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J Adv Nurs. 2020 Feb 7. doi: 10.1111/jan.14317. [Epub ahead of print]

Modeling Individual, Parental and Peer Factors to Glycemic Control in Adolescents with Type 1 Diabetes: A Prospective Study.

Author information

1
College of Nursing, Kaohsiung Medical University, No. 100, Shih-Chuan 1st Rd, San-Ming District, Kaohsiung City, 80708, Taiwan.
2
School of Nursing, University of California, 2 Koret Way, Rm 405L UCSF Box 0606, San Francisco, CA, 94143, United States.
3
Division of Genetics Metabolism and Endocrinology, Department of Pediatrics, National Cheng Kung University Hospital, and Clinical Assistant Professor, College of Medicine, National Cheng Kung University, No.138, Sheng Li Road, Tainan City, 704, Taiwan.
4
Department of Nursing, Changhua Christian Hospital, and Assistant Professor, College of Nursing and Health Sciences, Dayeh University, No.135, Nanxiao St., Changhua City, Changhua County 500, Taiwan.
5
College of Nursing, Kaohsiung Medical University, Adjunct researcher, Department of Medical Research, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan.

Abstract

AIM:

To construct a model addressing the pathways from baseline diabetes distress, attribution of peer reactions, parenting style and three-month self-management to six-month glycated hemoglobin levels in adolescents with type 1 diabetes.

DESIGN:

A prospective design was adopted.

METHODS:

A total of 177 adolescents aged 10-19 with type 1 diabetes were enrolled from four hospitals in Taiwan. Diabetes distress, attribution of peer reactions and parenting style were collected at baseline, self-management was collected at the third month and glycated hemoglobin levels were collected at the sixth month. Data were collected from May 2015 to June 2016.

RESULTS:

Baseline diabetes distress and three-month self-management directly affected six-month glycated hemoglobin levels. Baseline attribution of peer reactions directly affected baseline diabetes distress and three-month self-management; also, it indirectly affected six-month glycated hemoglobin levels through three-month self-management. Baseline parenting style directly affected baseline diabetes distress, baseline attribution of peer reactions, three-month self-management and six-month glycated hemoglobin levels; it also indirectly affected six-month glycated hemoglobin levels through baseline diabetes distress and three-month self-management.

CONCLUSION:

A model simultaneously incorporating individual, parental and peer factors to glycemic control in adolescents with type 1 diabetes has been constructed. Improving diabetes distress and self-management should be essential strategies to improve glycemic control in adolescents with type 1 diabetes. Encouraging adolescents with type 1 diabetes to communicate openly with peers regarding diabetes care and educating their parents to provide more responsive and autonomy-encouraging parenting style might be vital strategies to improve diabetes distress, three-month self-management and glycemic control.

IMPACT:

Individual, parental and peer factors should be simultaneously considered to improve glycemic control in adolescents with type 1 diabetes. Nurses should evaluate these factors to tailor interventions improving glycemic control in adolescents with type 1 diabetes.

KEYWORDS:

adolescents; diabetes distress; glycemic control; model; nurses; parents; peers; self-management; type 1 diabetes

PMID:
32030779
DOI:
10.1111/jan.14317

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