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初级和二级照料者的协作参与:与青少年糖尿病结局的关联

Collaborative involvement of primary and secondary caregivers: associations with youths' diabetes outcomes.

作者信息

Wysocki Tim, Nansel Tonja R, Holmbeck Grayson N, Chen Rusan, Laffel Lori, Anderson Barbara J, Weissberg-Benchell Jill

机构信息

Nemours Children's Clinic, Jacksonville, FL 32207, USA.

出版信息

J Pediatr Psychol. 2009 Sep;34(8):869-81. doi: 10.1093/jpepsy/jsn136. Epub 2008 Dec 26.

Abstract

OBJECTIVE

Collaboration between youths with type 1 diabetes (T1D) and their adult caregivers may be central to effective management of T1D. This article includes analysis of cross-sectional associations between T1D outcomes (adherence, glycemic control, quality of life, family conflict, depression, and self-efficacy) and scores on the Collaborative Parent Involvement (CPI) Scale obtained from 309 youths with T1D about their primary and secondary caregivers.

METHODS

MANCOVA, controlling for age, evaluated associations of diabetes outcomes with youths' CPI scores for each caregiver.

RESULTS

Diabetes outcomes were poor when both caregivers obtained CPI scores below the median. Diabetes outcomes were more strongly associated with CPI scores of primary, rather than secondary, caregivers. CPI scores at or above the median among primary caregivers were associated with more favorable status on multiple youth outcomes. When both caregivers obtained CPI scores at or above the median, children had significantly lower HbA1C and parents retained more responsibility for diabetes care.

CONCLUSIONS

Higher collaborative involvement, particularly among primary caregivers, was associated with favorable status along a variety of diabetes outcomes. Longitudinal studies could confirm if youth-parent collaboration is a justifiable intervention target.

摘要

目的

1型糖尿病(T1D)青少年与其成年照料者之间的协作可能是T1D有效管理的核心。本文分析了309名T1D青少年就其主要和次要照料者在协作式家长参与(CPI)量表上的得分与T1D结局(依从性、血糖控制、生活质量、家庭冲突、抑郁和自我效能感)之间的横断面关联。

方法

采用多因素协方差分析,控制年龄因素,评估每位照料者的青少年CPI得分与糖尿病结局之间的关联。

结果

当两位照料者的CPI得分均低于中位数时,糖尿病结局较差。糖尿病结局与主要照料者的CPI得分而非次要照料者的CPI得分关联更强。主要照料者的CPI得分处于或高于中位数与多项青少年结局的更有利状况相关。当两位照料者的CPI得分均处于或高于中位数时,儿童的糖化血红蛋白(HbA1C)显著更低,且父母对糖尿病护理承担更多责任。

结论

更高的协作参与度,尤其是主要照料者中的协作参与度,与多种糖尿病结局的有利状况相关。纵向研究可以证实青少年与家长之间的协作是否是一个合理的干预目标。

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