Hood Korey K, Butler Deborah A, Anderson Barbara J, Laffel Lori M B
Pediatric, Adolescent, and Young Adult Section, Joslin Diabetes Center, Harvard Medical School, Boston, MA 02215, USA.
Diabetes Care. 2007 Jul;30(7):1764-9. doi: 10.2337/dc06-2358. Epub 2007 Mar 19.
The purpose of this study was to update the Diabetes Family Conflict Scale (DFCS) in the era of intensive diabetes management and provide an indication of its psychometric properties.
The revised DFCS and measures of negative emotions around blood glucose monitoring (BGM), quality of life, and perceived parental burden from diabetes management were completed by 202 children and adolescents with type 1 diabetes and their primary caregivers. Insulin regimen, adherence, and glycemic control were also assessed.
The revised DFCS demonstrated strong psychometric properties. There was acceptable internal consistency for child and caregiver forms of the DFCS. Factor analysis revealed two factors related to direct and indirect management tasks. Both child (r = 0.27, P < 0.01) and caregiver (r = 0.26, P < 0.01) DFCS scores were correlated with A1C values. Multivariate analysis of factors usually associated with A1C values showed an additive, independent contribution of diabetes-specific family conflict to the prediction of glycemic control: F (12,189) = 6.17, P < 0.01, R2 = 0.28. Conflict around direct management tasks (e.g., BGM) was a more important predictor of higher A1C levels than conflict around indirect management tasks (e.g., telling friends about diabetes).
The revised and updated DFCS demonstrates strong psychometric properties and can be used as a tool for measuring the level of diabetes-specific conflict in families with children and adolescents with type 1 diabetes.
本研究旨在更新强化糖尿病管理时代的糖尿病家庭冲突量表(DFCS),并给出其心理测量特性的相关指标。
202名1型糖尿病儿童及青少年及其主要照顾者完成了修订后的DFCS以及血糖监测(BGM)周围负面情绪、生活质量和糖尿病管理中感知到的父母负担的测量。还评估了胰岛素治疗方案、依从性和血糖控制情况。
修订后的DFCS显示出很强的心理测量特性。DFCS儿童版和照顾者版具有可接受的内部一致性。因子分析揭示了与直接和间接管理任务相关的两个因子。儿童(r = 0.27,P < 0.01)和照顾者(r = 0.26,P < 0.01)的DFCS得分均与糖化血红蛋白(A1C)值相关。对通常与A1C值相关的因素进行多变量分析表明,糖尿病特异性家庭冲突对血糖控制预测有累加、独立的贡献:F(12,189)= 6.17,P < 0.01,R2 = 0.28。直接管理任务(如血糖监测)周围的冲突比间接管理任务(如向朋友讲述糖尿病)周围的冲突更能预测更高的A1C水平。
修订和更新后的DFCS显示出很强的心理测量特性,可作为测量1型糖尿病儿童及青少年家庭中糖尿病特异性冲突水平的工具。