Journal of Pediatric Psychology Advance Access originally published online on March 3, 2005
Journal of Pediatric Psychology 2006 31(2):174-183; doi:10.1093/jpepsy/jsj004
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The Relation Between Family Factors and Metabolic Control: The Role of Diabetes Adherence
1 Department of Clinical and Health Psychology, University of Florida, 2 Department of Psychiatry, University of Florida, 3 Department of Pediatrics, University of Florida, and 4 Department of Psychology, Mount Washington Pediatric Hospital
All correspondence concerning this article should be addressed to Adam B. Lewin, Department of Clinical and Health Psychology, Box 100165, University of Florida, Gainesville, Florida 32610-0165. E-mail: alewin{at}phhp.ufl.edu.
Received July 16, 2004; revisions received October 28, 2004 and January 14, 2005; accepted January 19, 2005
Objectives To examine family factors as predictors of metabolic control in children with type 1 diabetes and determine whether adherence behaviors mediate this relationship. Method Participants were 109 children (ages 8–18) and a parent. Measures of diabetes-specific family functioning and an adherence interview were completed. Glycosylated hemoglobin (HbA1c) was the index of metabolic control. Results Family functioning and adherence were strongly associated with metabolic control. Combined with demographic information, these constructs accounted for 49% of the variance in metabolic control. Age moderated the relation between aspects of family functioning and HbA1c. Path analyses suggest that adherence mediates the relationship between family functioning and metabolic control. Conclusions Family functioning and adherence behaviors are strongly related to a child’s health status. Assessment of diabetes-specific family functioning, in addition to adherence, is an important factor in understanding metabolic control.
Key words: adherence; family functioning; mediator; metabolic control; type 1 diabetes.
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