Longitudinal associations of diabetes-specific family conflict and diabetes management in adolescents with type 1 diabetes.

IF 1.2 4区 医学 Q3 FAMILY STUDIES
MaryJane S Campbell, Qinxin Shi, Jonathan Butner, Deborah J Wiebe, Cynthia A Berg
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Abstract

Introduction: Diabetes-specific family conflict is a risk factor for diabetes indicators (e.g., higher hemoglobin A1c (HbA1c), lower adherence), but little longitudinal data are available to understand associations across time. To better inform targets and timing of interventions, we examined (a) whether fluctuations in conflict covary with diabetes indicators within adolescents across time; (b) whether reciprocal associations exist; and (c) whether aspects of the parent-adolescent relationship (e.g., parental acceptance) buffer associations across time.

Method: Adolescents (N = 235, ages 11.5-15.5 at baseline, 53.6% female) completed measures of diabetes-related conflict with mothers and with fathers (separately), parental acceptance, and adherence every 6 months across 1 year (three time points). HbA1c was obtained from medical records. Data were collected in 2009.

Results: Bivariate between-person correlations indicated that at each time point, adolescents who reported more conflict with mothers and fathers also had higher HbA1c and lower adherence. Within-person correlations (fluctuations across three time points) indicated that fluctuations in conflict with mothers were associated with fluctuations in HbA1c but not adherence. Actor-partner multilevel models indicated that fluctuations in family conflict at each time point were not associated with future diabetes indicators. Parental acceptance did not moderate associations of family conflict and diabetes indicators.

Discussion: While findings corroborate extant literature noting that adolescents with high average diabetes-specific family conflict may benefit from interventions designed to reduce conflict, conflict at one time point may not be predictive of future diabetes indicators. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

1 型糖尿病青少年患者的糖尿病家庭冲突与糖尿病管理的纵向联系。
导言:糖尿病特异性家庭冲突是糖尿病指标(如较高的血红蛋白 A1c (HbA1c)、较低的依从性)的风险因素,但很少有纵向数据可用于了解不同时期的关联。为了更好地确定干预目标和时机,我们研究了:(a)冲突的波动是否与青少年糖尿病指标在不同时期存在协变关系;(b)是否存在相互关联;以及(c)父母与青少年关系的各个方面(如父母的接受程度)是否会缓冲不同时期的关联:青少年(人数 = 235,基线年龄为 11.5-15.5,53.6% 为女性)在一年内(三个时间点)每 6 个月完成一次与母亲和父亲(分别)的糖尿病相关冲突、父母接受度和依从性的测量。HbA1c 取自医疗记录。数据收集于 2009 年:结果:人与人之间的双变量相关性表明,在每个时间点,报告与母亲和父亲冲突较多的青少年的 HbA1c 也较高,依从性也较低。人内相关性(三个时间点的波动)表明,与母亲冲突的波动与 HbA1c 的波动有关,但与坚持率无关。角色-伙伴多层次模型表明,每个时间点的家庭冲突波动与未来的糖尿病指标无关。父母的接受程度并不能调节家庭冲突与糖尿病指标之间的关系:讨论:研究结果证实了现有文献的观点,即糖尿病家庭冲突平均值较高的青少年可能会从旨在减少冲突的干预措施中受益,但某个时间点的冲突可能无法预测未来的糖尿病指标。(PsycInfo Database Record (c) 2024 APA, 版权所有)。
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
Families Systems & Health
Families Systems & Health HEALTH CARE SCIENCES & SERVICES-PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
CiteScore
1.50
自引率
7.70%
发文量
81
审稿时长
>12 weeks
期刊介绍: Families, Systems, & Health publishes clinical research, training, and theoretical contributions in the areas of families and health, with particular focus on collaborative family healthcare.
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