Personal and family factors associated with quality of life in adolescents with diabetes

• Published in: Diabetes care Vol. 21; no. 6; pp. 909 - 914
• Main Authors: GREY, M, BOLAND, E. A, CHANG YU, SULLIVAN-BOLYAI, S, TAMBORLANE, W. V
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01-06-1998
• Subjects: Adjustment; Adolescent; Adult; Biological and medical sciences; Child; Children & youth; Chronic illnesses; Coping; Depression - epidemiology; Diabetes; Diabetes Mellitus, Type 1 - psychology; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Families & family life; Family; Female; Glycated Hemoglobin A - analysis; Humans; Interpersonal Relations; Male; Management. Various non-drug treatments. Langerhans islet grafts; Medical sciences; Mental depression; Metabolism; Personality Tests; Psychology, Adolescent; Quality of Life; Questionnaires; Regression Analysis; Research design; Self Care; Social Behavior; Teenagers; Endocrinopathy; Human; Immunopathology; Evaluation; Autoimmune disease; Quality of life; Personal experience; Surveillance; Hemoglobin A1c; Adolescent; Insulin dependent diabetes; Family environment; Influence; Psychopathology
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/diacare.21.6.909

Personal and family factors associated with quality of life in adolescents with diabetes.
M Grey ,
E A Boland ,
C Yu ,
S Sullivan-Bolyai and
W V Tamborlane
Department of Pediatrics, School of Medicine, Yale University School of Nursing, New Haven, Connecticut 06536-0740, USA. [e-mail]
Abstract
OBJECTIVE: Quality of life is an important criterion for assessing outcomes of treatment in chronic illness related to psychosocial
well-being. The purpose of this study was to evaluate the factors that influence quality of life in adolescents with IDDM.
RESEARCH DESIGN AND METHODS: Self-reports were obtained from 52 adolescents (age 13-20 years, mean 16.1 +/- 1.9 [mean +/-
SD], diabetes duration 8.2 +/- 3.4 years, 49% female) using the following scales: Diabetes Quality of Life for Youths, Children's
Depression Inventory, Issues in Coping with Diabetes, Diabetes Family Behavior Scale, Family Adaptability and Cohesion, Self-Efficacy
for Diabetes, and the Adolescent Coping Orientation. Metabolic control was measured by HbA1c. RESULTS: Teenagers whose diabetes
had the greater impact (R2 = 0.48) and were less satisfied (R2 = 0.45) felt that management was more difficult (r = 0.56)
and that diabetes was more upsetting (r = 0.63). They also used fewer rebellion strategies for coping (r = -0.44), had lower
diabetes self-efficacy (r = -0.36), and had more depressive symptoms (r = 0.61). Higher impact was also associated with higher
family warmth and caring (r = -0.54) and lower family adaptability (r = -0.42). Teenagers who were more worried (R2 = 0.37)
about their diabetes felt that management was more difficult (r = 0.40) and that diabetes was more upsetting (r = 0.58), and
they used less rebellion (r = -0.49) and more ventilation (r = 0.42) to cope, had lower diabetes (r = -0.40) and medical (r
= -0.30) self-efficacy, were more depressed (r = 0.55), and their families were less warm and caring (r = -0.33). HbA1c levels
were not associated with quality of life or any other psychosocial factors except in teenagers who perceived their families
as providing more guidance and control. These teenagers had lower HbA1c values than those whose families were less involved.
CONCLUSIONS: Even teenagers who are successfully achieving HbA1c goals of therapy may perceive diabetes as having a negative
impact on their lives, be depressed, and find diabetes difficult to manage. Diabetes treatment teams need to pay equal attention
to the psychosocial needs to the quiet, nonrebellious teen with well-controlled diabetes from a supportive family as they
do to the rebellious adolescent with poorly controlled diabetes.