1型糖尿病青少年的执行功能、糖尿病困扰与糖尿病管理：青少年及其父母的观点
Executive Functioning, Diabetes Distress, and Diabetes Management Among Adolescents With Type 1 Diabetes: Youth and Parent Perspectives.
作者信息
Choe Allison, Fredericks Emily M, Albright Dana, Lee Joyce M, Sturza Julie M, Riley Hurley O, Kaciroti Niko, Bauer Katherine W, Miller Alison L
机构信息
Department of Psychology, University of Michigan, East Hall 1004 530 Church Street, Ann Arbor 48109, Michigan, USA.
Department of Pediatrics, Michigan Medicine, University of Michigan, 1540 E Hospital Dr, Ann Arbor 48109, Michigan, USA.
出版信息
Pediatr Diabetes. 2025 Feb 27;2025:7036544. doi: 10.1155/pedi/7036544. eCollection 2025.
Most adolescents with Type 1 Diabetes (T1D) do not achieve recommended glycemic targets, placing them at risk for long-term complications. Executive functioning (EF), or the cognitive processes that support goal-directed action and management of behavior, emotion, and cognition, is proposed to support effective T1D management and contribute to glycemic stability. We sought to examine associations of EF with T1D management behaviors and diabetes-related distress in adolescents with T1D. Participants were 13-17-year-olds ( = 15.44, = 1.38 years) from a randomized controlled trial ( = 88). We conducted secondary analyses of preintervention data. Youth and their parents each reported on youth EF (Behavior Rating Inventory of Executive Functioning; BRIEF) and T1D management behaviors (Self-Care Inventory-Revised; SCI-R), parents reported on responsibility for T1D management (Diabetes Family Responsibility Questionnaire; DFRQ), and youth reported on their diabetes-related distress (Problem Areas In Diabetes-Teen; PAID-T). Youth also completed performance-based measures of EF. Questionnaire-based and performance-based EF measures were generally unrelated. Regression analysis showed that youth self-reported EF predicted youth-reported T1D management (SCI-R) and diabetes distress (PAID-T) outcomes, and parent-reported youth EF predicted parent-reported T1D management behaviors, such that greater EF difficulties predicted suboptimal management and greater diabetes-related distress (youth PAID-T : 0.41, < 0.01; youth SCI-R : -0.40, < 0.01; parent SCI-R -0.33, < 0.01). Older child age and poorer performance-based EF also predicted greater youth responsibility for T1D management (age : 0.43, < 0.01; EF reaction time : 0.23, < 0.05; EF accuracy : -0.23, < 0.05). Youth EF may shape which adolescents are at increased risk for suboptimal T1D management as well as diabetes distress; understanding EF challenges may help guide T1D family management across this developmental period. Implications for EF measurement approaches in youth are also discussed. ClinicalTrials.gov identifier: NCT03688919.
大多数1型糖尿病（T1D）青少年未达到推荐的血糖目标，这使他们面临长期并发症的风险。执行功能（EF），即支持目标导向行动以及行为、情绪和认知管理的认知过程，被认为有助于有效的T1D管理并促进血糖稳定。我们试图研究EF与T1D青少年的T1D管理行为及糖尿病相关困扰之间的关联。参与者为来自一项随机对照试验的13至17岁青少年（ = 15.44， = 1.38岁）（ = 88）。我们对干预前数据进行了二次分析。青少年及其父母分别报告青少年的EF（执行功能行为评定量表；BRIEF）和T1D管理行为（自我护理量表修订版；SCI-R），父母报告对T1D管理的责任（糖尿病家庭责任问卷；DFRQ），青少年报告其糖尿病相关困扰（青少年糖尿病问题领域；PAID-T）。青少年还完成了基于表现的EF测量。基于问卷和基于表现的EF测量通常不相关。回归分析表明，青少年自我报告的EF可预测青少年报告的T1D管理（SCI-R）和糖尿病困扰（PAID-T）结果，父母报告的青少年EF可预测父母报告的T1D管理行为，即EF困难越大，管理越不理想，糖尿病相关困扰越大（青少年PAID-T：0.41， < 0.01；青少年SCI-R：-0.40， < 0.01；父母SCI-R -0.33， < 0.01）。年龄较大的儿童以及基于表现的EF较差也预示着青少年对T1D管理的责任更大（年龄：0.43， < 0.01；EF反应时间：0.23，< 0.05；EF准确性：-0.23， < 0.05）。青少年的EF可能会影响哪些青少年在T1D管理不理想以及糖尿病困扰方面风险增加；了解EF挑战可能有助于指导这一发育阶段的T1D家庭管理。还讨论了青少年EF测量方法的意义。ClinicalTrials.gov标识符：NCT03688919。
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