The University of Massachusetts–College of Nursing, Dartmouth, Massachusetts (Dr Keough)
University of Massachusetts–Graduate School of Nursing & Department of Pediatrics, Worcester, Massachusetts (Dr Sullivan-Bolyai)
Diabetes Educ. 2011 Jul-Aug;37(4):486-500. doi: 10.1177/0145721711406140. Epub 2011 May 20.
The purpose of this study was to examine differences in self-management behaviors (Collaboration with Parents, Diabetes Care Activities, Diabetes Problem Solving, Diabetes Communication, and Goals) between early, middle, and late adolescence. The role of regimen and gender as covariates in self-management behaviors was also examined.
This was a secondary analysis with a cross-sectional descriptive survey design. A sample of 504 participants ages 13 to 21 years from the Self-Management of Diabetes-Adolescent instrument development study were analyzed to determine self-management behaviors in early, middle, and late adolescence. This study was partially guided by the Self and Family Management Framework. This framework contains broad conceptual areas that are thought to pose a risk to or have a protective influence on self-management and family management behaviors and associated outcomes.
Significant findings included a decline between early, middle, and late adolescence in the Collaboration with Parents scale as well as an increase between early and late adolescence on the Diabetes Problem Solving scale. Regimen was a significant covariate for Collaboration with Parents, Diabetes Care Activities, and Diabetes Problem Solving, and gender was a significant covariate for Diabetes Care Activities and Diabetes Communication.
Clinicians should consider the influence of adolescent stage and development on self-management when educating adolescents. Youth and their families should be educated to consider the implications that regimen will have on daily self-management when making treatment decisions. Furthermore, gender variations can necessitate different educational approaches to meet different needs. Future research should identify other variables that can influence self-management at different points across adolescence.
本研究旨在探讨青少年早期、中期和晚期自我管理行为（与父母合作、糖尿病护理活动、糖尿病问题解决、糖尿病沟通和目标）的差异。还检查了方案和性别作为自我管理行为的协变量的作用。
这是一项具有横断面描述性调查设计的二次分析。对来自自我管理糖尿病-青少年工具开发研究的 504 名 13 至 21 岁的参与者样本进行了分析，以确定青少年早期、中期和晚期的自我管理行为。本研究部分遵循自我和家庭管理框架。该框架包含广泛的概念领域，这些领域被认为对自我管理和家庭管理行为及其相关结果构成风险或具有保护影响。
显著的发现包括在父母合作量表中，青少年早期、中期和晚期之间的下降，以及在糖尿病问题解决量表中，青少年早期和晚期之间的增加。方案是与父母合作、糖尿病护理活动和糖尿病问题解决的重要协变量，性别是糖尿病护理活动和糖尿病沟通的重要协变量。
临床医生在教育青少年时应考虑青少年阶段和发展对自我管理的影响。当做出治疗决策时，青年及其家属应接受教育，考虑方案对日常自我管理的影响。此外，性别差异可能需要不同的教育方法来满足不同的需求。未来的研究应确定在青少年时期的不同时间点影响自我管理的其他变量。
