Giving adolescents with cystic fibrosis a voice: Predicting cystic fibrosis nutritional adherence from their decision-making involvement.

IF 2.7 3区心理学 Q2 PSYCHOLOGY, DEVELOPMENTAL

Journal of Pediatric Psychology Pub Date : 2024-07-01 DOI:10.1093/jpepsy/jsae034

Jennifer Kelleher, Kristine Durkin, David A Fedele, Kathryn Moffett, Stephanie S Filigno, Courtney Lynn, Robin S Everhart, Lori J Stark, Christina L Duncan

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引用次数: 0

Abstract

Objective: Suboptimal nutritional adherence in adolescents with cystic fibrosis (awCF) has been associated with lower lung function. AwCF often have more independence in dietary decisions than younger children, yet little research has examined how adolescent decision-making relates to nutritional adherence. This study explored whether components of adolescent decision-making involvement facilitate enzyme and caloric adherence in awCF.

Methods: 37 families participated and completed study procedures. AwCF and caregivers completed electronic surveys, including the Decision-Making Involvement Scale (DMIS). The DMIS evaluated awCF behaviors during nutrition-related decision-making/discussions with caregivers using DMIS subscales: Child Seek (asking for help/advice from caregivers), Child Express (awCF stating opinions) and Joint/Options (awCF participating in joint decision-making or caregiver providing options). AwCF completed 2, 24-hr diet recalls via videoconferencing/phone to estimate adherence. Chart reviews collected medical information. DMIS subscales were regressed onto enzyme and caloric adherence.

Results: 43% of awCF met calorie recommendations; 48.6% took all enzymes as prescribed. Caloric adherence was positively correlated with adolescent- and parent-reported Child Seek (r = 0.53; r = 0.36) and adolescent-reported Joint/Options (r = 0.41). Per adolescent-report, the caloric adherence regression model was significant, with Child Seek contributing unique variance in caloric adherence (β = .62, p = .03). Parent-reported adolescent-decision-making involvement significantly predicted caloric adherence, but none of the subscales contributed unique variance. No other regressions were significant.

Conclusions: When awCF participated in nutrition-related discussions with a caregiver, especially with questions, caloric adherence was better. Future research should examine whether family factors influence these results. AwCF are encouraged to ask questions in nutrition discussions.

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让患有囊性纤维化的青少年有发言权：从青少年的决策参与中预测囊性纤维化患者的营养依从性。

目的：囊性纤维化青少年（awCF）营养依从性不佳与肺功能降低有关。与年龄较小的儿童相比，囊性纤维化青少年通常在饮食决策方面有更大的独立性，但很少有研究探讨青少年的决策与营养依从性之间的关系。本研究探讨了青少年参与决策的因素是否有助于AwCF坚持摄入酶和热量。方法：37个家庭参与并完成了研究程序。AwCF和照顾者完成了电子调查，包括决策参与量表（DMIS）。DMIS 使用 DMIS 分量表评估了幼儿在与照顾者进行营养相关决策/讨论时的行为：儿童寻求（向看护人寻求帮助/建议）、儿童表达（AwCF 陈述意见）和共同/选择（AwCF 参与共同决策或看护人提供选择）。通过视频会议/电话，AwCF 完成了 2 次 24 小时饮食回顾，以评估饮食坚持情况。病历审查收集了医疗信息。将 DMIS 子量表与酶和热量依从性进行回归：43%的awCF符合热量建议；48.6%的awCF遵医嘱服用了所有酶制剂。卡路里摄入量与青少年和家长报告的 "寻找孩子"（Child Seek）（r = 0.53；r = 0.36）和青少年报告的 "关节/选择"（Joint/Options）（r = 0.41）呈正相关。根据青少年的报告，热量依从性回归模型是显著的，"寻找孩子 "对热量依从性有独特的影响（β = 0.62，p = 0.03）。家长报告的青少年参与决策的情况对热量依从性有显著的预测作用，但没有一个子量表对热量依从性有独特的影响。其他回归结果均不显著：当青少年参与与照顾者的营养相关讨论，尤其是提出问题时，热量摄入的依从性会更好。未来的研究应探讨家庭因素是否会影响这些结果。鼓励儿童营养顾问在营养讨论中提出问题。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Pediatric Psychology PSYCHOLOGY, DEVELOPMENTAL-

CiteScore

6.00

自引率

11.10%

发文量

期刊介绍： The Journal of Pediatric Psychology is the official journal of the Society of Pediatric Psychology, Division 54 of the American Psychological Association. The Journal of Pediatric Psychology publishes articles related to theory, research, and professional practice in pediatric psychology. Pediatric psychology is an integrated field of science and practice in which the principles of psychology are applied within the context of pediatric health. The field aims to promote the health and development of children, adolescents, and their families through use of evidence-based methods.