Adolescents with Type 1 Diabetes: Parental perceptions of child health and family functioning and their relationship to adolescent metabolic control

Health and Quality of Life Outcomes (Impact Factor: 2.12). 03/2013; 11(1):50. DOI: 10.1186/1477-7525-11-50
Source: PubMed


Adolescents with Type 1 diabetes (T1D) show less effective metabolic control than other age groups, partly because of biological changes beyond their control and partly because in this period of developmental transition, psychosocial factors can militate against young people upholding their lifestyle and medical regimens. Parents have an important role to play in supporting adolescents to self-manage their disease, but resultant family tensions can be high. In this study, we aimed to assess family functioning and adolescent behaviour/ adjustment and examine the relationships between these parent-reported variables and adolescent metabolic control (HbA1c), self-reported health and diabetes self-care.

A sample of 76 parents of Australian adolescents with T1D completed the Child Health Questionnaire –Parent form. Their adolescent child with T1D provided their HbA1c level from their most recent clinic visit, their self-reported general health, and completed a measure of diabetes self-care.

Parent-reported family conflict was high, as was disease impact on family dynamics and parental stress. Higher HbA1c (poorer metabolic control) and less adequate adolescent self-care were associated with lower levels of family functioning, more adolescent behavioural difficulties and poorer adolescent mental health.

The implication of these findings was discussed in relation to needs for information and support among Australian families with an adolescent with T1D, acknowledging the important dimension of family functioning and relationships in adolescent chronic disease management.

Download full-text


Available from: Susan M Moore,
  • Source
    • "Adolescents play an ever-increasing role in diabetes management, according to their developmental acquisitions [5] [10]. However, adolescents' risk behaviors, such as those related with their sexual development, use of illicit drugs, smoking and alcohol, and the vulnerability to the development of mental health problems also compromise their metabolic and psychological outcomes [3] [5]. In the transition to adolescence, young people with T1DM tend to have poor self-management, which deteri‐ orates metabolic control, increases psychosocial distress and negatively influences their quality of life [11]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The incidence of type 1 diabetes mellitus (T1DM) in childhood and adolescents is increasing worldwide and diagnosis of type 1 diabetes represents an important stressful condition for families and adolescents. The maintenance of normal glycemic results requires adherence to self-care behaviors in order to prevent disease compli‐ cations. However, diabetes self-care requires extensive and daily behavioral demands from adolescents that may interfere with their quality of life. Parents have an important influence on T1DM' management, in adolescents. Family functioning is an important determinant of metabolic control and adolescents' quality of life. During adolescence, parents must transfer the responsibility for diabetes care to the adolescent and supervise diabetes management. Parental style and family conflict are related to glycemic control and quality of life in adolescents. The main goal of this chapter was to analyze the relationship between metabolic control, quality of life and family functioning in T1DM adolescents.
    Major Topics in Type 1 Diabetes, Edited by Kenia Pedrosa Nunes, 11/2015: chapter The Role of Family Functioning on Metabolic Control and Quality of Life in Adolescents with Type 1 Diabetes Mellitus: pages 137-148; , ISBN: ISBN 978-953-51-2204-3
  • [Show abstract] [Hide abstract]
    ABSTRACT: This study examined the relationship of family functioning and depressive symptoms with self-management, glycemic control, and quality of life in a sample of adolescents with type 1 diabetes. It also explored whether self-management mediates family functioning, depressive symptoms, and diabetes-related outcomes. Structural equation modeling was used to estimate parameters in the conceptual causal pathway and test mediation effects. Adolescents (n = 320) were primarily female (55%), younger adolescents (58%), and self-identified as White (63%). Self-management mediated the relationship between family conflict, family warmth-caring, parent guidance-control, and youth depressive symptoms with glycosylated hemoglobin (A1C). In addition, self-management mediated the relationship between family conflict and youth depressive symptoms with quality of life. Supporting optimal family functioning and treating elevated depressive symptoms in adolescents with type 1 diabetes has the potential to improve self-management, glycemic control, and quality of life.
    Western Journal of Nursing Research 12/2013; 36(9). DOI:10.1177/0193945913516546 · 1.03 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate mental health problems and associations between mental health problems and health-related quality of life in adolescents with type 1 diabetes in comparison with the general population. A total of 629 11- to 17-year-olds with early-onset and long-lasting type 1 diabetes and their parents completed comprehensive questionnaires. Mental health was assessed using the parent- and self-report versions of the Strengths and Difficulties Questionnaire (SDQ). The Revised Children's Quality of Life Questionnaire (KINDL-R) was used to measure quality of life. The comparison group (n = 6,813) was a representative sample from the German KiGGS study. The proportion of youths with mental health problems (defined as abnormal SDQ total difficulties score) was, based on self-reports, 4.4% in the patient group and 2.9% in the general population (adjusted OR = 1.61, p = 0.044); and based on proxy reports, 7.9% in the patient group and 7.2% in the general population (OR = 1.05, p = 0.788). Youths with type 1 diabetes and self-reported mental health problems scored worse in the KINDL-R subscales of physical well-being (adjusted average difference β = -16.74, p<0.001) and family (β = -11.09, p = 0.017), and in the KINDL-R total score (β = -8.09, p<0.001), than peers with self-reported mental health problems. The quality of life of diabetic adolescents and proxy-reported mental health problems did not differ from peers with proxy-reported mental health problems adjusted for confounders. Compared with the general population with mental health problems, the quality of life of adolescents with type 1 diabetes who report mental health problems is more severely impaired. This observation calls for early prevention and intervention as part of pediatric diabetes long-term care.
    PLoS ONE 03/2014; 9(3):e92473. DOI:10.1371/journal.pone.0092473 · 3.23 Impact Factor
Show more