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

Abstract

BackgroundAdolescents 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.MethodA 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.ResultsParent-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.ConclusionsThe 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.

Self-Management as a Mediator of Family Functioning and Depressive Symptoms With Health Outcomes in Youth With Type 1 Diabetes

“…Considerable research has demonstrated the role of family conflict and warmth-caring behaviors on glycemic control in youth with type 1 diabetes (Anderson et al, 2002; Berg et al, 2008; Cohen et al, 2004; Hilliard et al, 2011; Ingerski et al, 2010; Moore et al, 2013), suggesting that self-management mediates this relationship (Hilliard et al, 2011, 2013). Results of this study provide further evidence of the critical importance of family conflict on youth quality of life, with self-management mediating this relationship as well.…”

Supported self-care for children and adolescents with chronic disease and their families

“…In the context of the pediatric age group, it is possible to valorize the use of a motivational process as a way of guiding professionals to recognize and lead the user to changes (2) , since even children/adolescents and their families are aware of the need to modify certain habits, however this is not always put into practice (5) . With the child, support for self-care can be provided in two main areas: family and school (6) . On the other hand, adolescents are also influenced by their peers and online health information, since electronic media are more accessible, they tend to broaden health care and education (7) .…”

The Effect of Family Psychoeducation on Burden of Care in Families with Type I Diabetic Children

“…In the study conducted by Moor et al (2013), high family conflicts and their effects on family dynamics, parents' stresses, and poor control of blood sugar have been reported in families who had teenagers with type I diabetes (16).…”