Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O.Box: 19395-4763, Tehran, Iran.
Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
BMC Psychol. 2020 Apr 6;8(1):30. doi: 10.1186/s40359-020-00396-3.
Several studies indicate the role of psychosocial factors in the management and control of chronic diseases in adolescents. In this regard, the roles of attachment and alexithymia in the management of type 1 diabetes in adolescents and related gender-specific patterns have rarely been the focus of empirical research. In this study we investigate the gender-specific relationship of alexithymia and attachment with self-care and blood glucose level in adolescents with type1 diabetes.
This is a cross-sectional study conducted on adolescents aged 12-18 years, with type 1 diabetes. Participants were recruited from diabetes clinics and the Iranian Diabetes Society. Data were collected using the Farsi versions of the Toronto Alexithymia Scale (FTAS-20), the Inventory of Parent and Peer Attachment (IPPA) and the Summary of Diabetes Self-Care Activities Scale (SDSCA). Blood glucose levels were measured by determining HbA1c which were abstracted from medical records. Data were analyzed using SPSS21 software.
Participants were 150 adolescents (57% female), mean age 14.97 ± 2.30. Alexithymia (β = 0.10, P = 0.01), difficulty identifying feelings (β = 0.15, P = 0.03) and communication with mothers (β = - 0.08, P = 0.03) predicted HbA1c in girls, whereas no significant relationships were observed for HbA1c with alexithymia and attachment in boys. Factors that predicted self-care in girls were alexithymia (β = - 0.04, P = 0.02), difficulty identifying feelings (β = - 0.06, P = 0.04); in boys however in addition to these two factors predicting self-care [alexithymia (β = - 0.07, P = 0.01) and difficulty identifying feelings (β = - 0.11, P = 0.01)], we also found difficulty describing feelings (β = - 0.16, P = 0.02), communication with mother (β = 0.04, P = 0.04), alienation to mother (β = - 0.06, P = 0.03), to father (β = - 0.06, P = 0.01) and to peers (β = - 0.09, P = 0.03).
Our results suggest that, in a gender-specific pattern, alexithymia and attachment could affect self-care and blood glucose level in adolescents with type 1 diabetes; findings that can be used to facilitate more effective treatment strategies and interventions in this age group.
多项研究表明，心理社会因素在青少年慢性病的管理和控制中起着重要作用。在这方面，依恋和述情障碍在青少年 1 型糖尿病管理中的作用以及相关的性别特定模式很少成为实证研究的焦点。本研究旨在调查 1 型糖尿病青少年中述情障碍和依恋与自我护理及血糖水平的性别特异性关系。
这是一项横断面研究，纳入了 12-18 岁的 1 型糖尿病青少年。参与者从糖尿病诊所和伊朗糖尿病协会招募。使用 Farsi 版多伦多述情障碍量表（FTAS-20）、父母和同伴依恋量表（IPPA）和糖尿病自我护理活动量表（SDSCA）收集数据。血糖水平通过测定 HbA1c 来衡量，HbA1c 从病历中提取。数据使用 SPSS21 软件进行分析。
参与者为 150 名青少年（57%为女性），平均年龄为 14.97±2.30 岁。在女孩中，述情障碍（β=0.10，P=0.01）、识别情感困难（β=0.15，P=0.03）和与母亲的沟通（β=-0.08，P=0.03）与 HbA1c 相关，而男孩中述情障碍和依恋与 HbA1c 之间无显著相关性。在女孩中，预测自我护理的因素有述情障碍（β=-0.04，P=0.02）、识别情感困难（β=-0.06，P=0.04）；而在男孩中，除了这两个因素（述情障碍（β=-0.07，P=0.01）和识别情感困难（β=-0.11，P=0.01））外，我们还发现描述情感困难（β=-0.16，P=0.02）、与母亲的沟通（β=0.04，P=0.04）、与母亲的疏远（β=-0.06，P=0.03）、与父亲的疏远（β=-0.06，P=0.01）和与同伴的疏远（β=-0.09，P=0.03）也与自我护理相关。
我们的研究结果表明，在性别特定模式下，述情障碍和依恋可能会影响 1 型糖尿病青少年的自我护理和血糖水平；这些发现可以用于促进该年龄段更有效的治疗策略和干预措施。
