Background: Life satisfaction of stroke survivors is known to be associated with socio-economic factors and the survivor’s and his/her caregiver’s quality of life, but their respective influence remains to be fully elucidated. Purpose: To analyse the stroke survivors’ life satisfaction 2 years after the event and its relationships with quality of life, socio-economic and stroke-related characteristics, and with informal caregivers’ life satisfaction and quality of life . Methods: Over 18 months, all stroke patients from Luxembourg and north-eastern Portugal who lived at home were identified from the Inspection Générale de la Sécurité Sociale and hospital records, respectively. The clinical diagnosis of cerebrovascular disease was confirmed. We excluded all patients who declared that stroke did not result in neurological impairments at the time of stroke from the statistical analysis. The samples comprised 79 patients in Luxembourg and 48 in Portugal. Patients and the people they identified as their main caregivers were interviewed using validated questionnaires measuring life satisfaction, i.e. the Newcastle Stroke-Specific Quality of Life (Newsqol – 11 subscales), which identifies the areas affected by stroke among patients, and the World Health Organization Quality of Life – bref (Whoqol-bref – 4 subscales) of informal caregivers. Survivors without neurological impairment at the time of stroke were excluded. Data were analysed via multiple-regression models. Results: Life satisfaction was higher among women and lower among subjects with impaired motor functions. It was lower among Portuguese respondents with low-level education (<12th grade) and higher among those at work (37.6/100). In Luxembourg, retired people had more life satisfaction than did working people (–7.9/100). Controlling for socio-economic factors, life satisfaction was associated with feelings- Newsqol (slope 0.25) among Luxembourg residents, and with feelings-, mobility- and self-care-Newsqol (slopes 0.24, 0.27 and 0.33, respectively) among Portuguese respondents. Life satisfaction of patients was strongly related to that of family caregivers among the Portuguese respondents (slope 0.66) but the relationship was moderate in Luxembourg (slope 0.28). The survivors’ life satisfaction was not correlated with any Whoqol-bref domain in the Luxembourg group, but was correlated with the Whoqol-bref psychological, social relationships and environment domains among the Portuguese respondents (slopes 0.55, 0.59 and 0.51, respectively). Conclusions: The life satisfaction scale and the Newsqol stroke instrument, which identify areas of quality of life affected by stroke, are reliable patient-centred markers of intervention outcome. They can be used within the framework of medical follow-up (such as telephone assistance, clinical practice and prevention). Depending on the stroke survivor’s and the family caregiver’s habitual lifestyle and material circumstances, enhancement of a caregiver’s quality of life can help maintain the patient’s life satisfaction, ...

Adherence and glycemic control usually decrease during adolescence and family relationships influence diabetes outcomes. This study analyzed the interaction effect of adolescents' family support, age, and gender in the relationship between adherence and glycemic control in adolescents with Type 1 Diabetes. The sample included 100 adolescents with Type 1 Diabetes and one of their parents during a routine endocrinology appointment. Adolescents answered the Self-Care Inventory-Revised, the Diabetes Family Behavior Scale and were also assessed on the glycosylated hemoglobin. The three-way interaction between adherence, family support, and adolescents' age/gender was both negatively significant and explained 24.12% and 22.02% of the variance, respectively. Higher family support, being female, and younger age moderated the relationship between adherence and glycemic control. According to results, it is important that intervention programs provide negotiation skills, according to adolescent's age and gender in the process of transferring diabetes management responsibility in order to promote better adherence to diabetes self-care, glycemic control, and prevent family conflicts regarding diabetes management.

Cerebrovascular diseases are a public health and social policy priority in Europe due to their high prevalence and the long-term disability they may result in (as

Introduction:The General Family Functioning is a subscale of the Family Assessment Device (FAD) that assess overall family functioning. This study analyzed the psychometric properties of the General Family Functioning subscale in Portuguese families with adolescents diagnosed with Type I Diabetes and healthy adolescents comparing also family functioning in both samples. Method: A total of 100 parents of adolescents with Type I Diabetes and 106 parents of healthy adolescents participated in this study. A confirmatory factor analysis was performed for both samples to analyze the adequacy of each model. Results: Both confirmatory factor analyses maintained the design in one-factor models with good fit indexes. The internal consistency in both samples was good, but slightly higher in parents of healthy adolescents. The instrument also presented good convergent and divergent validity. Discussion: The Portuguese version of the General Family Functioning subscale showed good psychometric properties and reliability in healthy adolescents and in adolescent with Type I Diabetes.

