Patton Susana R, Dolan Lawrence M, Powers Scott W
Division of Child Behavioral Health, Department of Pediatrics and Communicable Diseases, C.S. Mott Children's Hospital and the University of Michigan, Ann Arbor, MI 48109-0318, USA.
Diabetes Care. 2006 May;29(5):1002-6. doi: 10.2337/diacare.2951002.
This study examined the relationships between parent-child mealtime interactions and dietary adherence and glycemic control in young children with type 1 diabetes. It was hypothesized that young children who exhibited disruptive mealtime behaviors would have more dietary deviations (poorer dietary adherence) and poor glycemic control. It was also hypothesized that parents of young children who used ineffective/coercive parenting strategies at mealtimes would have children with more dietary deviations and poor glycemic control.
A total of 35 families of children (aged 2.2-7.9 years) with type 1 diabetes were recruited from a pediatric hospital. Families had at least three meals videotaped in their home, which were coded for parent, child, and eating behaviors, using the Dyadic Interaction Nomenclature for Eating. Children's dietary adherence was assessed according to deviations from the prescribed number of carbohydrate units per meal. Children's average glycemic excursion was assessed prospectively for 2 weeks, using a standardized home blood glucose meter.
Findings demonstrated significant positive relationships between children's mealtime behavior, dietary deviations, and glycemic control. An examination of parent behaviors revealed significant positive correlations between parents' use of ineffective/coercive parenting strategies and children's dietary deviations and glycemic control.
This was the first study to examine the relationship between parent-child mealtime interactions and health outcomes in young children with type 1 diabetes. The mealtime problems examined can be improved through specific behavioral interventions. Future research is needed to examine how parent-child interactions at mealtimes relate to children's health outcomes to inform clinical care.
本研究探讨了1型糖尿病幼儿的亲子用餐互动与饮食依从性及血糖控制之间的关系。研究假设表现出用餐时破坏性行为的幼儿会有更多的饮食偏差（较差的饮食依从性）和血糖控制不佳的情况。还假设在用餐时使用无效/强制育儿策略的幼儿家长会有饮食偏差更多且血糖控制不佳的孩子。
从一家儿科医院招募了35个患有1型糖尿病的儿童家庭（年龄在2.2 - 7.9岁之间）。家庭至少有三餐在家中被录像，使用饮食二元互动命名法对家长、孩子和进食行为进行编码。根据每餐规定碳水化合物单位数量的偏差评估儿童的饮食依从性。使用标准化家用血糖仪对儿童的平均血糖波动进行了为期2周的前瞻性评估。
研究结果表明儿童用餐行为、饮食偏差和血糖控制之间存在显著的正相关关系。对家长行为的检查发现，家长使用无效/强制育儿策略与儿童饮食偏差和血糖控制之间存在显著的正相关。
这是第一项研究1型糖尿病幼儿亲子用餐互动与健康结果之间关系的研究。所研究的用餐问题可通过特定的行为干预得到改善。需要进一步研究用餐时的亲子互动如何与儿童健康结果相关，以为临床护理提供参考。
