Model of Associations Between Psychosocial Variables and Health-Outcome Measures of Adolescents with IDDM

Abstract

The purpose of this study was to develop a model that describes the contributions of key psychosocial variables to the health outcome of adolescents with insulin-dependent diabetes mellitus (IDDM). Subjects were 93 adolescents with IDDM and their parents. Health-outcome measures included adherence and metabolic control (HbA1c). Psychosocial variables included adolescent age, chronic life stress, social competence, family relations, and family knowledge about IDDM. Multiple regression analyses showed that adherence (P less than .029) and stress (P less than .052) were directly related to metabolic control and that knowledge about IDDM (P less than .029), family relations (P less than .099), and adolescent age (P less than .086) had direct effects on adherence. Combined, the independent variables accounted for 14.5% of the variance in predicting HbA1c and 18.5% of the variance in predicting adherence. In general, these findings are consistent with extant theory. The direct link between stress and metabolic control, however, contrasts with the current view that psychosocial variables affect metabolic control indirectly through their influence on adherence behavior. The methodological limitations of the findings are noted, directions for future research are suggested, and the implications for clinical interventions are described.

Lessons Learnt from Influences of the Marmara Earthquake on Glycemic Control and Quality of Life in People with Type 1 Diabetes

“…Stress negatively affects either people with diabetes [24,29,35,36] or without [17][18][19][20][21][22]. Positive life events were associated with improved glycemic control; on the other hand, recent severe stressors were associated with poorer glycemic control [35].…”

Stress and Diabetes: A Review of the Links

“…[18][19][20][21] These later studies are not without problems however, such as, the myriad possibilities for measurement and/or observation, which makes cross-study comparisons difficult. Stress may take the form of day-today hassles, and it may be that major life events (death of a close relative, losing a job) are an added layer of complexity, along with long-term chronic difficulties (e.g., providing long-term care for a relative or longterm unemployment).…”

Adolescent views of diabetes-related parent conflict and support: a focus group analysis

“…However, increased parental involvement in diabetes management is also reported to create diabetes-related family conflict [17,18]. Furthermore, high levels of family conflict and low levels of family cohesion and support are associated with poorer metabolic control [19][20][21][22] and poorer adherence [23][24][25][26][27] among adolescents.…”