Department of Psychology, University of Utah.
Division of Psychology, Department of Psychiatry, University of Texas Southwestern Medical Center.
Health Psychol. 2014 May;33(5):424-32. doi: 10.1037/a0032804. Epub 2013 Jun 24.
The purpose of this study was to examine longitudinal trajectories of parental involvement and adolescent adherence to the Type 1 diabetes regimen, to determine whether changes in multiple facets of parental involvement over time predicted subsequent changes in adolescents' adherence, and to examine whether adolescent self-efficacy mediated the effect of parental involvement on adherence.
Two hundred fifty-two adolescents (M age = 12.49 years, SD = 1.53; 53.6% females) diagnosed with Type 1 diabetes mellitus, their mothers, and 188 fathers were enrolled in a 2.5-year longitudinal study. Across 5 time points, up to 252 adolescents and their parents completed measures of adherence, parental involvement (diabetes monitoring, behavioral involvement in diabetes management, and acceptance), and adolescent diabetes self-efficacy.
Using multilevel modeling, analyses indicated significant average declines over time in adherence and most indicators of parental involvement. Lagged multilevel models indicated that declines in mothers' and fathers' acceptance and diabetes monitoring predicted subsequent declines in adolescents' adherence. Additional analyses revealed that longitudinal associations between both maternal acceptance and diabetes monitoring and subsequent adolescent adherence were mediated by adolescents' self-efficacy.
Results of this study, which were largely consistent across reporters, highlight the importance of maintaining parental involvement in diabetes across adolescence and suggest that parental involvement is beneficial for adolescents' adherence, in part, because it contributes to higher self-efficacy for diabetes management among adolescents.
本研究旨在考察父母参与度和青少年对 1 型糖尿病治疗方案的依从性的纵向轨迹，以确定父母参与度在多个方面随时间的变化是否可以预测青少年依从性的后续变化，以及是否青少年自我效能感可以调节父母参与度对依从性的影响。
252 名青少年（平均年龄=12.49 岁，标准差=1.53；女性占 53.6%）被诊断患有 1 型糖尿病，他们的母亲和 188 位父亲参加了一项为期 2.5 年的纵向研究。在 5 个时间点上，最多有 252 名青少年及其父母完成了依从性、父母参与度（糖尿病监测、糖尿病管理中的行为参与和接受度）和青少年糖尿病自我效能感的测量。
使用多层次模型分析表明，在整个研究期间，青少年的依从性和父母参与度的大多数指标都呈显著下降趋势。滞后多层次模型表明，母亲和父亲的接受度和糖尿病监测的下降预测了青少年后续的依从性下降。进一步的分析显示，母亲的接受度和糖尿病监测与青少年后续的依从性之间的纵向关联，部分是通过青少年的自我效能感来介导的。
本研究结果在很大程度上与报告人一致，强调了在青少年时期保持父母参与度对糖尿病管理的重要性，并表明父母参与度对青少年的依从性有益，部分原因是它可以提高青少年对糖尿病管理的自我效能感。
