Diabetes representations on adherence and quality of life: Do parents and adolescents differ?

Type 1 diabetes is one of the most frequent chronic diseases in adolescents. To manage diabetes and prevent complications, a set of self-care behaviors needs to be implemented into family daily routines. This study analyzed diabetes representations in adolescents and their parents, the dissimilarities between them, and the relationship between illness dissimilarities and adherence/quality of life (QoL) in adolescents with type 1 diabetes. The sample included 200 participants: 100 adolescents with type 1 diabetes and 100 parents who accompanied the adolescents. Adolescents were assessed on adherence (Self-Care Inventory-Revised), quality of life (Diabetes QoL) and family support (Diabetes Family Behavior Scale). Both adolescents and parents were assessed on illness representations (Brief-Illness Perception Questionnaire). Dissimilarities in illness representations between parents and adolescents were performed using Olsen et al's proposal. Parents showed a more negative representation of diabetes than adolescents. Adolescents' illness representations, the dissimilarities between adolescents' and parents' illness representations, and family support were associated with adolescents' adherence and QoL. Higher family support moderated the relationship between the dissimilarity in timeline representations and QoL, explaining 17.8% of the variance on QoL. Adolescent's  gender (male) was a moderator in the relationship between adolescent's coherence and QoL, explaining 18.6% of the variance on QoL. Adolescent's gender (female) was a moderator in the relationship between timeline and QoL, explaining 11.9% of the variance on QoL. Being a male parent was a moderator in the relationship between adolescent's concerns and QoL, explaining 13.5% of the variance on QoL. Intervention programs should focus on illness representations, particularly on the dissimilarities between adolescents and parents, as well as on family support in order to promote adolescents' adherence and QoL.

Psychometric properties of the Portuguese adaptation of General Functioning of Family Assessment Device: A comparative study

INTRODUCTION

The General Family Functioning is a subscale of the Family Assessment Device (FAD) that assess overall family functioning. This study analyzed the psychometric properties of the General Family Functioning subscale in Portuguese families with adolescents diagnosed with Type I Diabetes and healthy adolescents comparing also family functioning in both samples.

METHOD

A total of 100 parents of adolescents with Type I Diabetes and 106 parents of healthy adolescents participated in this study. A confirmatory factor analysis was performed for both samples to analyze the adequacy of each model.

RESULTS

Both confirmatory factor analyses maintained the design in one-factor models with good fit indexes. The internal consistency in both samples was good, but slightly higher in parents of healthy adolescents. The instrument also presented good convergent and divergent validity.

DISCUSSION

The Portuguese version of the General Family Functioning subscale showed good psychometric properties and reliability in healthy adolescents and in adolescent with Type I Diabetes. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Individual and Family Management in Portuguese Adolescents with Type 1 Diabetes: a Path Analysis

BACKGROUND

This study evaluates the adequacy of the Revised Self and Family Management Framework (Grey et al., Nurs Outlook 63:162-170, 2015) in Portuguese adolescents with type 1 diabetes and analyzes the effect of parental coping, family support, and adherence in the association between illness representations, school support, metabolic control, quality of life, and family functioning.

METHOD

One hundred adolescents (aged 12-19) and their parents participated in a cross-sectional study. Adolescents were assessed on school support, adherence to self-care, family support, and quality of life. Parents were assessed on parental coping and family functioning. Both adolescents and parents were assessed on illness representations. Adolescent's metabolic control was evaluated through glycosylate hemoglobin.

RESULTS

Adolescents' and parents' illness representations were associated with metabolic control, quality of life and family functioning. Parental coping, family support and adherence had an indirect effect between illness representations and diabetes outcomes.

CONCLUSION

Findings showed the adequacy of Grey and colleagues' model (Nurs Outlook 63:162-170, 2015) in adolescents with type 1 diabetes and how family support, parental coping, and adherence contribute to diabetes management. Interventions to improve adolescents' and family's management of Type 1 diabetes should be designed to change adolescents' and family's representations and enhance their ability and skills in diabetes management.

Family functioning and quality of life in adolescents with type 1 diabetes: The role of dissimilarity in illness representations and school support

This study analyzed the impact of dissimilarities in illness perceptions between parents and adolescents, school support, and family functioning on quality of life of adolescents with type 1 diabetes (T1D). A total of 100 adolescents diagnosed with T1D for at least 1 year and a primary caregiver participated in the study (N=200). Adolescents answered the Diabetes Quality of Life and the School Support Questionnaire, and parents answered the general functioning subscale of the Family Assessment Device. Both answered the Brief-Illness Perception Questionnaire, regarding the adolescents' diabetes. The interception effect of dissimilarities regarding identity and concerns perceptions toward diabetes, between parents and adolescents, and school support in the relationship between family functioning and quality of life was significant and explained 27% and 32% of the variance, respectively. The results showed a negative relationship between family functioning and quality of life when school support was low and dissimilarities in identity and concerns perceptions were high. Therefore, to increase quality of life of adolescents with T1D, intervention programs should include family, teachers, school staff, and peers to improve their knowledge of diabetes and support to adolescents.