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DeBoer MD, Valdez R, Corbett JP, Krauthause K, Wakeman CA, Luke AS, Oliveri MC, Cherñavvsky DR, Patek SD. Effect of an Automated Advice Algorithm (CloudConnect) on Adolescent-Parent Diabetes-Specific Communication and Glycemic Management: A Randomized Trial. Diabetes Ther 2023; 14:899-913. [PMID: 37027118 PMCID: PMC10080500 DOI: 10.1007/s13300-023-01401-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 03/22/2023] [Indexed: 04/08/2023] Open
Abstract
INTRODUCTION Because adolescence is a time of difficult management of Type 1 diabetes (T1D) in part from adolescent-parent shared responsibility of T1D management, our objective was to assess the effects of a decision support system (DSS) CloudConnect on T1D-related communication between adolescents and their parents and on glycemic management. METHODS We followed 86 participants including 43 adolescents with T1D (not on automated insulin delivery systems, AID) and their parents/care-giver for a 12-week intervention of UsualCare + CGM or CloudConnect, which included a Weekly Report of automated T1D advice, including insulin dose adjustments, based on data from continuous glucose monitors (CGM), Fitbit and insulin use. Primary outcome was T1D-specific communication and secondary outcomes were hemoglobin A1c, time-in-target range (TIR) 70-180 mg/dl, and additional psychosocial scales. RESULTS Adolescents and parents reported a similar amount of T1D-related communication in both the UsualCare + CGM or CloudConnect groups and had similar levels of final HbA1c. Overall blood glucose time in range 70-180 mg/dl and time below 70 mg/dl were not different between groups. Parents but not children in the CloudConnect group reported less T1D-related conflict; however, compared to the UsualCare + CGM group, adolescents and parents in the CloudConnect reported a more negative tone of T1D-related communication. Adolescent-parent pairs in the CloudConnect group reported more frequent changes in insulin dose. There were no differences in T1D quality of life between groups. CONCLUSIONS While feasible, the CloudConnect DSS system did not increase T1D communication or provide improvements in glycemic management. Further efforts are needed to improve T1D management in adolescents with T1D not on AID systems.
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Affiliation(s)
- Mark D. DeBoer
- Division of Pediatric Endocrinology and Center for Diabetes Technology, University of Virginia, School of Medicine, PO Box 800386, Charlottesville, VA 22908 USA
- Department of Pediatrics, University of Virginia, Charlottesville, VA USA
| | - Rupa Valdez
- Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA USA
- Department of Engineering Systems and Environment, University of Virginia, Charlottesville, VA USA
| | - John P. Corbett
- Division of Pediatric Endocrinology and Center for Diabetes Technology, University of Virginia, School of Medicine, PO Box 800386, Charlottesville, VA 22908 USA
| | - Katie Krauthause
- Division of Pediatric Endocrinology and Center for Diabetes Technology, University of Virginia, School of Medicine, PO Box 800386, Charlottesville, VA 22908 USA
| | - Christian A. Wakeman
- Division of Pediatric Endocrinology and Center for Diabetes Technology, University of Virginia, School of Medicine, PO Box 800386, Charlottesville, VA 22908 USA
| | - Alexander S. Luke
- Division of Pediatric Endocrinology and Center for Diabetes Technology, University of Virginia, School of Medicine, PO Box 800386, Charlottesville, VA 22908 USA
| | - Mary C. Oliveri
- Division of Pediatric Endocrinology and Center for Diabetes Technology, University of Virginia, School of Medicine, PO Box 800386, Charlottesville, VA 22908 USA
| | - Daniel R. Cherñavvsky
- Division of Pediatric Endocrinology and Center for Diabetes Technology, University of Virginia, School of Medicine, PO Box 800386, Charlottesville, VA 22908 USA
- Department of Engineering Systems and Environment, University of Virginia, Charlottesville, VA USA
| | - Stephen D. Patek
- Division of Pediatric Endocrinology and Center for Diabetes Technology, University of Virginia, School of Medicine, PO Box 800386, Charlottesville, VA 22908 USA
- Department of Engineering Systems and Environment, University of Virginia, Charlottesville, VA USA
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Rawdon C, Kilcullen SM, Murphy N, Swallow V, Gallagher P, Lambert V. Parents' perspectives of factors affecting parent-adolescent communication about type 1 diabetes and negotiation of self-management responsibilities. J Child Health Care 2022:13674935221146009. [PMID: 36529483 DOI: 10.1177/13674935221146009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Adolescence is an important time in which young people take on type 1 diabetes (T1D) self-management responsibility. Parents are key facilitators of this process. Little is known about parents' experiences of communicating with their children about T1D during adolescence. Semi-structured interviews were conducted with 32 parents (24 mothers and 8 fathers) of adolescents (11-17 years) living with T1D to explore how parents communicate about T1D and self-management with their adolescent children. Parents were recruited through two national child and adolescent diabetes and endocrine clinics and online advertisement through a national diabetes advocacy organisation. Interviews were transcribed verbatim and thematically analysed. Six themes were identified: parent factors, quality of the parent-adolescent relationship, communication strategies, adolescent factors, communication triggers and family/system factors. Understanding factors that impact communication about self-management between parents and adolescents will enable healthcare professionals to provide support and targeted interventions as parent and adolescent roles change over time.
