Division of Endocrinology, Diabetes and Clinical Pharmacology, Department of Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA.
Division of Pediatric Psychology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Diabet Med. 2024 May;41(5):e15300. doi: 10.1111/dme.15300. Epub 2024 Feb 2.
Maternal caregiver involvement is strongly associated with psychosocial and glycemic outcomes amongst adolescents with type 1 diabetes (T1D); however, previous studies have lacked detailed, objective examinations of caregiver involvement. We examined the relationship between observed parenting behaviors and psychosocial and glycemic outcomes amongst youth with T1D.
Data collected from adolescents with T1D (age 11-17) and their female caregivers as a part of a randomized controlled trial were analyzed. These included structured, observation-based scores of adolescent-caregiver dyads engaged in videotaped interactions and selected psychosocial and glycemic outcome measures.
In adjusted analyses, higher levels of intrusive parenting behaviors during observed interactions were associated with higher diabetes distress in adolescents, but no difference in HbA1c. Associations between intrusive parenting behaviors and psychosocial outcomes were stronger for females compared to males for both diabetes distress and quality of life. Similarly, associations between collaborative parenting behaviors and quality of life were stronger for female adolescents than males. No associations were observed between collaborative parenting behaviors and glycemic outcomes. Consistent with previous work, we noted higher levels of adolescent-reported family conflict were associated with lower adolescent quality of life and higher diabetes distress with no significant difference between male and female adolescents.
These findings indicate that high levels of intrusive parenting behaviors, such as lecturing or over-controlling behaviors, are associated with lower levels of adolescent well-being, particularly among adolescent girls. This work suggests that interventions to reduce intrusive parenting by maternal caregivers could result in improved psychosocial outcomes for adolescents with T1D.
在 1 型糖尿病（T1D）青少年中，母亲照顾者的参与与心理社会和血糖结果密切相关；然而，以前的研究缺乏对照顾者参与情况的详细、客观的检查。我们研究了观察到的父母行为与 T1D 青少年的心理社会和血糖结果之间的关系。
从作为随机对照试验一部分的 T1D 青少年（年龄 11-17 岁）及其女性照顾者那里收集的数据进行了分析。这些数据包括青少年-照顾者对在录像互动中参与的观察性结构评分以及选择的心理社会和血糖结果测量。
在调整分析中，观察到的互动中过度养育行为水平较高与青少年的糖尿病困扰程度较高相关，但与 HbA1c 没有差异。与男性相比，女性青少年的过度养育行为与糖尿病困扰和生活质量之间的关联更强。同样，协作养育行为与生活质量之间的关联在女性青少年中比男性更强。协作养育行为与血糖结果之间没有关联。与以前的工作一致，我们注意到青少年报告的家庭冲突水平较高与青少年生活质量较低和糖尿病困扰程度较高相关，而男性和女性青少年之间没有显著差异。
这些发现表明，高水平的过度养育行为，如说教或过度控制行为，与青少年幸福感水平较低有关，特别是在少女中。这项工作表明，通过减少母亲照顾者的过度养育行为的干预措施可能会改善 T1D 青少年的心理社会结果。
