Vesco Anthony T, Feldman Marissa A, Evans Meredyth A, Weissberg-Benchell Jill
Department of Psychiatry and Behavioral Health.
Fam Syst Health. 2018 Sep;36(3):357-367. doi: 10.1037/fsh0000358. Epub 2018 Jul 12.
This study examined concordance and discordance between parent-adolescent report of diabetes-specific emotional distress and associations with A1c and diabetes-related strengths. refer to adaptive behaviors and attitudes that enhance resilience in living with diabetes.
One thousand two hundred sixteen adolescent-parent dyads completed measures of diabetes distress and adolescent-reported diabetes strengths. Polynomial regression with response surface analysis assessed concordant and discordant reports of adolescent-parent distress and independent associations of each reporter's distress on measures of diabetes strengths and A1c.
A1c was lower in concordantly lower distress dyads compared to concordantly higher distress dyads. For discordant dyadic reports, A1c was higher when distress was higher for parents and lower for adolescents compared to low-parent-high-adolescent distress. Greater diabetes-related strengths were reported when distress was concordantly low among dyads and fewer strengths were reported when distress was concordantly higher. Greater strengths were reported when distress was lower for adolescents and higher for parents compared to high-adolescent/low-parent distress. Dyadic distress for both A1c and diabetes strengths were robust when adjusted for significant demographic predictors of outcome including age, race, income, pump use, and continuous glucose monitoring use.
A1c and diabetes strengths are associated with degree of concordant and discordant reports of diabetes distress among adolescent-parent dyads. Programmatic interventions should target parents and adolescents, particularly when diabetes distress is higher among both adolescents and their parents. (PsycINFO Database Record
本研究考察了青少年与父母报告的糖尿病特异性情绪困扰之间的一致性和不一致性,以及与糖化血红蛋白(A1c)和糖尿病相关优势的关联。糖尿病相关优势是指有助于增强糖尿病患者生活适应能力的行为和态度。
1216对青少年-父母二元组完成了糖尿病困扰测量以及青少年报告的糖尿病优势测量。采用带有响应面分析的多项式回归评估青少年与父母困扰的一致和不一致报告,以及每位报告者的困扰与糖尿病优势和糖化血红蛋白测量值之间的独立关联。
与困扰程度一致较高的二元组相比,困扰程度一致较低的二元组糖化血红蛋白水平更低。对于不一致的二元组报告,与父母困扰程度高而青少年困扰程度低的情况相比,当父母困扰程度高而青少年困扰程度低时,糖化血红蛋白水平更高。当二元组中困扰程度一致较低时,报告的糖尿病相关优势更大;当困扰程度一致较高时,报告的优势更少。与青少年困扰程度高/父母困扰程度低的情况相比,当青少年困扰程度低而父母困扰程度高时,报告的优势更大。在对包括年龄、种族、收入、胰岛素泵使用和持续血糖监测使用等显著的人口统计学预测因素进行调整后,糖化血红蛋白和糖尿病优势的二元组困扰仍然显著。
糖化血红蛋白和糖尿病优势与青少年-父母二元组中糖尿病困扰的一致和不一致报告程度相关。系统性干预应针对父母和青少年,尤其是当青少年及其父母的糖尿病困扰都较高时。(《心理学文摘数据库记录》