Parenting, autonomy and self-care of adolescents with Type 1 diabetes.
Parenting, autonomy and self-care of adolescents with Type 1 diabetes.
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DOI：
10.1111/j.1365-2214.2008.00892.x
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发表时间：
2009-01
期刊：
影响因子：
--
通讯作者：
Wallander J
中科院分区：
文献类型：
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作者：
Dashiff C;Vance D;Abdullatif H;Wallander J
在青春期，糖尿病造成了一个非常复杂的疾病管理需求与发展需求的结合点，包括青少年争取更大的自主权。在此期间，父母对青少年糖尿病自我管理能力的担忧和恐惧可以提高父母的依恋行为，并影响父母支持有效自我护理所需的自主性发展的能力。母亲养育过程可能对那些患有1型糖尿病的青少年特别重要，因为母亲是主要的照顾者。本研究以依恋理论为基础，探讨母亲-青少年发展冲突、母亲分离焦虑、母亲自主性和关联性抑制对1型糖尿病青少年认知自主性和自我照顾的影响。共有131个有11至15岁青少年的家庭每年分三次提供数据。母亲和青少年完成了纸和笔的措施和两个互动的情况下，由训练有素的工作人员从录音带编码。青少年还完成了结构化访谈和问卷调查，以评估自我护理。青少年11-15岁时的母亲分离焦虑直接预测一年随访时的认知自主性，并且认知自主性与一年后的自我护理直接相关，但并不介导分离焦虑和自我护理之间的关系。父母分离焦虑对青少年自主性发展的影响以及自主性发展对青少年糖尿病自我管理行为的贡献值得进一步研究。
During adolescence diabetes creates a juncture of very complex disease management demands with developmental needs, including the striving of adolescents for greater autonomy. Parents' concerns and fears about the teen's diabetes self-management abilities during this time can heighten parental attachment behavior and affect the parents' ability to support autonomy development necessary for effective self-care. Maternal parenting processes may be especially important for those adolescents who have Type 1 diabetes because mothers are the primary caregivers. Based on attachment theory, the aim was to test a model of the influence of mother-adolescent developmental conflict, maternal separation anxiety, and maternal inhibition of autonomy and relatedness on cognitive autonomy and self-care of adolescents with Type 1 diabetes. A total of 131 families with an adolescent, ages 11-15, contributed data annually across three waves. Mothers and adolescents completed paper-and-pencil measures and two interaction scenarios that were coded by trained staff from audio-tapes. The adolescent also completed a structured interview and questionnaire to assess self-care. Maternal separation anxiety when adolescents were 11-15 years of age directly predicted cognitive autonomy at one year follow-up, and that cognitive autonomy was directly related to self-care one year later, but did not mediate between separation anxiety and self-care. Future investigation of the influence of separation anxiety of parents on adolescent autonomy development is warranted, as well as the contribution of autonomy development to diabetes self-management behaviors of adolescents.