self-efficacy partially mediated the within-person effect of impulse control on adherence. On occasions when youth reported increases in impulse control, they tended to report higher adherence, and this was, in part, due to increases in youths' perceived self-efficacy. Self-efficacy accounted for approximately 21% of the within-person relationship between impulse control and youth-reported adherence. There was no association between impulse control and adherence between-individuals. Impulse control and self-efficacy were not related to parent-reported adherence. CONCLUSION Environments that enrich youth with confidence in their own diabetes-related abilities may benefit self-care behaviors in youth with T1D, but such increases in youths' perceived competence do not fully account for, or override, the behavioral benefits of impulse control. Efforts to improve adherence in youth with T1D will benefit from consideration of both impulse control and self-efficacy.
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Affiliation(s)
- Karol Silva
- Department of Pediatrics, Children's Hospital of Philadelphia
| | - Victoria A Miller
- Department of Pediatrics, Children's Hospital of Philadelphia.,Perelman School of Medicine, University of Pennsylvania
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24
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Psihogios AM, Fellmeth H, Schwartz LA, Barakat LP. Family Functioning and Medical Adherence Across Children and Adolescents With Chronic Health Conditions: A Meta-Analysis. J Pediatr Psychol 2020; 44:84-97. [PMID: 29982694 DOI: 10.1093/jpepsy/jsy044] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 06/03/2018] [Indexed: 12/16/2022] Open
Abstract
Objectives A meta-analysis examined family functioning and medical adherence in children and adolescents with chronic health conditions. Family functioning was evaluated at the level of the family unit, as well as parent-child interactions. Methods We conducted literature searches using PubMed, PsycINFO, SCOPUS, Web of Science, and Cochrane. After reviewing 764 articles, 62 studies met eligibility criteria. Pearson's r correlations were the effect size of interest. We conducted both omnibus and domain-specific (e.g., family conflict, cohesion) meta-analyses. Meta-regressions examined whether relevant covariates related to the magnitude of the effect. Results The omnibus meta-analysis showed that family functioning was significantly related to medical adherence across a variety of pediatric chronic health conditions. Lower family conflict, greater family cohesion, greater family flexibility, more positive communication, and better family problem-solving were each associated with better adherence. There were no significant differences in the magnitude of the omnibus effect based on child age, measurement features (subjective vs. objective or bioassay adherence; family unit vs. parent-child interactions), or study quality. Conclusions Consistent with social-ecological frameworks, findings supported links between family functioning and medical adherence. This study highlights several limitations of the extant research, including absence of a guiding theoretical framework and several methodological weaknesses. We offer clinical and research recommendations for enhancing scientific understanding and promotion of adherence within the family context.
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Affiliation(s)
| | | | - Lisa A Schwartz
- The Children's Hospital of Philadelphia.,Perelman School of Medicine of the University of Pennsylvania
| | - Lamia P Barakat
- The Children's Hospital of Philadelphia.,Perelman School of Medicine of the University of Pennsylvania
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25
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Campbell MS, Berg CA, Wiebe DJ. Parental Self-Control as a Moderator of the Association Between Family Conflict and Type 1 Diabetes Management. J Pediatr Psychol 2019; 44:999-1008. [PMID: 31155648 PMCID: PMC6705714 DOI: 10.1093/jpepsy/jsz040] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 04/25/2019] [Accepted: 04/30/2019] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To examine whether parental self-control (i.e., parents' ability to regulate their emotions, cognitions, and behaviors) moderates the detrimental association between type 1 diabetes (T1D)-specific family conflict and adherence and HbA1c, such that conflict is most detrimental when parental self-control is low. METHODS One hundred and forty-nine adolescents diagnosed with T1D (Mage = 14.09; 53% female) reported on their T1D-specific conflict with their mothers and fathers and their adherence to the T1D regimen at two time points (6 months apart). Mothers and fathers reported on their self-control. Glycated hemoglobin (HbA1c) was obtained from the medical record at both time points. RESULTS Higher adolescent-reported conflict with father was associated concurrently with higher HbA1c and lower adherence only for fathers with low self-control (ps < .05). Higher adolescent-reported conflict with mother was also associated concurrently with lower adherence only for mothers with lower self-control (p < .05); no significant moderation was found for mothers' self-control in predicting HbA1c. Longitudinal analyses indicated family conflict with mother predicted changes in adherence and HbA1c, but there were no significant moderating effects of either mother or father self-control. CONCLUSIONS Lower parental self-control may prevent parents from handling diabetes-related family conflict in a productive manner. We discuss the implications of parental self-control as an intervention target for health care professionals working with adolescents with T1D and their families.
