Psychosocial family factors and glycemic control among children aged 1-15 years with type 1 diabetes: a population-based survey

BMC Pediatrics

Research Article

Tore Wentzel-Larsen¹  Berit Rokne²  Marit Graue³  Anne Haugstvedt⁴ 

[1] Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway;Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway;Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway;Department of Public Health and Primary Health Care, University of Bergen, Norway;Faculty of Health and Social Sciences, Bergen University College, Norway;Department of Pediatrics, Haukeland University Hospital, Bergen, Norway;Faculty of Health and Social Sciences, Bergen University College, Norway;Department of Public Health and Primary Health Care, University of Bergen, Norway;Department of Pediatrics, Haukeland University Hospital, Bergen, Norway;

关键词: Glycemic Control;    Marital Relationship;    Poor Glycemic Control;    Blood Glucose Measurement;    Good Glycemic Control;   

DOI  :  10.1186/1471-2431-11-118

 received in 2011-05-13, accepted in 2011-12-20,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundBeing the parents of children with diabetes is demanding. Jay Belsky's determinants of parenting model emphasizes both the personal psychological resources, the characteristics of the child and contextual sources such as parents' work, marital relations and social network support as important determinants for parenting. To better understand the factors influencing parental functioning among parents of children with type 1 diabetes, we aimed to investigate associations between the children's glycated hemoglobin (HbA1c) and 1) variables related to the parents' psychological and contextual resources, and 2) frequency of blood glucose measurement as a marker for diabetes-related parenting behavior.MethodsMothers (n = 103) and fathers (n = 97) of 115 children younger than 16 years old participated in a population-based survey. The questionnaire comprised the Life Orientation Test, the Oslo 3-item Social Support Scale, a single question regarding perceived social limitation because of the child's diabetes, the Relationship Satisfaction Scale and demographic and clinical variables. We investigated associations by using regression analysis. Related to the second aim hypoglycemic events, child age, diabetes duration, insulin regimen and comorbid diseases were included as covariates.ResultsThe mean HbA1c was 8.1%, and 29% had HbA1c ≤ 7.5%. In multiple regression analysis, lower HbA1c was associated with higher education and stronger perceptions of social limitation among the mothers. A higher frequency of blood glucose measurement was significantly associated with lower HbA1c in bivariate analysis. Higher child age was significantly associated with higher HbA1c both in bivariate and multivariate analysis. A scatterplot indicated this association to be linear.ConclusionsMost families do not reach recommended treatment goals for their child with type 1 diabetes. Concerning contextual sources of stress and support, the families who successfully reached the treatment goals had mothers with higher education and experienced a higher degree of social limitations because of the child's diabetes. The continuous increasing HbA1c by age, also during the years before puberty, may indicate a need for further exploring the associations between child characteristics, context-related variables and parenting behavior such as factors facilitating the transfer of parents' responsibility and motivation for continued frequent treatment tasks to their growing children.

【 授权许可】

CC BY   
© Haugstvedt et al; licensee BioMed Central Ltd. 2011