A family development approach to studying factors in the management and control of childhood diabetes.

The study of family factors that relate to diabetes management and metabolic control is crucial because of the family's central role in this management. Four sequential phases of diabetes management are specified in this review: (1) the pre-onset stage; (2) the onset, crisis stage; (3) the accommodation stage; and (4) the stabilization stage. Each stage can be expected to influence the following stage. Thus, each is important to later management of the condition. No theory of family functioning provides a satisfactory framework for understanding the complex relationships between family development and diabetes. The Peabody Family Development Model is introduced as a more complex and systematic way of understanding the stages of management and the long-term view of the individual and family development. Individual and family are acting and reacting, and at the same time, coping with outside influences while moving from one life stage to the other. Historic factors of family and community influence one's view of the world and, consequently, the way regular routines are carried out. Individual characteristics influence individual behavior at any given point in time. The model has at its core a stress-support paradigm, and has an ecologic frame of reference. Behavior is a result of all preceding factors, and information processed is fed back into the system. The Peabody Family Development Model is a way to organize a variety of information on family functioning and to specify how it might relate to the control of diabetes in children.