This study analyzed the impact of dissimilarities in illness perceptions between parents and adolescents, school support, and family functioning on quality of life of adolescents with type 1 diabetes (T1D). A total of 100 adolescents diagnosed with T1D for at least 1 year and a primary caregiver participated in the study (N=200). Adolescents answered the Diabetes Quality of Life and the School Support Questionnaire, and parents answered the general functioning subscale of the Family Assessment Device. Both answered the Brief-Illness Perception Questionnaire, regarding the adolescents’ diabetes. The interception effect of dissimilarities regarding identity and concerns perceptions toward diabetes, between parents and adolescents, and school support in the relationship between family functioning and quality of life was significant and explained 27% and 32% of the variance, respectively. The results showed a negative relationship between family functioning and quality of life when school support was low and dissimilarities in identity and concerns perceptions were high. Therefore, to increase quality of life of adolescents with T1D, intervention programs should include family, teachers, school staff, and peers to improve their knowledge of diabetes and support to adolescents.

Background This study evaluates the adequacy of the Revised Self and Family Management Framework (Grey et al., Nurs Outlook 63:162-170, 2015) in Portuguese adolescents with type 1 diabetes and analyzes the effect of parental coping, family support, and adherence in the association between illness representations, school support, metabolic control, quality of life, and family functioning. Method One hundred adolescents (aged 12-19) and their parents participated in a cross-sectional study. Adolescents were assessed on school support, adherence to self-care, family support, and quality of life. Parents were assessed on parental coping and family functioning. Both adolescents and parents were assessed on illness representations. Adolescent's metabolic control was evaluated through glycosylate hemoglobin.Results Adolescents' and parents' illness representations were associated with metabolic control, quality of life and family functioning. Parental coping, family support and adherence had an indirect effect between illness representations and diabetes outcomes. Conclusion Findings showed the adequacy of Grey and colleagues' model (Nurs Outlook 63:162-170, 2015) in adolescents with type 1 diabetes and how family support, parental coping, and adherence contribute to diabetes management. Interventions to improve adolescents' and family's management of Type 1 diabetes should be designed to change adolescents' and family's representations and enhance their ability and skills in diabetes management.

Type 1 diabetes is one of the most frequent chronic diseases in adolescents. To manage diabetes and prevent complications, a set of self‐care behaviors needs to be implemented into family daily routines. This study analyzed diabetes representations in adolescents and their parents, the dissimilarities between them, and the relationship between illness dissimilarities and adherence/quality of life (QoL) in adolescents with type 1 diabetes. The sample included 200 participants: 100 adolescents with type 1 diabetes and 100 parents who accompanied the adolescents. Adolescents were assessed on adherence (Self‐Care Inventory‐Revised), quality of life (Diabetes QoL) and family support (Diabetes Family Behavior Scale). Both adolescents and parents were assessed on illness representations (Brief‐Illness Perception Questionnaire). Dissimilarities in illness representations between parents and adolescents were performed using Olsen et al's proposal. Parents showed a more negative representation of diabetes than adolescents. Adolescents' illness representations, the dissimilarities between adolescents' and parents' illness representations, and family support were associated with adolescents' adherence and QoL. Higher family support moderated the relationship between the dissimilarity in timeline representations and QoL, explaining 17.8% of the variance on QoL. Adolescent's  gender (male) was a moderator in the relationship between adolescent's coherence and QoL, explaining 18.6% of the variance on QoL. Adolescent's gender (female) was a moderator in the relationship between timeline and QoL, explaining 11.9% of the variance on QoL. Being a male parent was a moderator in the relationship between adolescent's concerns and QoL, explaining 13.5% of the variance on QoL. Intervention programs should focus on illness representations, particularly on the dissimilarities between adolescents and parents, as well as on family support in order to promote adolescents' adherence and QoL.

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