The Blood Glucose Monitoring Communication Questionnaire

Abstract

OBJECTIVE -The aim of this study was to present the psychometric properties of a new tool for evaluating affective response to blood glucose monitoring (BGM) in youths with type 1 diabetes and their parents. RESULTS -Youth and parent BGMC questionnaires had acceptable internal consistency (youth, ␣ ϭ 0.77; parent, ␣ ϭ 0.82) and 1-year test-retest reliability (youth, r ϭ 0.60; parent, r ϭ 0.80). Higher BGMC questionnaire scores (indicating more negative affect) showed a strong association with higher levels of diabetes-specific family conflict (youth, r ϭ 0.33; parent, r ϭ 0.44) and poorer health-related psychosocial quality of life (youth, r ϭ Ϫ0.50; parent, r ϭ Ϫ0.42). Higher BGMC questionnaire scores were also associated with poorer glycemic control (youth, r ϭ 0.28; parent, r ϭ 0.20), even when the effects of diabetes-specific family conflict and psychosocial quality of life were controlled. Youths with BGMC questionnaire scores in the upper quartile had A1c values 1 percentage point higher (9.1%) than youths with scores in the lowest quartile (8.0%). RESEARCH DESIGN AND METHODSCONCLUSIONS -The BGMC questionnaires have strong psychometric properties and are convenient measures of affect specific to BGM. Further, BGM affect is associated with glycemic outcomes and may provide a unique contribution to factors associated with glycemic control in youths. Diabetes Care 27:2610 -2615, 2004D uring the past two decades, blood glucose monitoring (BGM) has been established as an important component of type 1 diabetes management. Findings from the Diabetes Control and Complications Trial and other studies stress the necessity of BGM for intensive treatment of diabetes, largely because of the relationship between BGM and glycemic outcomes in populations with type 1 and type 2 diabetes and the link between hyperglycemia and long-term complications (1-5). Further, in pediatric and adolescent patients with type 1 diabetes, a strong association exists between adherence to BGM and glycemic control; a higher frequency of BGM is associated with lower A1c levels (6 -8). Thus, it is not surprising that the American Diabetes Association, in its clinical practice guidelines (9), stresses the importance of frequent BGM for intensive treatment of diabetes.Despite an emphasis on intensive diabetes management, which includes frequent BGM, glycemic control remains suboptimal in pediatric and adolescent populations. Although biological and social changes in youths impact glycemic control in direct and in indirect ways (10), the demands of diabetes management can promote negative feelings in family members. Diabetes-specific family conflict is consistently identified as having a negative impact on adherence to diabetes tasks and glycemic outcomes (11-13) and may arise from either parental perception of inadequate monitoring frequency or the child's inability to achieve or maintain near-normal blood glucose levels. Thus, conflict around BGM, such as parental nagging or criticism, may serve to promote negative feelings in the youth directed...

Routine Psychological Screening in Youth With Type 1 Diabetes and Their Parents

“…Studies have consistently found that high family conflict is related to poorer diabetes self-care behaviors and poorer metabolic control, while positive family attributes such as support, warmth, and cohesion are associated with better diabetes self-care behaviors and metabolic control (31,33,108 -110). Data from several studies indicate that parental (predominantly maternal) psychological wellbeing correlates positively with all diabetes metabolic outcomes in their children (i.e., happier mother and better outcomes) (111,112). This finding is similar to a study of patient-perceived family stress in adults by Parkerson et al (113) but is at odds with a more recent study of diabetes-related stress by Stallwood (114).…”

“…The mediating variable between caregiver stress and diabetes outcomes may be the circumstances around blood glucose monitoring (BGM). Disagreement about responsibility of BGM and the level of affect surrounding BGM have both been found to be associated with metabolic outcome (112).…”

Updated and Revised Diabetes Family Conflict Scale

“…Total scores can range from a minimum of 8 (indicating no negative affect) to 24 (indicating a high level of negative affect). This survey shows strong psychometric properties with regard to internal consistency and predictive validity (19). It can be completed in Ͻ5 min.…”

“…Blood Glucose Monitoring Communication Questionnaire. The Blood Glucose Monitoring Communication (BGMC) questionnaire was designed to evaluate emotional responses to BGM results experienced by youth and their caregivers (19). Youth and their caregivers were asked to report their emotional responses to high and low blood glucose levels.…”

Closed-Loop Glucose Control: Psychological and Behavioral Considerations

“…Diabetes-specific constructs such as fear of hypoglycemia and hyperglycemia, as well as tendency to have negative emotional reactions to glucose readings, will also likely influence use of diabetes technology. 67,68 Numerous studies support the relationship between the HBM and a wide range of diabetes self-care behaviors in both adolescents and adults, including foot care 69 and adherence to insulin, diet, and exercise. [70][71][72][73] The TPB is another behavior change model that predicts diabetes management behaviors, including a healthy diet and engaging in physical activity.…”