Factors influencing the psychological adjustment of young patients with Type 1 diabetes in the first year after diagnosis

Introduction: Factors have been identified in association with the psychological adjustment of children and adolescents with Type 1 diabetes such as metabolic control (McDonnell et al., 2007), maternal functioning (Schmidt, 2007) and protective parenting (Mullins et al., 2004). Parenting factors may have an impact on young children (Whittemore et al., 2003; Davis et al., 2001); while other factors such as self-efficacy are important to adolescent patients (Littlefield et al., 1992) as responsibility for diabetes management is gradually transferred from parent to child (Palmer et al., 2004). Many studies have examined family and peer support in the context of adolescents’ capacity to cope with their diabetes (La Greca & Bearman, 2002; Lewandowski & Drotar, 2007), but few have demonstrated the link between diabetes-specific factors for adolescent patients and psychological adjustment in their mothers (Berg et al., 2007). The number of studies on very young patients with Type 1 diabetes is also limited (Grey et al. 1995) in spite of the doubling of incidence of diabetes in children under five years of age in Australia (Taplin et al., 2005). Objective: To examine the child, adolescent and parental factors associated with psychological adjustment and health status in children and adolescents with Type 1 diabetes and their mothers over a post-diagnosis period of 12 months.Method: Sixty-two families of young patients from birth to 18 years of age completed standard measures in a longitudinal analysis on psychological and diabetes-specific variables. Data included child/adolescent measures of adjustment, self-report measures of maternal psychological adjustment, parental protectiveness, maternal separation anxiety, adolescent quality of life, self-efficacy and medical records of metabolic control at the first time point following diagnosis, and repeated at the second time point 12 months post-diagnosis. Results: Increased psychological symptoms in mothers were mildly associated with poor child/adolescent adjustment following diagnosis, and then moderately associated 12 months post-diagnosis. Metabolic control was adequate, although levels declined over time, and adolescent metabolic control was predicted by both maternal and adolescent adjustment. In a separate test, maternal and adolescent adjustment and self-efficacy were associated with quality of life for adolescents. Relatively high levels of maternal separation anxiety and protectiveness were shown; however they were not associated with the other variables. Conclusions: This study highlights the role of mothers in the adjustment of children and adolescents with Type 1 diabetes and the potential risk to the adjustment of a significant minority of young patients and their mothers over time. The influence of maternal adjustment to quality of life and diabetes health status of adolescents was emphasised. Support for families in the first year after diagnosis is indicated.

Level dc:type.qualificationlevel

other

Grantor dc:publisher.institution

Victoria University

Year dc:date.issued

2008

Author dc:creator

• Power, Helen Jennifer

• 380000 Behavioural and Cognitive Sciences
• School of Social Sciences and Psychology

Language dc:language

en