Swipe om te navigeren naar een ander artikel
Despite the increasing number of studies on the health-related quality of life (HRQOL) of children with type 1 diabetes (T1D), little is known about the influence of family and parental factors on this outcome. This study aimed to explore whether family cohesion and children’s HRQOL were connected through three indicators of parental psychological adjustment (parenting stress, depressive symptoms, and anxious symptoms) as well as whether these links varied according to the child’s age. Levels of family cohesion, parenting stress, and depression/anxiety symptoms of parents of children with T1D and parents of healthy children were compared. The sample included 88 child–parent dyads composed of children/adolescents (8–18 years old) with T1D and one of their parents and 121 dyads composed of healthy children/adolescents and one of their parents. The parents completed self-report measures of family cohesion, parenting stress, and emotional adjustment, and the children completed measures of HRQOL. Testing of the hypothesized moderated mediational model showed that higher HRQOL ratings in children were associated with higher levels of cohesion through lower levels of parental stress, regardless of the child’s age. Parents of children with T1D perceived less cohesion and felt more anxiety and stress about parenting tasks compared to parents of healthy children. Our findings suggest that parents of children with T1D are at an increased risk of psychological maladjustment. Moreover, this study highlights the interrelation between family/parental functioning and child adjustment and makes an innovative contribution by identifying a mechanism that may account for the link between family and child variables.
Log in om toegang te krijgen
Met onderstaand(e) abonnement(en) heeft u direct toegang:
Abidin, R. R. (1995). Parenting stress index: Professional manual (3rd ed.). Odessa, FL: Psychological Assessment Resources, Inc.
Anderson, B., Ho, J., Brackett, J., Finkelstein, D., & Laffel, L. (1997). Parental involvement in diabetes management tasks: Relationships to blood glucose monitoring adherence and metabolic control in young adolescents with insulin-dependent diabetes mellitus. The Journal of Pediatrics, 130, 257–265. PubMedCrossRef
Baars, R., Atherton, C., Koopman, H., Bullinger, M., Power, M., & the DISABKIDS group. (2005). The European DISABKIDS project: Development of seven condition-specific modules to measure health related quality of life in children and adolescents. Health and Quality of Life Outcomes, 3, 70. doi: 10.1186/1477-7525-3-70. PubMedCentralPubMedCrossRef
Beck, A. T., Emery, G., & Greenberg, R. L. (1985). Anxiety disorders and phobias: A cognitive perspective. New York: Basic Books.
Blankfeld, D., & Holahan, C. (1996). Family support, coping strategies, and depressive symptoms among mothers of children with diabetes. Journal of Family Psychology, 10, 173–179. CrossRef
Carona, C., Crespo, C., Silva, N., Lopes, A. F., Canavarro, M. C., & Bullinger, M. (2012). Examining a developmental approach to health-related quality of life assessment: Psychometric analysis of DISABKIDS generic module in a Portuguese sample. Vulnerable Children and Youth Studies. Advance online publication. doi: 10.1080/17450128.2012.736647.
Cohen, J. (1988). Statistical power analysis for the behavioral sciences. Hillsdale, NJ: Erlbaum.
Cohen, D., Lumley, M., Naar-King, S., Partridge, T., & Cakan, N. (2004). Child behavior problems and family functioning as predictors of adherence and glycemic control in economically disadvantaged children with Type 1 Diabetes: A prospective study. Journal of Pediatric Psychology, 29, 171–184. doi: 10.1093/jpepsy/jsh019. PubMedCrossRef
Eckshtain, D., Ellis, D., Kolmodin, K., & Naar-King, S. (2010). The effects of parental depression and parenting practices on depressive symptoms and metabolic control in urban youth with insulin dependent diabetes. Journal of Pediatric Psychology, 35, 426–435. doi: 10.1093/jpepsy/jsp068. PubMedCrossRef
Eiser, C., & Morse, R. (2001b). The measurement of quality of life in children: Past and future perspectives. Developmental and Behavioral Pediatrics, 22, 248–256. CrossRef
Field, C., & Duchoslav, R. (2009). Family influence on adolescent treatment outcomes. In W. T. O’Donohue & L. W. Tolle (Eds.), Behavioral approaches to chronic disease in adolescence (pp. 47–54). New York: Springer. CrossRef
Gaspar, T., & Matos, M. G. (Eds.). (2008). Qualidade de vida em crianças e adolescentes: Versão portuguesa dos instrumentos KIDSCREEN-52 [quality of life in children and adolescents: Portuguese version of the instruments KIDSCREEN-52]. Cruz Quebrada: Aventura Social e Saúde.
