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Journal of Pediatric Psychology Advance Access first published online on June 24, 2008
This version published online on June 27, 2008
Journal of Pediatric Psychology, doi:10.1093/jpepsy/jsn062
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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

Predictors of Diabetes-related Quality of Life after Transitioning to the Insulin Pump

Marisa E. Hilliard, MA1,2, Marcie Goeke-Morey, PhD2, Fran R. Cogen, MD1,3, Celia Henderson, RN1 and Randi Streisand, PhD1,3

1Children's National Medical Center, 2The Catholic University of America, and 3The George Washington University Medical School

All correspondence concerning this article should be addressed to Dr Randi Streisand, Department of Psychiatry and Behavioral Sciences, Children's National Medical Center, 111 Michigan Avenue, NW, Washington, DC 20010, USA. E-mail: rstreis{at}cnmc.org


  Abstract

Objective To examine family and individual psychosocial, medical, and demographic factors associated with improved diabetes-related quality of life (QOL) after transitioning to the insulin pump among youth with type 1 diabetes. Method Fifty-three parent–child dyads completed questionnaires on four occasions prior to and following this medical regimen change, assessing QOL, family environment, depressive and anxiety symptoms, and medical and demographic information. Trajectories of change in QOL were analyzed using multilevel modeling. Result Psychosocial, medical, and demographic characteristics were associated with QOL prior to pump-start. Elements of children's QOL significantly improved after the transition, and improvement was predicted by psychosocial, medical, and demographic characteristics. Conclusion Results indicate that individual and contextual factors may play a role in QOL as children transition to the insulin pump. Findings may guide efforts to support families through this challenging time and potentially inform candidacy for transition to the pump.

Key words: children; diabetes; quality of life.

The author's name has been corrected in the runninghead.

Received October 3, 2007; revision received May 23, 2008; accepted May 23, 2008


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