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MIRZAEI-ALAVIJEH M, JOUYBARI T, JALILIAN F, MOTLAGH M, JALILIAN F. Using intervention mapping approach to finding socio-cognitive determinants of diabetes preventive behaviors. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2019; 60:E237-E242. [PMID: 31650060 PMCID: PMC6797886 DOI: 10.15167/2421-4248/jpmh2019.60.3.1159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 02/26/2019] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Diabetes is one of the most common chronic illnesses with complications. The objective of this study was to determine socio-cognitive determinants of diabetes preventive behaviors among sample of at risk group based on intervention mapping approach (IM) in Kermanshah, the west of Iran. METHODS This cross-sectional study conducted among a total of 200 male and female aged more than 30 years old referred to health centers that randomly selected to participate voluntarily, during 2018. Participants filled out a self-report questionnaire. Data were analyzed by SPSS version 16 using bivariate correlations and linear regression at 95% significant level. RESULTS The mean age of respondents was 38.4 years [95% CI: 37.3, 39.4], ranged from 30 to 56 years. Socio-cognitive determinants were accounted for 40% of the variation in diabetes prevention behaviors F = 35.559, P < 0.001. As well as, perceived self-efficacy, perceived severity, and perceived barrier were the most influential predictors on diabetes preventive behaviors. CONCLUSIONS It seems that planning health promotion programs to reduce barrier to perform diabetes preventive behaviors and increase confidence towards ability to perform preventive behaviors, and seriousness about sides effect of diabetes may be usefulness of the results in order to promotion of diabetes preventive behaviors among at risk group.
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Affiliation(s)
- M. MIRZAEI-ALAVIJEH
- Social Development & Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - T.A. JOUYBARI
- Clinical Research Development Center, Imam Khomeini Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - F. JALILIAN
- Lifestyle Modification Research Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - M.E. MOTLAGH
- Department of Pediatrics, Faculty Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - F. JALILIAN
- Social Development & Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Wilt L. The Relationships Among School Nurse to Student Ratios, Self-Efficacy, and Glycemic Control in Adolescents With Type 1 Diabetes. J Sch Nurs 2019; 37:230-240. [DOI: 10.1177/1059840519870314] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Adolescents with Type 1 diabetes (T1D) experience unique self-management challenges, which can lead to poor glycemic control and sequelae. School nurses may impact student self-efficacy behaviors for T1D management in adolescents. The purpose of this study was to determine the relationships among school nurse staffing patterns, measured by school nurse to student ratios, self-efficacy, and glycemic control in adolescents with T1D. The sample consisted of 89 parent–adolescent dyads. Adolescents aged 10–16 years old with T1D completed the Self-Efficacy for Diabetes Self-Management (SEDM) Scale. Parents completed a demographic questionnaire. Higher school nurse to student ratios correlated with better glycemic control and older age. Higher SEDM scores correlated with older age, and females scored significantly higher. Findings contribute new knowledge to the paucity of literature on school nursing and adolescents with T1D, with implications for nursing practice, education, research, and policy.
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Affiliation(s)
- Lori Wilt
- Seton Hall University, South Orange, NJ, USA
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28
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Diabetes management mediates the association between sleep duration and glycemic control in youth with type 1 diabetes mellitus. Sleep Med 2019; 60:132-138. [DOI: 10.1016/j.sleep.2019.01.043] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 10/28/2018] [Accepted: 01/31/2019] [Indexed: 01/28/2023]
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Systematic Review of Father Involvement and Child Outcomes in Pediatric Chronic Illness Populations. J Clin Psychol Med Settings 2019; 27:89-106. [PMID: 31077009 DOI: 10.1007/s10880-019-09623-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The overall objective of this paper was to systematically review and synthesize the emerging literature investigating the role of father involvement in pediatric outcomes among chronic illness populations. This review sought to answer the following questions: (1) what measures are used to assess father involvement in pediatric chronic illness populations, and who is the respondent, and (2) how is father involvement associated with child psychosocial and health related outcomes in pediatric chronic illness populations? Databases were searched using a key word search strategy. Articles were screened according to exclusion criteria, resulting in 15 identified articles that included a pediatric illness population, and assessed both father involvement and a child outcome variable. Qualitative analysis revealed that several measures have been used to assess father involvement in pediatric chronic illness populations. As a whole, the majority of findings indicate that better outcomes are associated with more father involvement in illness and non-illness related activities, and higher father-child relationship quality. Contradictory findings may be due to the quality of the involvement being assessed, or the possibility that father's become more involved with illness tasks in response to their child's poorer health outcomes. Future research should include the development and use of psychometrically sound measures of father involvement and employ more diverse samples with rigorous methodology.
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Emotional abilities and HbA1c levels in patients with type 1 diabetes. Psychoneuroendocrinology 2018; 93:118-123. [PMID: 29723781 DOI: 10.1016/j.psyneuen.2018.04.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 04/12/2018] [Accepted: 04/13/2018] [Indexed: 02/01/2023]
Abstract
In recent years a growing body of research is focused on the relationships between emotions and health. When it comes to diabetes, findings suggest that distress might play a key role in the acquisition and maintenance of health habits associated with diabetic management. This report describes two studies examining the roles of emotional abilities in diabetic management from two different conceptual points of view using two culturally different samples. In study 1, we examined the relationship between emotional intelligence and HbA1c levels in a sample of eighty-five patients with type 1 diabetes mellitus (DM1) in Israel. In study 2, we examined the relationship between specific emotional regulation strategies and HbA1c in sixty-seven adolescents with DM1, while examining the mediating role of distress in this association. The results showed a negative association between emotional intelligence and HbA1c levels, even after controlling for potential intervening factors. We found that the relationship between difficulties in emotion regulation and HbA1c seemed to be mediated by diabetes-related distress. These findings may aid in the design of psychological models for future research as well as interventions aimed at improving emotional abilities in people with DM1.