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Affiliation(s)
| | | | - Nuala Murphy
- 11457Children's Health Ireland at Temple Street, Dublin, Ireland
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Zelihić D, Williamson H, Kling J, Feragen KB. "It's tough because I see that it's upsetting her…": A qualitative exploration of parents' perceptions of talking with their adolescents about having a visible difference. Body Image 2021; 38:306-316. [PMID: 34052591 DOI: 10.1016/j.bodyim.2021.05.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 05/07/2021] [Accepted: 05/12/2021] [Indexed: 10/21/2022]
Abstract
Many adolescents live with a visible difference that affects their lives in profound ways, but studies investigating parents' perceptions of raising appearance issues during conversations with their adolescent are lacking. As part of a larger study exploring the effectiveness of a web-based intervention (YP Face IT), semi-structured interviews were conducted with 18 parents of adolescents with a visible difference. Thematic analysis revealed four overarching themes: (1) Conversational settings; (2) Understanding adolescents' feelings and thoughts; (3) Providing parental guidance and encouragement; and (4) When the dialogue becomes difficult. Results showed that parents resorted to specific settings when instigating conversations about appearance, such as when their adolescents expressed a need for emotional care, were perceived to be upset, or whilst managing their condition. The choice of setting was also important as some parents generally felt uncomfortable raising appearance issues with their adolescent, for fear of fueling appearance concerns. Results further suggest that open communication can enable parents to stay informed about their adolescent's psychosocial adjustment to a visible difference. These results stress the need to make available support to facilitate open communication about appearance-related topics between parents and adolescents.
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Affiliation(s)
- Deniz Zelihić
- Centre for Rare Disorders, Rikshospitalet, Oslo University Hospital, Norway.
| | - Heidi Williamson
- Centre for Appearance Research, University of the West of England, Bristol, UK
| | - Johanna Kling
- Centre for Rare Disorders, Rikshospitalet, Oslo University Hospital, Norway
| | - Kristin B Feragen
- Centre for Rare Disorders, Rikshospitalet, Oslo University Hospital, Norway
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Baechle C, Stahl-Pehe A, Castillo K, Gontscharuk V, Holl RW, Rosenbauer J. Family and household structure are associated with acute type 1 diabetes complications: results of cross-sectional analyses. Diabet Med 2020; 37:2075-2080. [PMID: 31943332 DOI: 10.1111/dme.14230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/09/2020] [Indexed: 12/11/2022]
Abstract
AIM To examine the association of family/household structure with short-term diabetes complications in adolescents and emerging adults with early-onset type 1 diabetes in more detail. METHODS Data on 1690 11-21-year-olds with type 1 diabetes were used to estimate associations of family/household structure with self-reported severe hypoglycaemia, hospitalizations for severe hypoglycaemia or diabetic ketoacidosis, applying multiple negative binomial regression. RESULTS Compared with living with both biological parents living with a single mother was associated with an increased rate of hospitalizations for ketoacidosis (incidence rate ratio 1.71, 95% CI 1.00-2.82). Incidence rate ratio of hospitalizations for ketoacidosis was similar (1.67, 95% CI 0.91-3.07) if the mother lived with a partner, however, hypoglycaemia-related hospitalizations increased (3.66, 95% CI 1.54-8.71). Participants living with a single father had 4.43 (95% CI 1.30-15.05) /10.42 (95% CI 1.55-70.22) times higher rates of severe hypoglycaemia and related hospitalizations, while living with a father and his partner was associated with an increased incidence rate ratio of hospitalizations for ketoacidosis (3.48, 95% CI 0.96-12.63) compared with living with both biological parents. CONCLUSIONS Findings of our exploratory analyses point to different self-reported diabetes outcomes depending on the family/household structure. If confirmed in future studies, they may help to identify young people with diabetes at risk of short-term diabetes complications.
