Hansmann Merel, Volkening Lisa K, Snelgrove Rebecca K, Guo Zijing, Laffel Lori M
Section on Clinical, Behavioral, and Outcomes Research, Joslin Diabetes Center, Boston, MA.
Diabetes Spectr. 2023 Winter;36(1):23-32. doi: 10.2337/ds21-0107. Epub 2022 Jul 7.
The aims of this study were to assess domains of executive function in relation to diabetes management and glycemic control in adolescents with type 1 diabetes and to compare adolescent self-report and parent proxy-report of adolescent executive function.
Adolescents with type 1 diabetes ( = 169, 46% female, age 15.9 ± 1.3 years) and their parents completed self-report and parent proxy-report versions of the Behavior Rating Inventory of Executive Function (BRIEF).
Self-report and parent proxy-report BRIEF scores were moderately to strongly correlated; parent proxy scores were significantly higher than self-report scores. Executive function problems (Global Executive Composite score ≥60) occurred in 9% of adolescents by self-report and 26% by parent proxy-report. For almost all Metacognition Index scales, elevated ( score ≥60) parent proxy scores were associated with lower adherence, lower adolescent diabetes self-efficacy, and more parent involvement in diabetes management. Elevated scores on several Metacognition Index scales were associated with less pump use (Plan/Organize by self-report, Initiate by parent proxy-report, and Monitor by parent proxy-report) and higher A1C (Plan/Organize by self-report and parent proxy-report and Organization of Materials by parent proxy-report). The only significant associations for the Behavioral Regulation Index scales occurred for adherence (by parent proxy-report) and diabetes self-efficacy (by self-report and parent-report).
Adolescents with type 1 diabetes who have problems with metacognition may need additional support for diabetes self-management.
本研究旨在评估1型糖尿病青少年的执行功能领域与糖尿病管理及血糖控制的关系，并比较青少年执行功能的自我报告与家长代理报告。
1型糖尿病青少年（n = 169，46%为女性，年龄15.9±1.3岁）及其父母完成了执行功能行为评定量表（BRIEF）的自我报告版和家长代理报告版。
自我报告和家长代理报告的BRIEF分数呈中度到高度相关；家长代理分数显著高于自我报告分数。自我报告显示9%的青少年存在执行功能问题（总体执行能力综合得分≥60），家长代理报告显示为26%。对于几乎所有元认知指数量表，家长代理分数升高（得分≥60）与依从性降低、青少年糖尿病自我效能降低以及家长更多参与糖尿病管理相关。几个元认知指数量表得分升高与胰岛素泵使用减少（自我报告的计划/组织、家长代理报告的发起和家长代理报告的监控）和更高的糖化血红蛋白水平（自我报告和家长代理报告的计划/组织以及家长代理报告的材料组织）相关。行为调控指数量表的唯一显著关联出现在依从性（家长代理报告）和糖尿病自我效能（自我报告和家长报告）方面。
在元认知方面存在问题的1型糖尿病青少年可能需要在糖尿病自我管理方面获得额外支持。