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Martire LM, Helgeson VS. Close relationships and the management of chronic illness: Associations and interventions. ACTA ACUST UNITED AC 2018; 72:601-612. [PMID: 28880106 DOI: 10.1037/amp0000066] [Citation(s) in RCA: 116] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Self-management of a chronic illness involves not only monitoring symptoms, adhering to medication regimens, and keeping medical appointments but also making and maintaining difficult lifestyle changes. This article highlights correlational and intervention research suggesting family members are influential in children's and adults' illness management. The argument is made that a dyadic approach to chronic illness management that targets the influence of close relationships may yield more sustainable effects on patient behavior than has been achieved in the past. In particular, dyadic approaches aimed at helping patients and family members to find ways to collaborate in goal setting for these behaviors is recommended. Such dyadic interventions may also benefit family members who are ill or are at risk because of poor health behaviors. (PsycINFO Database Record
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Affiliation(s)
- Lynn M Martire
- Department of Human Development and Family Studies, The Pennsylvania State University
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Lindkvist EB, Kristensen LJ, Sildorf SM, Kreiner S, Svensson J, Mose AH, Birkebaek N, Thastum M. A Danish version of self-efficacy in diabetes self-management: A valid and reliable questionnaire affected by age and sex. Pediatr Diabetes 2018; 19:544-552. [PMID: 29094452 DOI: 10.1111/pedi.12601] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 08/18/2017] [Accepted: 09/29/2017] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Managing the chronic illness type 1 diabetes (T1D) is extremely demanding, especially during adolescence. Self-efficacy is belief in one's own capabilities and this is crucial for diabetes management. Having a valid method for measuring self-efficacy is important. OBJECTIVE Our aims were to psychometrically validate a Danish version of the self-efficacy in diabetes management (SEDM) questionnaire, and to examine the relationship between background variables and self-efficacy. METHODS All Danish adolescents with T1D (n = 1075) were invited to participate in our study. In total, 689 agreed to participate and 602 completed the study. Data were collected using a web-based survey. All participants were asked to provide a blood sample for HbA1c measurement. Graphical log-linear Rasch modeling (GLLRM) was used to validate the questionnaire and its reliability was assessed using Monte Carlo simulation. RESULTS We found the questionnaire to be valid and reliable, but it had a dual structure that suggested a need for 2 separate subscales. One subscale related to practical (SEDM1) and the other to emotional (SEDM2) aspects of diabetes management. Both subscales were targeted toward adolescents with lower self-efficacy and were associated with HbA1c. SEDM1 was influenced by treatment modality and age. In SEDM2 we found an interaction between age and sex. CONCLUSION The Danish version of the SEDM questionnaire should be divided into two parts, each with a valid and reliable subscale for self-efficacy measurement. The relationship between self-efficacy and age seems to differ between boys and girls.
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Affiliation(s)
- Emilie Bundgaard Lindkvist
- Department of Paediatrics, Copenhagen Diabetes Research Center (CPH-DIRECT), Herlev University Hospital, Herlev, Denmark
| | - Lene Juel Kristensen
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Stine Møller Sildorf
- Department of Paediatrics, Copenhagen Diabetes Research Center (CPH-DIRECT), Herlev University Hospital, Herlev, Denmark
| | - Svend Kreiner
- Section of Biostatistics, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jannet Svensson
- Department of Paediatrics, Copenhagen Diabetes Research Center (CPH-DIRECT), Herlev University Hospital, Herlev, Denmark
| | | | - Niels Birkebaek
- Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark
| | - Mikael Thastum
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
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Crandell JL, Sandelowski M, Leeman J, Havill NL, Knafl K. Parenting behaviors and the well-being of children with a chronic physical condition. FAMILIES, SYSTEMS & HEALTH : THE JOURNAL OF COLLABORATIVE FAMILY HEALTHCARE 2018; 36:45-61. [PMID: 29172624 PMCID: PMC5880719 DOI: 10.1037/fsh0000305] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Numerous studies have identified the importance of parenting behaviors to the well-being of children with chronic physical conditions. Synthesizing the findings of these studies has potential to identify which parenting behaviors are associated with specific aspects of child well-being. METHOD We retrieved research reports addressing the relationship between parenting behaviors and well-being in children with chronic physical conditions, and categorized parenting behaviors based on Skinner, Johnson, and Snyder's (2005) core dimensions of parenting (warmth, rejection, structure, chaos, autonomy support, and coercion) Through meta-analysis, we examined relationships between parenting dimension and child well-being variables. RESULTS Fifty-four reports from 47 unique studies met inclusion criteria. Parent warmth was associated with less child depression, better quality of life, better physical functioning, and fewer externalizing behavior problems. Parent rejection was associated with more child depression, internalizing/externalizing behavior problems, and poorer physical functioning. Parent structure was associated with better child physical functioning. Parent chaos was associated with poorer child physical functioning. Parent autonomy support was associated with better quality of life and fewer externalizing behavior problems. Parent coercion was associated with more child depression, poorer quality of life, poorer physical function, and more internalizing behavior problems. CONCLUSION The results identify multiple, potentially modifiable parenting dimensions associated with well-being in children with a chronic condition, which could be targeted in developing family-focused interventions. They also provide evidence that research using Skinner's core dimensions could lead to conceptualization and study of parenting behaviors in ways that would enable comparison of parenting in a variety of health and sociocultural contexts. (PsycINFO Database Record
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Affiliation(s)
| | | | - Jennifer Leeman
- School of Nursing, University of North Carolina at Chapel Hill
| | - Nancy L Havill
- School of Nursing, University of North Carolina at Chapel Hill
| | - Kathleen Knafl
- School of Nursing, University of North Carolina at Chapel Hill
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Abstract
PURPOSE OF REVIEW Adolescents, in particular those that are most disenfranchised, are increasingly at risk of acquiring HIV and, when acquiring HIV, have worse outcomes than adults. This article reviews the recent approaches to combination prevention aiming to optimize the HIV prevention and HIV treatment continua. RECENT FINDINGS There are dramatic sociodemographic differences in the HIV epidemics in low and middle-income countries (young women in sub-Saharan Africa) compared with high-income countries (predominantly gay, bisexual, transgendered youth, especially black and Latino youth). Researchers and clinicians are designing developmentally tailored interventions that anticipate youths' engagement with mobile technologies and build on the common features of evidence-based interventions that predate the use of antiretroviral therapies (ARV) for prevention and treatment. SUMMARY Evidence-based HIV prevention and treatment programs that are cost-effective need to be broadly diffused globally. Substantial investments must be made in understanding how to implement programs, which have clinically meaningful impact and continuously monitor intervention quality over time.