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Affiliation(s)
- C Baechle
- German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Institute for Biometrics and Epidemiology, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - A Stahl-Pehe
- German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Institute for Biometrics and Epidemiology, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - K Castillo
- German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Institute for Biometrics and Epidemiology, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
| | - V Gontscharuk
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
- Heinrich Heine University, Centre for Health and Society, Institute for Health Services Research and Health Economics, Faculty of Medicine, Düsseldorf, Germany
- German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University, Institute for Health Services Research and Health Economics, Düsseldorf, Germany
| | - R W Holl
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
- University of Ulm, Institute of Epidemiology and Medical Biometry, Ulm, Germany
| | - J Rosenbauer
- German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Institute for Biometrics and Epidemiology, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany
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Chen CY, Lo FS, Wang RH. Roles of Emotional Autonomy, Problem-Solving Ability and Parent-Adolescent Relationships on Self-Management of Adolescents with Type 1 Diabetes in Taiwan. J Pediatr Nurs 2020; 55:e263-e269. [PMID: 32493633 DOI: 10.1016/j.pedn.2020.05.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 05/19/2020] [Accepted: 05/19/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND High emotional autonomy has a negative association, whereas good problem-solving ability and parent-adolescent relationships have positive association with self-management in adolescents with type 1 diabetes (T1D). Exploring roles of these variables is crucial to design specific interventions to improve self-management in such afflicted adolescents. PURPOSE To explore the roles of emotional autonomy, problem-solving ability and parent-adolescent relationships on self-management in adolescents with T1D. DESIGN AND METHODS Cross-sectional design was used in this study. A total of 242 adolescents with T1D were recruited from an outpatient clinic of a medical center by convenience sampling in Taiwan. Self-reported questionnaires were used to collect personal characteristics, self-management, emotional autonomy, problem-solving ability, and parent-adolescent relationships. RESULTS Hierarchical multiple regressions indicated that body mass index, problem-solving ability, father-adolescent relationship, and emotional autonomy were significant factors associated with self-management. The interactions of emotional autonomy with problem-solving ability and with parent-adolescents relationship were not significantly associated with self-management. The overall model explained 47.5% variance of self-management. CONCLUSIONS High emotional autonomy was significantly associated with poor self-management. Problem-solving ability and father-adolescent relationships could not moderate, but were independently and significantly associated with self-management in adolescents with T1D. PRACTICE IMPLICATION Healthcare providers should evaluate emotional autonomy earlier and provide more timely help to reduce any negative impact on self-management in adolescents with T1D. Improving problem-solving ability and encouraging fathers to develop optimal father-adolescents relationship might be promising strategies to enhance self-management in adolescents with T1D.
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Affiliation(s)
- Chia-Ying Chen
- Administration Center of Research and Education, Ditmanson Medical Foundation Chai-Yi Christian Hospital, Taiwan.
| | - Fu-Sung Lo
- Division of Endocrinology, Department of Pediatrics, Chang Gung Memorial Hospital, College of Medicine, Chung Gung University, Taiwan.
| | - Ruey-Hsia Wang
- College of Nursing, Kaohsiung Medical University, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, Taiwan.
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Grossoehme DH, Smith E, Standiford D, Morwessel N, Kichler J, Maahs DM, Driscoll K, Seid M. Understanding adolescent and parent acceptability and feasibility experience in a large Type 1 diabetes mellitus behavioural trial. Diabet Med 2020; 37:1134-1145. [PMID: 30701596 PMCID: PMC6667304 DOI: 10.1111/dme.13913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/28/2019] [Indexed: 11/29/2022]
Abstract
AIMS Using an 18-month, multisite randomized control trial as an exemplar, the aim of this study was to identify themes related to adolescent and parental feasibility and acceptability for participation in large behavioural trials designed to improve adolescents' Type 1 diabetes self-management. METHODS Thematic analysis methodology was used to develop themes describing factors related to acceptability and feasibility. RESULTS Based on a sample of interviews (N = 72), factors contributing to intervention acceptability and feasibility were identified. Aspects of acceptability included: a framework for goal-setting, the coach as a non-judgemental listener, perception of an ongoing benefit to participation and the delivery mode. Aspects of feasibility included: participants' altruism to help adolescents with Type 1 diabetes; pre-enrolment preparation for intervention content and duration; and the option of remote intervention delivery via telephone or video, which minimized travel time and costs. In addition, participants described positive outcomes including improvements in behaviour, Type 1 diabetes self-management behaviours and parent-adolescent communication, and emotion-attitude changes. Participants also described potential revisions that may inform future trials. CONCLUSIONS Acceptability and feasibility of behavioural interventions with adolescents with chronic illness have multifactorial dimensions. While empowering adolescent self-management, parental support is also an under-appreciated aspect to consider. Potential revisions were identified for subsequent behavioural trials.
