Dyadic measures of the parent–child relationship during the transition to adolescence and glycemic control in children with type 1 diabetes.

Abstract

To identify aspects of family behavior associated with glycemic control in youth with type 1 diabetes mellitus (T1DM) during the transition to adolescence, we studied 121 9-to 14-year-olds (M = 12.1 yrs) and their parents, who completed the Diabetes Family Conflict Scale (DFCS) and the Diabetes Family Responsibility Questionnaire (DFRQ). From the DFRQ, we derived 2 dyadic variables, frequency of agreement (parent and child concurred exactly on who was responsible for a task) and frequency of discordance (parent and child had completely opposite reports of who was responsible). To examine the relationship between these variables and age, we divided the cohort into Younger (n = 57, M = 10.6 yrs) and Older (n = 64, M = 13.5 yrs) age groups. Family conflict was significantly related to glycemic control in the entire cohort and in both the Younger and Older age groups. However, only in the Younger (pre-teen) group was Agreement about responsibility for diabetes tasks related to glycemic control, with higher Agreement associated with better glycemic control. Findings suggest that Agreement about sharing of diabetes management responsibilities may be an important target for family-based interventions with pre-teen youth to optimize glycemic control during their transition to adolescence.

Relações entre qualidade de vida e diabetes mellitus tipo 1 na adolescência

“…As mudanças hormonais dificultam a estabilização da glicemia, podendo exigir uma maior dose de insulina e maior empenho para a realização do autocuidado (Anderson et al, 2009;Marques et al, 2011). As mudanças biológicas da adolescência também têm impacto no desenvolvimento físico e cognitivo, bem como na maturidade emocional (Minanni et al, 2010).…”

Designing for Positive Health Affect: Decoupling Negative Emotion and Health Monitoring Technologies

“…It is critical that there is clear communication between parent and child about division of diabetes management responsibility in order to mitigate conflict [9]. The parent-child relationship, which is often strained by normal developmental transitions toward independence, can be completely broken by the additional demands of diabetes management.…”

Treatment Adherence in Adolescents With Type 1 Diabetes mellitus

“…Na adolescência o controle glicêmico fica ainda mais complicado, dificultando a estabilização da glicemia devido às mudanças hormonais, podendo necessitar uma maior dose de insulina, maior esforço e empenho na realização do controle (Anderson et al, 2009;Marques, Fornés, & Stringhini, 2011). Contudo, são inúmeras as barreiras que impedem o bom controle metabólico, incluindo a baixa compreensão sobre os aspectos clínicos da doença, a falta de disciplina para aplicação de insulina e a necessidade de reeducação alimentar (Torres, Souza, Lima, & Bodstein, 2011).…”

“…Uma adesão adequada pode minimizar as complicações que a doença apresenta em longo prazo e pode manter os níveis de açúcar no sangue muito próximos dos normais (Anderson et al, 2009). Entretanto, para aderir ao tratamento o paciente precisa se apropriar da sua doença, participando do tratamento e do planejamento das intervenções.…”