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Affiliation(s)
- Mary Jane Rotheram-Borus
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA
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Butner JE, Berg CA, Munion AK, Turner SL, Hughes-Lansing A, Winnick JB, Wiebe DJ. Coordination of Self- and Parental-Regulation Surrounding Type I Diabetes Management in Late Adolescence. Ann Behav Med 2018; 52:29-41. [PMID: 28585097 PMCID: PMC5716913 DOI: 10.1007/s12160-017-9922-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Background Type 1 diabetes management involves self- and social-regulation, with past research examining components through individual differences unable to capture daily processes. Purpose Dynamical systems modeling was used to examine the coordinative structure of self- and social-regulation (operationalized as parental-regulation) related to daily diabetes management during late adolescence. Methods Two hundred and thirty-six late adolescents with type 1 diabetes (M age = 17.77 years, SD = .39) completed a 14-day diary reporting aspects of self- (e.g., adherence behaviors, cognitive self-regulation failures, and positive and negative affect) and parental-regulation (disclosure to parents, knowledge parents have, and help parents provide). Results Self-regulation functioned as one coordinative structure that was separate from parental-regulation, where mothers and fathers were coordinated separately from each other. Mothers' perceived helpfulness served as a driver of returning adolescents back to homeostasis. Conclusions The results illustrate a dynamic process whereby numerous facets of self- and social-regulation are coordinated in order to return diabetes management to a stable state.
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Affiliation(s)
- Jonathan E Butner
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Cynthia A Berg
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - A K Munion
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Sara L Turner
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | | | - Joel B Winnick
- School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Deborah J Wiebe
- Department of Psychology, University of California at Merced, Merced, CA, USA
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Litchman ML, Allen NA, Colicchio VD, Wawrzynski SE, Sparling KM, Hendricks KL, Berg CA. A Qualitative Analysis of Real-Time Continuous Glucose Monitoring Data Sharing with Care Partners: To Share or Not to Share? Diabetes Technol Ther 2018; 20:25-31. [PMID: 29154685 DOI: 10.1089/dia.2017.0285] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Little research exists regarding how real-time continuous glucose monitoring (RT-CGM) data sharing plays a role in the relationship between patients and their care partners. OBJECTIVE To (1) identify the benefits and challenges related to RT-CGM data sharing from the patient and care partner perspective and (2) to explore the number and type of individuals who share and follow RT-CGM data. METHODS This qualitative content analysis was conducted by examining publicly available blogs focused on RT-CGM and data sharing. A thematic analysis of blogs and associated comments was conducted. RESULTS A systematic appraisal of personal blogs examined 39 blogs with 206 corresponding comments. The results of the study provided insight about the benefits and challenges related to individuals with diabetes sharing their RT-CGM data with a care partner(s). The analysis resulted in three themes: (1) RT-CGM data sharing enhances feelings of safety, (2) the need to communicate boundaries to avoid judgment, and (3) choice about sharing and following RT-CGM data. RT-CGM data sharing occurred within dyads (n = 46), triads (n = 15), and tetrads (n = 2). CONCLUSIONS Adults and children with type 1 diabetes and their care partners are empowered by the ability to share and follow RT-CGM data. Our findings suggest that RT-CGM data sharing between an individual with diabetes and their care partner can complicate relationships. Healthcare providers need to engage patients and care partners in discussions about best practices related to RT-CGM sharing and following to avoid frustrations within the relationship.
