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Journal of Pediatric Psychology Advance Access published online on March 17, 2008
Journal of Pediatric Psychology, doi:10.1093/jpepsy/jsn024
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© The Author 2008. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Diabetes Problem Solving by Youths with Type 1 Diabetes and their Caregivers: Measurement, Validation, and Longitudinal Associations with Glycemic Control

Tim Wysocki, PhD1, Ronald Iannotti, PhD2, Jill Weissberg-Benchell, PhD3, Lori Laffel, MD4, Korey Hood, PhD4, Barbara Anderson, PhD5, Rusan Chen, PhD6 and for the Family Management of Childhood Diabetes Steering Committee

1Nemours Children's Clinic, 2National Institute of Child Health and Human Development, 3Children's Memorial Hospital, 4Joslin Diabetes Center, 5Texas Children's Hospital and 6Georgetown University

All correspondence concerning this article should be addressed to Tim Wysocki, PhD, Center for Pediatric Psychology Research, Nemours Children's Clinic, 807 Children's Way, Jacksonville, FL 32207-8426, USA. E-mail: twysocki{at}nemours.org


  Abstract

Objectives This article introduces a new measure of problem-solving skills of youths with type 1 diabetes (T1DM) and adult caregivers in correcting glycemic fluctuations. Methods The Diabetes Problem Solving Interview (DPSI), a structured interview, was validated during a pilot study of a behavioral intervention. DPSI data and measures of diabetes management were obtained at baseline from 114 youths (ages 9–14.5) and 109 caregivers. Glycosylated hemoglobin (HbA1c) was measured quarterly over 9 months. Results Results confirmed the psychometric adequacy of the DPSI. For caregivers, but not youths, low DPSI scores (indicating poor problem-solving skills) were significantly associated with worse HbA1c over 9 months. Conclusions The DPSI has clinical and research utility as a measure of diabetes problem-solving skills. Identification and targeted remediation of caregivers’ deficient diabetes problem-solving skills or promotion of youths’ utilization of these skills could possibly enhance glycemic control in youths with T1DM.

Key words: adolescents; children; diabetes; problem solving.

Received December 20, 2007; revision received February 28, 2008; accepted March 2, 2008


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