Hauser, S., Jacobson, A., Lavori, P., Wolfsdorf, J., Herskowitz, R., Milley, J., et al. (1990). Adherence among children and adolescents with insulin-dependent diabetes mellitus over a four-year longitudinal follow-up: II. Immediate and long-term linkages with the family milieu. Journal of Pediatric Psychology, 15, 527–542. doi: 10.1093/jpepsy/15.4.527. PubMedCrossRef
Hayes, A. F. (2011). SPSS MODMED macro syntax reference. Retrieved from http://www.afhayes.com/public/modmed.pdf.
Hayes, A. F. (2012). PROCESS: A versatile computational tool for observed variable mediation, moderation, and conditional process modeling [white paper]. Retrieved from http://www.afhayes.com/ public/process2012.pdf.
Kazak, A., Rourke, M., & Navsaria, N. (2009). Families and other systems in pediatric psychology. In M. C. Roberts & R. G. Steele (Eds.), Handbook of pediatric psychology (4th ed., pp. 656–671). New York: The Guilford Press.
Matos, P.M., & Fontaine, M. (1992). Family Environment Scale. Adaptação portuguesa [ Family Environment Scale— Portuguese version]. Unpublished manuscript, Faculdade de Psicologia e de Ciências da Educação, Universidade do Porto, Porto, Portugal.
Missotten, L., Luyckx, K., & Seiffge-Krenke, I. (2012). Family climate of adolescents with and without type 1 diabetes: Longitudinal associations with psychosocial adaptation. Journal of Child and Family Studies. Advance online publication. doi: 10.1007/s10826-012-9585-1.
Moos, R. H., & Moos, B. S. (1986). Family environment scale manual (2nd ed.). Palo Alto, CA: Consulting Psychologists Press.
Mullins, L., Fuemmeler, B., Hoff, A., Chaney, J., Pelt, J., & Ewing, C. (2004). The relationship of parental overprotection and perceived child vulnerability to depressive symptomatology in children with type 1 diabetes mellitus: The moderating influence of parenting stress. Children’s Health Care, 33, 21–34. doi: 10.1207/s15326888chc3301_2. CrossRef
Overstreet, S., Goins, J., Chen, R., Holmes, S., Greer, T., Dunlap, W., et al. (1995). Family environment and the interrelation of family structure, child behavior, and metabolic control for children with diabetes. Journal of Pediatric Psychology, 20, 435–447. doi: 10.1093/jpepsy/20.4.435. PubMedCrossRef
Peterson, C., Schmidt, S., Power, M., Bullinger, M., & The DISABKIDS Group. (2005). Development and pilot-testing of a health-related quality of life chronic generic module for children and adolescents with chronic health conditions: A European perspective. Quality of Life Research, 14, 1065–1077. doi: 10.1007/s11136-004-2575-z. CrossRef
Ravens-Sieberer, U., Erhart, M., Rajmil, L., Herdman, M., Auquier, P., Bruil, J., et al. (2010). Reliability, construct and criterion validity of the KIDSCREEN-10 score: A short measure for children and adolescents’ well-being and health-related quality of life. Quality of Life Research, 19, 1487–1500. doi: 10.1007/s11136-010-9706-5. PubMedCentralPubMedCrossRef
Rentinck, I. C., Ketelaar, M., Jongmans, M. J., & Gorter, J. W. (2006). Parents of children with cerebral palsy: A review of factors related to the process of adaptation. Child: Care, Health and Development, 33, 161–169.
Shor, E. L., & American Academy of Pediatrics Task Force on the Family. (2003). Family pediatrics: Report of the Task Force on the Family. Pediatrics, 111, 1541–1571.
Tabachnick, B. G., & Fidell, L. S. (2007). Using multivariate statistics (5th ed.). Boston: Allyn and Bacon.
The European DISABKIDS Group. (2006). The DISABKIDS Questionnaires—Quality of Life questionnaires for children with chronic conditions. Lengerich: Pabst Science Publishers.
Varni, J., Seid, M., & Kurtin, P. (1999). Pediatric health-related quality of life measurement technology: A guide for health care decisions makers. Journal of Clinical Outcomes Management, 6, 33–40.
Weissberg-Benchell, J., Nansel, T., Holmbeck, G., Chen, R., Anderson, B., Wysocki, T., et al. (2009). Generic and diabetes-specific parent–child behaviors and quality of life among youth with type 1 diabetes. Journal of Pediatric Psychology, 34, 977–988. doi: 10.1093/jpepsy/jsp003. PubMedCrossRef
Wysocki, T., Buckloh, L., & Greco, P. (2009). The psychological context of diabetes mellitus in youths. In M. C. Roberts & R. G. Steele (Eds.), Handbook of pediatric psychology (4th ed., pp. 287–302). New York: The Guilford Press.
- Family Cohesion and Health-Related Quality of Life of Children with Type 1 Diabetes: The Mediating Role of Parental Adjustment
Maria Cristina Canavarro
- Springer US