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Affiliation(s)
- Michelle L Litchman
- 1 University of Utah College of Nursing , Salt Lake City, Utah
- 2 Utah Diabetes and Endocrinology Center , Salt Lake City, Utah
| | - Nancy A Allen
- 1 University of Utah College of Nursing , Salt Lake City, Utah
| | | | | | | | | | - Cynthia A Berg
- 4 University of Utah Department of Psychology , Salt Lake City, Utah
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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: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Health behaviours in emerging adulthood: Their relationship with perceived maternal and paternal parental attitudes and the mediating role of self-efficacy. HEALTH PSYCHOLOGY REPORT 2017. [DOI: 10.5114/hpr.2018.71202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
<b>Background</b><br />
The present research examined the mediating role of self-efficacy in the association between perceived maternal and paternal parental attitudes and health behaviours of males and females in emerging adulthood. Parental attitudes shape children’s self-esteem, positive self-image, and self-competence. This may affect their physical health and health behaviours throughout their lives.<br />
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<b>Participants and procedure</b><br />
A total of 147 (mean age: 19.70, SD = 0.85, 68.7% females) participants took part in the study. They completed several questionnaires measuring health behaviours, perceived parental attitudes, and self-efficacy: the Inventory of Health Behaviours, the Retrospective Assessment of Parental Attitude, and the General Self-Efficacy Scale.<br />
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<b>Results</b><br />
We found that that female participants exhibited healthier eating habits but lower self-efficacy than male participants did. Accepting and autonomy granting maternal and paternal parental attitudes predicted a positive health attitude (of both male and female participants), preventive behaviours (of male participants), and healthy eating habits (of male participants). As predicted, emerging adults’ self-efficacy mediated the relationship between their health behaviours and perceived parental attitudes. However, the mediation patterns were different for female and male participants.<br />
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<b>Conclusions</b><br />
The quality of perceived parental attitudes and self-efficacy are important for health-related lifestyle choices among emerging adults. Mothers and fathers may play different roles in the formation of health behaviours.
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Helgeson VS, Vaughn AK, Seltman H, Orchard T, Becker D, Libman I. Relation of parent knowledge to glycemic control among emerging adults with type 1 diabetes: a mediational model. J Behav Med 2017; 41:186-194. [PMID: 28918521 DOI: 10.1007/s10865-017-9886-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 09/11/2017] [Indexed: 11/29/2022]
Abstract
The study goal was to examine the links of parent knowledge of children's behavior to diabetes outcomes and to test a mediational model that focused on psychological distress and self-care behavior. We recruited 132 adolescents (average age 12) and followed them to average age 23. At age 23 (n = 107), we conducted in-person interviews with these emerging adults to measure parent knowledge, psychological distress, self-care behavior and glycemic control. We used structural equation modeling to test our hypotheses with these cross-sectional data. Higher levels of parent knowledge were linked to better glycemic control, and this path was mediated by reduced psychological distress and enhanced self-care behavior. Parents remain an important influence in the lives of emerging adults with type 1 diabetes. When emerging adults have a relationship with their parents in which they share general information, psychological distress may be reduced which then facilitates self-care and, ultimately, glycemic control.
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Affiliation(s)
- Vicki S Helgeson
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA, 15213, USA.
| | - Abigail Kunz Vaughn
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA, 15213, USA
| | - Howard Seltman
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA, 15213, USA
| | | | - Dorothy Becker
- University of Pittsburgh, Pittsburgh, PA, USA.,Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA
| | - Ingrid Libman
- University of Pittsburgh, Pittsburgh, PA, USA.,Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA
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Lohan A, Morawska A, Mitchell AE. Development and Validation of a Measure Assessing Child Diabetes Behavior: The Diabetes Behavior Checklist. Compr Child Adolesc Nurs 2017; 41:111-127. [PMID: 28590880 DOI: 10.1080/24694193.2017.1323978] [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] [Indexed: 10/19/2022]
Abstract
Previous research in pediatric diabetes management has focused on general child behavior, which is linked with treatment adherence and health outcomes in children with type 1 diabetes. Little is known about child diabetes behavior problems specifically. The current study aimed to develop and validate a measure of diabetes-specific child behavior problems, and parents' confidence in managing these behaviors. Participants were a community sample of 186 parents of children aged 2-10 years with type 1 diabetes, recruited via online parenting forums and advertisements placed in school and childcare newsletters throughout Australia. The measure demonstrated excellent internal consistency and evidence of construct validity, and factor analyses revealed a 3-factor and a 1-factor structure for the Extent and Confidence scales, respectively. This study provides preliminary evidence of validity of the Diabetes Behavior Checklist. The implications of these findings for intervention development are discussed.
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Affiliation(s)
- Aditi Lohan
- a Parenting and Family Support Centre, School of Psychology, The University of Queensland , St. Lucia , Australia
| | - Alina Morawska
- a Parenting and Family Support Centre, School of Psychology, The University of Queensland , St. Lucia , Australia
| | - Amy E Mitchell
- a Parenting and Family Support Centre, School of Psychology, The University of Queensland , St. Lucia , Australia
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Different Demands, Same Goal: Promoting Transition Readiness in Adolescents and Young Adults With and Without Medical Conditions. J Adolesc Health 2017; 60:727-733. [PMID: 28274737 DOI: 10.1016/j.jadohealth.2017.01.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 01/02/2017] [Accepted: 01/03/2017] [Indexed: 01/19/2023]
Abstract
PURPOSE This study aimed to examine differences in transition readiness, self-involvement and parental involvement in completing medical tasks, and general self-efficacy between a sample of older adolescents and young adults (AYAs) with medical conditions and a sample of healthy peers. Relations among these variables were also examined. METHODS The sample included 494 AYAs (mean age = 19.30 years, standard deviation = 1.33) who reported on their levels of transition readiness, self-involvement and parental involvement in completing medical tasks, and general self-efficacy. RESULTS AYAs with medical conditions reported significantly higher levels of transition readiness and self-involvement in completing medical tasks and lower levels of parent involvement in completing medical tasks than healthy peers. Parent involvement in completing medical tasks indirectly related to transition readiness through AYA self-involvement in completing medical tasks for both AYAs with medical conditions and healthy peers. CONCLUSIONS AYAs with medical conditions appear to have greater transition readiness skills and demonstrate more independence in completing medical tasks than healthy peers. For AYAs with medical conditions and healthy peers, transition readiness appears to be enhanced as parents decrease their involvement in completing AYAs' medical tasks and AYAs increase self-involvement in completing these tasks. AYAs with medical conditions, as well as healthy peers, may benefit from programming delivered in primary care, specialty clinic, or educational settings that focuses on increasing AYAs' involvement in and responsibility for managing their health care.