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Affiliation(s)
- D H Grossoehme
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
- Divisions of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - E Smith
- Divisions of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - D Standiford
- Divisions of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - N Morwessel
- Divisions of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - J Kichler
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
- Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - D M Maahs
- Division of Pediatric Endocrinology, Stanford University, Stanford, CA
| | - K Driscoll
- Department of Pediatrics, Barbara Davis Center for Childhood Diabetes, The Children's Hospital of Colorado, Aurora, CO
| | - M Seid
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
- Divisions of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
- James M. Anderson Center for Healthy System Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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7
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Psihogios AM, Fellmeth H, Schwartz LA, Barakat LP. Family Functioning and Medical Adherence Across Children and Adolescents With Chronic Health Conditions: A Meta-Analysis. J Pediatr Psychol 2020; 44:84-97. [PMID: 29982694 DOI: 10.1093/jpepsy/jsy044] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 06/03/2018] [Indexed: 12/16/2022] Open
Abstract
Objectives A meta-analysis examined family functioning and medical adherence in children and adolescents with chronic health conditions. Family functioning was evaluated at the level of the family unit, as well as parent-child interactions. Methods We conducted literature searches using PubMed, PsycINFO, SCOPUS, Web of Science, and Cochrane. After reviewing 764 articles, 62 studies met eligibility criteria. Pearson's r correlations were the effect size of interest. We conducted both omnibus and domain-specific (e.g., family conflict, cohesion) meta-analyses. Meta-regressions examined whether relevant covariates related to the magnitude of the effect. Results The omnibus meta-analysis showed that family functioning was significantly related to medical adherence across a variety of pediatric chronic health conditions. Lower family conflict, greater family cohesion, greater family flexibility, more positive communication, and better family problem-solving were each associated with better adherence. There were no significant differences in the magnitude of the omnibus effect based on child age, measurement features (subjective vs. objective or bioassay adherence; family unit vs. parent-child interactions), or study quality. Conclusions Consistent with social-ecological frameworks, findings supported links between family functioning and medical adherence. This study highlights several limitations of the extant research, including absence of a guiding theoretical framework and several methodological weaknesses. We offer clinical and research recommendations for enhancing scientific understanding and promotion of adherence within the family context.
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Affiliation(s)
| | | | - Lisa A Schwartz
- The Children's Hospital of Philadelphia.,Perelman School of Medicine of the University of Pennsylvania
| | - Lamia P Barakat
- The Children's Hospital of Philadelphia.,Perelman School of Medicine of the University of Pennsylvania
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Brorsson AL, Leksell J, Andersson Franko M, Lindholm Olinder A. A person-centered education for adolescents with type 1 diabetes-A randomized controlled trial. Pediatr Diabetes 2019; 20:986-996. [PMID: 31268224 DOI: 10.1111/pedi.12888] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 04/18/2019] [Accepted: 06/21/2019] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Young people with type 1 diabetes and their parents need to receive person-centered education to be able to manage their diabetes. Guided Self-Determination-Young (GSD-Y) is a person-centered communication and reflection education model that can be used in educational program for young people with type 1 diabetes. OBJECTIVE To evaluate whether GSD-Y leads to improved glycaemic control, increased self-perceived health and health-related quality of life, fewer diabetes-related family conflicts, and improved self-efficacy in a group-based intervention for adolescents starting continuous subcutaneous insulin infusion (CSII) and their parents. METHODS This randomized controlled trial included 71 adolescents starting CSII. Participants were followed for 12 months. The intervention group (n = 37) attended seven group training sessions over a period of 5 months, using the GSD-Y model, the control group received standard care. Variables evaluated were HbA1c, self-perceived health, health-related quality of life, family conflicts, self-efficacy, and usage of continuous glucose monitoring. RESULTS When adjusted for sex and family conflicts, there was a difference in glycaemic control between the groups at 12 months, favoring the intervention group (62 vs 70 mmol/mol, P = .009). When analyses were performed on boys and girls separately and adjusted for family conflicts, the only difference detected was for boys after 12 months (P = .019). The intervention showed no effect on self-perceived health, health-related related quality of life, family conflicts, or self-efficacy. CONCLUSIONS An intervention with GSD-Y may have an effect on glycaemic control. The content of the GSD-Y groups may serve as a model for person-centered care in adolescents with type 1 diabetes.
