BEHAVIOR THERAPY FOR FAMILIES OF DIABETIC ADOLESCENTS

描述（改编自研究者摘要）：1型糖尿病青少年 糖尿病常常难以维持足够的治疗依从性， 糖尿病控制，导致可预防的住院和急诊 探访大量的横断面和前瞻性研究表明， 沟通和解决冲突的技能是重要的影响， 青少年糖尿病控制、治疗依从性和心理 加强结构性改革针对这些问题的心理干预的实证验证 过程可以减少多余的医疗保健费用和糖尿病的风险 并发症在父母补助金，行为家庭系统治疗（BFST; 罗宾和福斯特，1989年）取得了改善家庭沟通技巧， 父母与青少年的关系，但它有较弱和较不持久的影响， 治疗依从性和糖尿病控制。这种相互竞争的延续 应用依赖于广泛的初步数据和临床经验， BFST和其他人的调查结果，制定改进措施， BFST旨在最大限度地提高其对糖尿病治疗依从性的影响， 代谢控制这些措施包括要求针对行为障碍， 坚持和糖尿病控制为每个家庭，延长治疗从3 至6个月，并结合几个治疗成分显示， 在其他研究中有效。一项关于这种改良BFST的随机对照试验 干预将与标准药物治疗或参与 糖尿病教育支持小组采用以下措施：家庭 沟通，亲子关系，青少年心理 调整、治疗依从性、糖尿病控制和卫生保健使用。 将分析治疗结果的预测因素， 将进行评估，社会有效性和治疗效果的维持将 随访6个月和12个月。这些结果可能会影响 糖尿病管理和医疗保健政策的临床实践 患有糖尿病和其他慢性病的青少年。

Description (adapted from the investigator's abstract): Adolescents with Type 1 diabetes mellitus often struggle to maintain adequate treatment adherence and diabetic control, leading to preventable hospitalizations and emergency room visits. Numerous cross-sectional and prospective studies show that family communication and conflict resolution skills are important influences on adolescents' diabetic control, treatment adherence and psychological adjustment. Empirical validation of psychological interventions targeting these processes could reduce excess health care costs and risks of diabetic complications. In the parent grant, Behavioral Family Systems Therapy (BFST; Robin & Foster, 1989) yielded improvements in family communication skills and parent-adolescent relationships, but it had weaker and less durable effects on treatment adherence and diabetic control. This competing continuation application relies on extensive preliminary data and clinical experience with BFST and on the results of others' investigations, to formulate refinements to BFST designed to maximize its impact on diabetes treatment adherence and metabolic control. These include required targeting of behavioral barriers to adherence and diabetic control for every family, lengthening treatment from 3 to 6 months, and incorporating several treatment components shown to be effective in other studies. A randomized, controlled trial of this refined BFST intervention will be compared to standard medical therapy or participation in a diabetes educational support group using the following measures: family communication, parent-adolescent relationships, adolescent psychological adjustment, treatment adherence, diabetic control and health care use. Predictors of treatment outcome will be analyzed and the clinical significance will be evaluated, social validity and maintenance of treatment effects will be followed-up over 6- and 12-month intervals. These results could influence the clinical practice of diabetes management and health care policy regarding adolescents with diabetes and other chronic diseases.