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Martinez-Perez P, Orozco-Beltran D, Carratalá-Munuera C, Pomares-Gomez F, Morisky D. Adherence to insulin therapeutic regims in patients with type 1 diabetes. A nationwide survey in brazil-Comment on Gomes et al. Diabetes Res Clin Pract 2017; 128:136-137. [PMID: 28238443 DOI: 10.1016/j.diabres.2017.01.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 01/24/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Pablo Martinez-Perez
- Catedra de Medicina de Familia, Clinical Medicine Department, Miguel Hernandez University, Carretera Nacional 332, Alicante-Valencia s/n, 03550 San Juan de Alicante, Spain.
| | - Domingo Orozco-Beltran
- Catedra de Medicina de Familia, Clinical Medicine Department, Miguel Hernandez University, Carretera Nacional 332, Alicante-Valencia s/n, 03550 San Juan de Alicante, Spain
| | - Concepción Carratalá-Munuera
- Catedra de Medicina de Familia, Clinical Medicine Department, Miguel Hernandez University, Carretera Nacional 332, Alicante-Valencia s/n, 03550 San Juan de Alicante, Spain
| | | | - Donald Morisky
- Department of Community Health Sciences, Fielding School of Public Health, University of California at Los Angeles, Los Angeles, United States
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Abstract
OBJECTIVE Adherence to diabetes-management regimens in children requires teamwork and consistency from both parents and children. This study investigated a mediational model developed to understand the relationship between different modifiable parent factors influencing child diabetes-related behaviors. METHODS We recruited 186 parents of children aged 2 to 10 years with Type 1 diabetes to complete self-report questionnaires on child diabetes behavior, parental self-efficacy with managing the child's behavior, parent diabetes self-efficacy, parent adjustment, condition management effort, parent perception of their diabetes knowledge, and parenting behavior. We used structural equation modeling in AMOS to test our hypothesized model of interrelationships between variables associated with child diabetes behavior. RESULTS The hypothesized model provided good fit to the data. We found that parent perception of low levels of diabetes knowledge and higher levels of condition management effort, and parent adjustment difficulties were associated with lower parental self-efficacy with diabetes management. This was further linked with lower levels of parental self-efficacy with managing their child's diabetes behavior, and consequently, higher extent of child diabetes behavior problems. Contrary to our expectations, we did not find a significant effect of parenting behavior on child diabetes behavior problems, either directly or indirectly via parent self-efficacy for managing child's behavior. CONCLUSION Our findings shed light on the mechanisms through which different parenting factors interact and are associated with diabetes behavior in children. These factors can be targeted through parenting interventions to improve child's cooperation with diabetes-management tasks and reduce barriers to effective management.
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DeBoer MD, Valdez R, Chernavvsky DR, Grover M, Burt Solorzano C, Herbert K, Patek S. The Impact of Frequency and Tone of Parent-Youth Communication on Type 1 Diabetes Management. Diabetes Ther 2017; 8:625-636. [PMID: 28405895 PMCID: PMC5446384 DOI: 10.1007/s13300-017-0259-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The purpose of this study is to assess the impact of frequency and tone of parent-youth communication on glycemic control as measured by the Family Communication Inventory (FCI). Adolescence provides a unique set of diabetes management challenges, including suboptimal glycemic control. Continued parental involvement in diabetes management is associated with improved HbA1c outcomes; however, diabetes-related conflict within the family can have adverse effects. Although it is clear that communication plays an important role in diabetes outcomes, the specific impact of frequency and tone of such communication is largely understudied. METHODS A total of 110 youths with type 1 diabetes and their parents completed questionnaires assessing diabetes-related adherence, family conflict, and family communication (i.e., frequency and tone) during a routine clinic visit. Routine testing of HbA1c was performed. RESULTS Youth- and parent-reported frequency of communication were unrelated to HbA1c. Instead, greater discrepancies between parents and children on reported frequency of communication (most commonly parents reporting frequent and youth reporting less frequent communication) corresponded with poorer glycemic control and increased family conflict. More positive tone of communication as rated by youth was associated with lower HbA1c. CONCLUSIONS Diabetes-related communication is more complex than conveyed simply by how often children and their parents communicate. Tone of communication and discrepancies in a family's perception of the frequency of communication were better than frequency as predictors of glycemic control. The FCI appears to capture the frequency and tone of diabetes-related communication, though larger-scale studies are warranted to inform future use of this scale.
