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糖尿病对依从性和生活质量的影响:父母与青少年有差异吗?

Diabetes representations on adherence and quality of life: Do parents and adolescents differ?

作者信息

Almeida Ana C, Leandro M Engrácia, Pereira M Graça

机构信息

Psychology Research Center, School of Psychology, University of Minho, Braga, Portugal.

Centre for Research and Studies in Sociology, University Institute of Lisbon, Campus da Cidade Universitária de Lisboa, Lisbon, Portugal.

出版信息

Psych J. 2023 Feb;12(1):108-118. doi: 10.1002/pchj.591. Epub 2022 Sep 13.

DOI:10.1002/pchj.591
PMID:36100433
Abstract

Type 1 diabetes is one of the most frequent chronic diseases in adolescents. To manage diabetes and prevent complications, a set of self-care behaviors needs to be implemented into family daily routines. This study analyzed diabetes representations in adolescents and their parents, the dissimilarities between them, and the relationship between illness dissimilarities and adherence/quality of life (QoL) in adolescents with type 1 diabetes. The sample included 200 participants: 100 adolescents with type 1 diabetes and 100 parents who accompanied the adolescents. Adolescents were assessed on adherence (Self-Care Inventory-Revised), quality of life (Diabetes QoL) and family support (Diabetes Family Behavior Scale). Both adolescents and parents were assessed on illness representations (Brief-Illness Perception Questionnaire). Dissimilarities in illness representations between parents and adolescents were performed using Olsen et al's proposal. Parents showed a more negative representation of diabetes than adolescents. Adolescents' illness representations, the dissimilarities between adolescents' and parents' illness representations, and family support were associated with adolescents' adherence and QoL. Higher family support moderated the relationship between the dissimilarity in timeline representations and QoL, explaining 17.8% of the variance on QoL. Adolescent's  gender (male) was a moderator in the relationship between adolescent's coherence and QoL, explaining 18.6% of the variance on QoL. Adolescent's gender (female) was a moderator in the relationship between timeline and QoL, explaining 11.9% of the variance on QoL. Being a male parent was a moderator in the relationship between adolescent's concerns and QoL, explaining 13.5% of the variance on QoL. Intervention programs should focus on illness representations, particularly on the dissimilarities between adolescents and parents, as well as on family support in order to promote adolescents' adherence and QoL.

摘要

1型糖尿病是青少年中最常见的慢性病之一。为了控制糖尿病并预防并发症,需要将一系列自我护理行为纳入家庭日常生活中。本研究分析了青少年及其父母对糖尿病的认知、他们之间的差异,以及1型糖尿病青少年的疾病认知差异与依从性/生活质量(QoL)之间的关系。样本包括200名参与者:100名1型糖尿病青少年和100名陪同青少年的父母。对青少年进行了依从性(修订版自我护理量表)、生活质量(糖尿病生活质量量表)和家庭支持(糖尿病家庭行为量表)评估。青少年和父母都进行了疾病认知评估(简易疾病认知问卷)。使用奥尔森等人的提议来分析父母与青少年在疾病认知上的差异。父母对糖尿病的认知比青少年更消极。青少年的疾病认知、青少年与父母疾病认知的差异以及家庭支持与青少年的依从性和生活质量相关。更高的家庭支持调节了时间线认知差异与生活质量之间的关系,解释了生活质量方差的17.8%。青少年的性别(男性)是青少年连贯性与生活质量关系的调节因素,解释了生活质量方差的18.6%。青少年的性别(女性)是时间线与生活质量关系的调节因素,解释了生活质量方差的11.9%。作为男性家长是青少年担忧与生活质量关系的调节因素,解释了生活质量方差的13.5%。干预项目应关注疾病认知,特别是青少年与父母之间的差异,以及家庭支持,以促进青少年的依从性和生活质量。

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