Children's appraisals of maternal involvement in coping with diabetes: Enhancing our understanding of adherence, metabolic control, and quality of life across adolescence
Children's appraisals of maternal involvement in coping with diabetes: Enhancing our understanding of adherence, metabolic control, and quality of life across adolescence
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DOI：
10.1093/jpepsy/jsi004
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发表时间：
2005-03-01
影响因子：
3.6
通讯作者：
Donaldson, DL
中科院分区：
文献类型：
--
作者：
Wiebe, DJ;Berg, CA;Donaldson, DL
目的探讨儿童对母亲参与应对糖尿病的评价与青少年期的依从性、代谢控制和生活质量之间的关系。方法1型糖尿病儿童（N = 127，年龄10-15岁）完成了依从性、生活质量和母亲参与处理糖尿病问题的评价（即，母亲被评价为不参与、控制或合作）。代谢控制通过医疗记录索引。结果无论孩子的年龄和性别如何，母亲不参与与较差的依从性和生活质量相关，而母亲合作与较好的依从性和代谢控制相关。有证据表明，评估合作和代谢控制之间的关联部分介导的坚持。评估控制与年龄较大，但不是年轻的，儿童和老年女性的生活质量较差，但不是在老年男性或年龄较小的儿童中的依从性较差。结论：在10至15岁之间，保持母亲参与糖尿病护理是很重要的，但这种参与的最佳形式可能需要调整，以符合儿童的发展水平。目前的研究结果表明，当母亲被视为与孩子合作而不是控制孩子时，在处理糖尿病问题时，可以看到更好的依从性。
Objective To examine how children's appraisals of maternal involvement in coping with diabetes are associated with adherence, metabolic control, and quality of life across adolescence. Methods Children (N = 127, ages 10-15 years) with type 1 diabetes completed measures of adherence, quality of life, and appraisals of mothers' involvement in dealing with diabetes problems (i.e., mother appraised as uninvolved, controlling, or collaborative). Metabolic control was indexed through medical records. Results Regardless of age or sex of child, appraised maternal uninvolvement was associated with poorer adherence and quality of life, while appraised collaboration was associated with better adherence and metabolic control. There was evidence that the association between appraised collaboration and metabolic control was partially mediated by adherence. Appraised control was associated with poorer adherence among older, but not younger, children and with poorer quality of life among older females but not among older males or younger children of either sex. Conclusions Maintaining maternal involvement in diabetes care is important across ages 10 to 15, but the optimal form of this involvement may need to be adjusted to be consistent with the child's level of development. The present findings suggest that better adherence is seen across age when mothers are viewed as collaborating with, as opposed to controlling, their child when dealing with diabetes problems.