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Affiliation(s)
- Mark D DeBoer
- Department of Pediatrics, University of Virginia Health System, Charlottesville, VA, USA.
| | - Rupa Valdez
- Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, 22908, USA
| | - Daniel R Chernavvsky
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, 22908, USA
| | - Monica Grover
- Department of Pediatrics, University of Virginia Health System, Charlottesville, VA, USA
| | | | - Kirabo Herbert
- Department of Pediatrics, University of Virginia Health System, Charlottesville, VA, USA
| | - Stephen Patek
- Department of Systems and Information Engineering, University of Virginia School of Medicine, Charlottesville, VA, 22908, USA
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Delay discounting and parental monitoring in adolescents with poorly controlled type 1 diabetes. J Behav Med 2017; 40:864-874. [PMID: 28500504 DOI: 10.1007/s10865-017-9856-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 04/29/2017] [Indexed: 01/04/2023]
Abstract
In a sample of adolescents with poorly controlled type 1 diabetes, this study examined if delay discounting, the extent to which individuals prefer immediate over delayed rewards, was associated with severity of non-adherence and poor glycemic control, and if parental monitoring of diabetes management moderated those associations. Sixty-one adolescents (M age = 15.08 years, SD 1.43) with poorly controlled type 1 diabetes completed a delayed discounting task and an HbA1c blood test. Adherence was assessed via self-monitoring of blood glucose (SMBG) data from adolescents' glucometers. Parents completed a parental monitoring questionnaire. Greater delay discounting was associated with higher HbA1c, but not SMBG. Direct parent observation of diabetes tasks, but not indirect parental monitoring, moderated the link between greater delay discounting and higher HbA1c, with higher direct parent observation buffering the link between greater discounting and poorer glycemic control. Delay discounting may be a target for future interventions to improve HbA1c in youth with type 1 diabetes.
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Lansing AH, Turner SL, Osborn PG, Winnick JB, Taheri K, Murray M, Butner J, Wiebe DJ, Berg CA. Academic achievement and metabolic control in adolescents with type 1 diabetes. CHILDRENS HEALTH CARE 2017. [DOI: 10.1080/02739615.2016.1275641] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | - Sara L. Turner
- Department of Psychology, University of Utah, Salt Lake City, UT
| | - Peter G. Osborn
- Department of Psychology, University of Utah, Salt Lake City, UT
| | - Joel B. Winnick
- Clearinghouse for Military Family Readiness, Pennsylvania State University, University Park, PA
| | - Kiana Taheri
- Department of Psychology, University of Utah, Salt Lake City, UT
| | - Mary Murray
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT
| | - Jonathan Butner
- Department of Psychology, University of Utah, Salt Lake City, UT
| | - Deborah J. Wiebe
- Department of Psychological Sciences, University of California, Merced, Merced, CA
| | - Cynthia A. Berg
- Department of Psychology, University of Utah, Salt Lake City, UT
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Hilliard ME, Powell PW, Anderson BJ. Evidence-based behavioral interventions to promote diabetes management in children, adolescents, and families. ACTA ACUST UNITED AC 2017; 71:590-601. [PMID: 27690487 DOI: 10.1037/a0040359] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
As members of multidisciplinary diabetes care teams, psychologists are well-suited to support self-management among youth with Type 1 diabetes (T1D) and Type 2 diabetes (T2D) and their families. Psychological and behavioral interventions can promote adherence to the complex and demanding diabetes care regimen, with the goals of promoting high quality of life, achieving optimal glycemic control, and ultimately preventing disease-related complications. This article reviews well-researched contemporary behavioral interventions to promote optimal diabetes family- and self-management and health outcomes in youth with T1D, in the context of key behavioral theories. The article summarizes the evidence base for established diabetes skills training programs, family interventions, and multisystemic interventions, and introduces emerging evidence for technology and mobile health interventions and health care delivery system interventions. Next steps in behavioral T1D intervention research include tailoring interventions to meet individuals' and families' unique needs and strengths, and systematically evaluating cost-effectiveness to advocate for dissemination of well-developed interventions. Although in its infancy, this article reviews observational and intervention research for youth with T2D and their families and discusses lessons for future research with this population. Interventions for youth with T2D will need to incorporate family members, consider cultural and family issues related to health behaviors, and take into account competing priorities for resources. As psychologists and behavioral scientists, we must advocate for the integration of behavioral health into routine pediatric diabetes care in order to effectively promote meaningful change in the behavioral and medical well-being of youth and families living with T1D and T2D. (PsycINFO Database Record
