Nardi Laura, Zucchini Stefano, D'Alberton Franco, Salardi Silvana, Maltoni Giulio, Bisacchi Nicoletta, Elleri Daniela, Cicognani Alessandro
Department of Pediatrics, Azienda Ospedaliero-Universitaria di Bologna Policlinico S Orsola-Malpighi, Via Massarenti, Bologna, Italy.
Pediatr Diabetes. 2008 Oct;9(5):496-503. doi: 10.1111/j.1399-5448.2008.00414.x. Epub 2008 May 28.
To evaluate self and parent reports on quality of life (QoL) and psychological adjustment of youths with type 1 diabetes, in comparison to a general paediatric population, and identify relationships between disease duration, metabolic control and psychological parameters.
Participants included 70 youths with type 1 diabetes and their parents. They were compared with 70 non-diabetic subjects. Data were analyzed in the whole group and in subgroups aged 6-10, 11-13 and 14-18 yr. All cases performed pediatric QoL, Child Behaviour Checklist, filled in by parents, and Youth Self-Report, filled in by youths. Data were compared with haemoglobin A1c (HbA1c) values and disease duration.
Self-reports showed a psychological adjustment of youths with type 1 diabetes similar to that of controls. Parent reports showed that parents of children with type 1 diabetes were more worried than those of controls (p < 0.01). Adolescents showed a worse QoL and more frequent psychological disturbances. In this group, for youth and parent reports, HbA1c levels correlated positively with psychological problems (p < 0.05) and negatively with QoL (p < 0.05). Only for parent reports, in the whole group and in subgroups aged 6-10 and 11-13 yr, disease duration correlated positively with psychological adjustment (p < 0.05).
Before adolescence, youths with type 1 diabetes showed only slight problems in psychological adjustment and QoL, with an association with disease duration reported by parents. In adolescence, both youths and their parents reported more emotional and behavioural problems, independent of disease duration. Better metabolic control and psychological well-being seemed directly related.
与普通儿科人群相比，评估1型糖尿病青少年的生活质量（QoL）自我报告和家长报告以及心理调适情况，并确定疾病持续时间、代谢控制与心理参数之间的关系。
参与者包括70名1型糖尿病青少年及其父母。将他们与70名非糖尿病受试者进行比较。对整个组以及6 - 10岁、11 - 13岁和14 - 18岁的亚组进行数据分析。所有病例均完成了儿科生活质量、由家长填写的儿童行为清单以及由青少年填写的青少年自我报告。将数据与糖化血红蛋白（HbA1c）值和疾病持续时间进行比较。
自我报告显示1型糖尿病青少年的心理调适与对照组相似。家长报告显示，1型糖尿病患儿的家长比对照组家长更担心（p < 0.01）。青少年的生活质量较差，心理困扰更频繁。在这个组中，对于青少年和家长报告，HbA1c水平与心理问题呈正相关（p < 0.05），与生活质量呈负相关（p < 0.05）。仅对于家长报告，在整个组以及6 - 10岁和11 - 13岁的亚组中，疾病持续时间与心理调适呈正相关（p < 0.05）。
在青春期之前，1型糖尿病青少年在心理调适和生活质量方面仅表现出轻微问题，家长报告称这与疾病持续时间有关。在青春期，青少年及其家长都报告了更多的情绪和行为问题，与疾病持续时间无关。更好的代谢控制和心理健康似乎直接相关。
