Aim: To construct a model addressing the pathways from baseline diabetes distress, attribution of peer reactions, parenting style and 3-month self-management to 6-month glycated haemoglobin 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 haemoglobin levels were collected at the sixth month. Data were collected from May 2015-June 2016.
Results: Baseline diabetes distress and 3-month self-management directly affected 6-month glycated haemoglobin levels. Baseline attribution of peer reactions directly affected baseline diabetes distress and 3-month self-management; also, it indirectly affected 6-month glycated haemoglobin levels through 3-month self-management. Baseline parenting style directly affected baseline diabetes distress, baseline attribution of peer reactions, 3-month self-management and 6-month glycated haemoglobin levels; it also indirectly affected 6-month glycated haemoglobin levels through baseline diabetes distress and 3-month self-management.
Conclusion: A model simultaneously incorporating individual, parental and peer factors to glycaemic control in adolescents with type 1 diabetes has been constructed. Improving diabetes distress and self-management should be essential strategies to improve glycaemic control in adolescents with type 1 diabetes. Encouraging adolescents with type 1 diabetes to communicate openly with peers about diabetes care and educating their parents to provide more responsive and autonomy-encouraging parenting style might be vital strategies to improve diabetes distress, 3-month self-management and glycaemic control.
Impact: Individual, parental and peer factors should be simultaneously considered to improve glycaemic control in adolescents with type 1 diabetes. Nurses should evaluate these factors to tailor interventions improving glycaemic control in adolescents with type 1 diabetes.
目的: 构建模型,说明患有1型糖尿病青少年从基准时间糖尿病困扰、同龄人反应归因、父母教养方式以及3个月自我管理到6个月糖化血红蛋白水平的转变途径。 设计: 采用前瞻性设计。 方法: 共选取台湾四所医院177名10-19岁患有1型糖尿病的青少年作为研究对象。于基准时间收集糖尿病困扰、同龄人反应归因和父母教养方式情况数据,于第3个月收集自我管理情况数据,于第6个月收集糖化血红蛋白水平数据。数据于2015年5月至2016年6月期间收集。 结果: 基准时间糖尿病困扰和3个月的自我管理对6个月时的糖化血红蛋白水平有直接影响。基准时间同龄人反应归因会直接影响基准时间糖尿病困扰以及3个月的自我管理情况;同时,它还通过3个月的自我管理对6个月时的糖化血红蛋白水平产生间接影响。基准时间父母教养方式对基准时间糖尿病困扰、基准时间同龄人反应归因、3个月的自我管理情况以及6个月时的糖化血红蛋白水平具有直接影响;同时,它还通过基准时间糖尿病困扰和3个月的自我管理情况对6个月时的糖化血红蛋白水平产生间接影响。 结论: 本研究建立了一个针对患有1型糖尿病青少年的血糖控制模型,且该模型同时纳入了个人、父母和同龄人因素。改善糖尿病困扰和自我管理情况应可作为改善患有1型糖尿病的青少年的血糖控制的基本策略。通过鼓励患有1型糖尿病的青少年与同龄人就糖尿病护理进行坦诚沟通,并指导其父母提供更多的响应式和自主鼓励式教养方式,此等方法可成为改善糖尿病困扰、3个月自我管理和血糖控制的重要策略。 影响: 为改善患有1型糖尿病的青少年的血糖控制情况,应同时考虑个人、父母和同龄人因素。护士应对此类因素进行评估,为患有1型糖尿病的青少年量身制定干预措施,以改善其血糖控制情况。.
Keywords: adolescents; diabetes distress; glycaemic control; model; nurses; parents; peers; self-management; type 1 diabetes.
© 2020 John Wiley & Sons Ltd.