Hanna K M, Weaver M T, Stump T E, Dimeglio L A, Miller A R, Crowder S, Fortenberry J D
Indiana University School of Nursing Division of Biostatistics, Indiana University School of Medicine, and Indiana University School of Medicine, Indianapolis, IN 46202, USA.
Child Care Health Dev. 2013 Jan;39(1):61-8. doi: 10.1111/j.1365-2214.2011.01320.x. Epub 2011 Oct 21.
Emerging adults with diabetes are assuming diabetes care responsibility, graduating from high school and leaving their parental homes. We examined: (1) how diabetes care responsibility changed in relation to time (high school to post high school) and living situation (living independently or not of parents) and (2) the association of diabetes self-efficacy, worry about hypoglycaemia, gender and glycaemic control with these changes in responsibility among emerging adults with type 1 diabetes.
During the last 6 months in high school (T1), 113 participants completed diabetes care responsibility (total, daily and non-daily), diabetes self-efficacy and worry about hypoglycaemia scales. Participants again completed the responsibility scales post high school graduation (T2). We used a linear mixed-effects model with diabetes self-efficacy, worry about hypoglycaemia, time since graduation, living situation, gender and glycaemic control as independent variables; and diabetes care responsibility (total, daily and non-daily) as dependent variables. Moderation involving diabetes self-efficacy, worry about hypoglycaemia, gender and glycaemic control was also tested.
Diabetes care responsibility increased over time for total (P < 0.001), daily (P= 0.002) and non-daily (P < 0.001), but the associations of self-efficacy and gender with diabetes care responsibility were moderated by living situation. Self-efficacy was negatively related to total (P= 0.006), daily (P= 0.010) and non-daily (P= 0.030) responsibility for those not living independently while positively related only to total responsibility (P= 0.028) for those living independently. Being female was positively related to total (P= 0.007) and non-daily (P= 0.001) responsibility for those living independently.
Diabetes care responsibility increased from high school to post high school among these emerging adults with diabetes. There is a complex relationship between self-efficacy, gender and responsibility related to living independently of parents for these youth.
患有糖尿病的青少年逐渐承担起糖尿病护理责任，他们高中毕业并离开父母家。我们研究了：（1）糖尿病护理责任如何随时间（从高中到高中后）和生活状况（是否独立于父母生活）而变化；（2）糖尿病自我效能感、对低血糖的担忧、性别和血糖控制与这些1型糖尿病青少年责任变化之间的关联。
在高中的最后6个月（T1），113名参与者完成了糖尿病护理责任量表（总分、日常和非日常）、糖尿病自我效能感量表以及对低血糖的担忧量表。参与者在高中毕业（T2）后再次完成责任量表。我们使用线性混合效应模型，将糖尿病自我效能感、对低血糖的担忧、毕业时间、生活状况、性别和血糖控制作为自变量；将糖尿病护理责任（总分、日常和非日常）作为因变量。还测试了涉及糖尿病自我效能感、对低血糖的担忧、性别和血糖控制的调节作用。
随着时间推移，糖尿病护理责任在总分（P<0.001）、日常（P = 0.002）和非日常（P<0.001）方面均有所增加，但自我效能感和性别与糖尿病护理责任的关联受到生活状况的调节。对于不独立生活的人，自我效能感与总分（P = 0.006）、日常（P = 0.010）和非日常（P = 0.030）责任呈负相关，而对于独立生活的人，自我效能感仅与总分责任呈正相关（P = 0.028）。对于独立生活的女性，女性身份与总分（P = 0.007）和非日常（P = 0.001）责任呈正相关。
在这些患有糖尿病的青少年中，糖尿病护理责任从高中到高中后有所增加。对于这些青少年，自我效能感、性别和与独立于父母生活相关的责任之间存在复杂的关系。