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Affiliation(s)
- Anna Lena Brorsson
- Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden.,School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
| | - Janeth Leksell
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.,Department of Medical Sciences, Clinical Diabetology and Metabolism, Uppsala University, Uppsala, Sweden
| | - Mikael Andersson Franko
- Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden
| | - Anna Lindholm Olinder
- Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden.,Department of Medical Sciences, Clinical Diabetology and Metabolism, Uppsala University, Uppsala, Sweden
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O'Toole S, Gallagher P, Benson A, Shahwan A, Austin JK, Lambert V. Exploring the relationship between parent-child communication about epilepsy and psychosocial well-being. J Health Psychol 2019; 26:1207-1221. [PMID: 31448626 DOI: 10.1177/1359105319871642] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
This study examined the relationship between parent-child communication and psychosocial well-being of 47 children living with epilepsy and 72 parents of children living with epilepsy. Open communication was associated with positive illness attitude, positive self-perception and greater health-related quality of life for children living with epilepsy; positive response to illness for parents; and more perceived social support and less need for epilepsy-related support for children living with epilepsy and parents. By contrast, closed communication was associated with poorer psychosocial well-being in children living with epilepsy and parents. Healthcare professionals should provide guidance for families living with childhood epilepsy on the importance of open communication in promoting greater psychosocial well-being.
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Affiliation(s)
| | | | | | - Amre Shahwan
- Children's Health Ireland at Temple Street, Ireland
| | - Joan K Austin
- Indiana University-Purdue University Indianapolis, USA
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10
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Abstract
OBJECTIVE While past research found family conflict, disordered eating, body image concerns and anxious self-doubts may affect adolescent diabetic glucose control, available measures of adherence mainly focus on management tasks. The current study aimed to combine measures of emotional distress and beliefs with decisions concerning management in a new measure of resistance to treatment adherence: the 12-item Glucose Control Resistance Scale (GCRS). METHODS Participants included 135 adolescents and their parents from a pediatric diabetes clinic. Family conflict, body image concerns, anxious self-doubts and glucose control resistance were assessed. RESULTS Factor analysis identified 12 items, with loadings of ≥0.40, which were used to form the GCRS. The scale had adequate reliability and there was a significant correlation between child and parent GCRS scores. One factor, family conflict, was significantly related to hemoglobin A1c (HbA1c) levels, but a set of four factors explained a total of 12% of the variance in HbA1c levels. Of the demographic variables considered (gender, number of parents at home, age, body mass index z-score), only gender was significantly associated with adolescent perceptions of family conflict. CONCLUSION The GCRS may allow diabetic care teams to better understand the origin of family conflict perceptions and the motivational beliefs that modify behavior and contribute to independent self-management and glucose control. Each question was designed to be meaningful in interventions by addressing common items of resistance to adherence and impulsive management decisions. The GCRS may be used by providers as an initial short screening survey on an annual or semi-annual basis.
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Affiliation(s)
| | - Helen M. Hendy
- Penn State University, Schuylkill Campus, Department of Psychology, Pennsylvania, United States
| | - Keith E. Williams
- Penn State Hershey Medical Center, Department of Pediatrics, Pennsylvania, United States,* Address for Correspondence: Penn State Hershey Medical Center, Department of Pediatrics, Pennsylvania, United States Phone: +7175317117 E-mail:
| | - Paul L. Mueller
- Penn State Hershey Medical Center, Department of Pediatrics, Pennsylvania, United States
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Mangelsdorf SN, Mehl MR, Qiu J, Alisic E. How Do Mothers and Fathers Interact With Their Children After An Injury? Exploring the Role of Parental Acute Stress, Optimism, and Self-Efficacy. J Pediatr Psychol 2019; 44:311-322. [DOI: 10.1093/jpepsy/jsy107] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 11/28/2018] [Accepted: 12/05/2018] [Indexed: 01/23/2023] Open
Affiliation(s)
- Shaminka N Mangelsdorf
- School of Psychological Sciences, Monash University
- Monash University Accident Research Centre, Monash University
| | | | - Jianrong Qiu
- Monash University Accident Research Centre, Monash University
| | - Eva Alisic
- Murdoch Children’s Research Institute
- Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, The University of Melbourne
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