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Winnick JB, Berg CA, Wiebe DJ, Schaefer BA, Lei PW, Butner JE. Metabolic control and academic achievement over time among adolescents with type 1 diabetes. ACTA ACUST UNITED AC 2017; 32:105-117. [PMID: 28080100 DOI: 10.1037/spq0000190] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The relation between metabolic control (HbA1c) and achievement (grade point average [GPA]) was examined over a period of 2.5 years (every 6 months) employing a dynamical systems approach that allowed for the examination of whether HbA1c was associated with change in subsequent GPA and vice versa. Metabolic control tends to deteriorate (i.e., with higher HbA1c reflecting poorer metabolic control) during adolescence. It was hypothesized that these higher levels of HbA1c would limit subsequent increases in GPA. The sample included 252 adolescents (Mbaseline age = 12.49 years, SD = 1.53; 53.6% female) with Type 1 diabetes. Mothers' report and school records provided information on relevant demographics and GPA; medical records provided values of HbA1c. Two simultaneous coupled change equations (i.e., examining current values in 1 variable associated with changes in the other) controlling relevant risk indicators (i.e., age, sex, disease duration, insulin delivery method, IQ) revealed higher levels of HbA1c limited increases in GPA. Higher levels of GPA, however, were not associated with change in HbA1c except for 2 instances where moderation existed by disease duration and IQ. Higher GPA was associated with slower increases in HbA1c over time for youth with shorter disease duration and lower IQ. These results affirm the importance of maintaining good metabolic control to facilitate adequate school performance across the adolescent years. Further, the results suggest that factors related to school achievement may protect adolescents who are newly diagnosed or who have low cognitive ability from subsequent deterioration in metabolic control. (PsycINFO Database Record
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Affiliation(s)
- Joel B Winnick
- Department of Educational Psychology, Counseling, and Special Education, Pennsylvania State University
| | | | - Deborah J Wiebe
- Department of Psychological Sciences, University of California, Merced
| | - Barbara A Schaefer
- Department of Educational Psychology, Counseling, and Special Education, Pennsylvania State University
| | - Pui-Wa Lei
- Department of Educational Psychology, Counseling, and Special Education, Pennsylvania State University
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Karimy M, Araban M, Zareban I, Taher M, Abedi A. Determinants of adherence to self-care behavior among women with type 2 diabetes: an explanation based on health belief model. Med J Islam Repub Iran 2016; 30:368. [PMID: 27493912 PMCID: PMC4972051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 09/12/2015] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Self-care is an essential element in treating a person with diabetes; and managing diabetes is of prime importance. The aim of this study was to investigate the predictors of adherence to self-care behavior among women with Type 2 diabetes. METHODS This cross-sectional study was conducted on 210 female patients aged 30 to 60. Data collection tool was an anonymous valid and reliable questionnaire designed based on the Health Belief Model (HBM), which acquired information about the followings: Perceived susceptibility, severity, benefits, barriers, self-efficacy and diabetes self-care behavior. Data were analyzed by t-test, chisquare and regression analysis. RESULTS The multiple regression models revealed 59.9% of the variance of self-care behavior with self-efficacy, perceived barrier, benefit and susceptibility. Additionally, the highest weight for β (β=0.87) was found for self-efficacy. Self-care behavior was positively correlated with all HBM variables except for perceived barriers showing a negative correlation. CONCLUSION The Health Belief Model may be used as a framework to design intervention programs in an attempt to improve adherence to self-care behaviors of women with diabetes. In addition, the results indicated that self-efficacy might play a more crucial role in developing self-care behaviors than t other HBM components. Therefore, if the focus is placed on self-efficacy when developing educational programs, it may increase the likelihood of adherence to self-care behavior.
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Affiliation(s)
- Mahmood Karimy
- 1 Assistant Professor, Public Health Department, Faculty of Health, Saveh University of Medical Sciences, Saveh, Iran.
| | - Marzieh Araban
- 2 Assistant Professor, Public Health Department, Faculty of Health, Ahvaz University of Medical Sciences, Ahvaz, Iran.
| | - Iraj Zareban
- 3 Assistant Professor, Health education Department, Faculty of Health, Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran. ,(Corresponding author) Assistant Professor, Health education Department, Faculty of Health, Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.
| | - Mohammad Taher
- 4 MSc, Nursing Department, Faculty of Nursing and Midwifery, Saveh University of Medical Sciences, Saveh, Iran.
| | - Ahmadreza Abedi
- 5 Assistant Professor, Nursing Department, Faculty of Nursing and Midwifery, Arak University of Medical Sciences, Arak, Iran.
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Landers SE, Friedrich EA, Jawad AF, Miller VA. Examining the interaction of parental involvement and parenting style in predicting adherence in youth with type 1 diabetes. FAMILIES, SYSTEMS & HEALTH : THE JOURNAL OF COLLABORATIVE FAMILY HEALTHCARE 2016; 34:41-50. [PMID: 26866945 PMCID: PMC4786450 DOI: 10.1037/fsh0000183] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
INTRODUCTION This study examined whether aspects of parenting style (specifically, warmth, autonomy support, and coercion) moderated the association between parental involvement and adherence in youth with type 1 diabetes. METHODS Children ages 8 to 16 years with type 1 diabetes and a parent completed assessments of parental involvement, parenting style, and adherence. RESULTS Parent autonomy support and coercion were associated with adherence but warmth was not. Child report of more parental involvement was associated with better adherence. Warmth, autonomy support, and coercion were not moderators. DISCUSSION The findings underscore the importance of parental involvement, operationalized as responsibility for diabetes tasks, and parenting style, specifically coercion and autonomy support, for adherence in pediatric chronic illness management. Longitudinal research is needed to better understand how and why dimensions of involvement (e.g., responsibility, monitoring, support) vary over time and whether they impact outcomes differentially.
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Affiliation(s)
- Sara E Landers
- Department of Pediatrics, The Children's Hospital of Philadelphia
| | | | - Abbas F Jawad
- Department of Pediatrics, The Children's Hospital of Philadelphia
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