Family conflict, adherence, and glycaemic control in youth with short duration Type 1 diabetes
Family conflict, adherence, and glycaemic control in youth with short duration Type 1 diabetes
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DOI：
10.1046/j.1464-5491.2002.00752.x
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发表时间：
2002-08-01
影响因子：
3.5
通讯作者：
Laffel, LMB
中科院分区：
文献类型：
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作者：
Anderson, BJ;Vangsness, L;Laffel, LMB
目的围绕糖尿病管理任务的行为支持与血糖结局有关。在这项研究中，我们调查了与糖尿病相关的父母行为（周围冲突和参与治疗任务）、坚持血糖监测（BGM）和短期1型糖尿病（DM）青少年血糖控制之间的关系。方法在一项横断面研究中，104名青少年（8-17岁，1型糖尿病持续时间0.5-6年）与父母一起完成了糖尿病冲突量表。通过结构化访谈和糖尿病家庭责任问卷评估家长对管理任务的参与程度。通过家庭报告和独立临床医生评分来评估BGM的依从性。用糖化血红蛋白（HbA(1c)）评估血糖控制（参考范围，4-6%）。结果儿童（8-12岁，n = 69）和青少年（13-17岁，n = 35）的糖尿病持续时间相似（x +/- SD; 2.7 +/- 1.69, 2.4 +/- 0.32年），血糖控制相似（8.3 +/- 1.1%,8.4 +/- 0.1%）。在两个年龄组中，父母参与是BGM依从性的显著预测因子（P = 0.01）。多变量分析，控制年龄、性别、病程和BGM依从性，显示较高的糖尿病冲突与较差的血糖控制（HbA(1c)）显著相关（R-2 = 0.17; P < 0.01）。这些发现表明，在该队列中，在糖尿病病程早期，糖尿病特异性冲突和BGM依从性与儿童的血糖控制密切相关。这表明，为了确保最佳控制，在负面行为形成之前，在疾病过程的早期，引入有针对性的干预措施，在糖尿病任务中建立积极的家庭参与和互动，可能是有益的。
Aims Behavioural support around diabetes management tasks is linked to glycaemic outcomes. In this study we investigated the relationship between diabetes-related parental behaviours (conflict around and involvement in treatment tasks), adherence to blood glucose monitoring (BGM), and glycaemic control in youth with short duration Type 1 diabetes mellitus (DM).Methods In a cross-sectional study, 104 youth (aged 8-17 years, duration of Type 1 DM 0.5-6 years) along with a parent, completed the Diabetes Conflict Scale. Parental involvement in management tasks was assessed with structured interviews and the Diabetes Family Responsibility Questionnaire. Adherence to BGM was evaluated by family report and by independent clinician rating. Glycaemic control was assessed with glycosylated haemoglobin (HbA(1c)) (ref. range, 4-6%).Results Children (8-12 years; n = 69) and adolescents (13-17 years; n = 35), respectively, had similar durations of diabetes (x +/- SD; 2.7 +/- 1.69, 2.4 +/-.32 years) and similar glycaemic control (8.3 +/- 1.1%, 8.4 +/-.1%). In both age groups, parental involvement was a significant predictor of adherence to BGM (P = 0.01). Multivariate analyses, controlling for age, sex, disease duration, and BGM adherence, revealed that higher diabetes conflict significantly related to poorer glycaemic control (HbA(1c)) (R-2 = 0.17; P < .01).Conclusions These findings indicate that in this cohort, early in the course of diabetes, diabetes-specific conflict and adherence to BGM became strongly linked to the child's glycaemic control. This suggests that to insure optimal control, it may be beneficial to introduce targeted interventions to build positive family involvement and interaction around diabetes tasks early in the disease course, before negative behaviours become established.