OBJECTIVE: This article evaluated whether deviation from developmentally appropriate self-care autonomy moderated the effects of intensive therapy (IT) or usual care (UC) on glycosylated hemoglobin (HbA(1C)) in 142 youths with diabetes. METHODS: Youths received an autonomy/maturity ratio (AMR) score at baseline that was a ratio of standardized scores on measures of self-care autonomy to standardized scores on measures of psychological maturity and were categorized by tertile split into low, moderate, and high AMR. RESULTS: Higher baseline AMR was associated with higher baseline HbA(1C) for IT and UC. Baseline AMR scores predicted glycemic outcomes from UC; the high AMR tertile showed deteriorating glycemic control over time, whereas the low AMR tertile maintained better glycemic control. All three AMR groups derived equal glycemic benefit from IT. CONCLUSION:Children with inordinate diabetes self-care autonomy may fare poorly in UC but these same children may realize less glycemic deterioration during IT.
RCT Entities:
OBJECTIVE: This article evaluated whether deviation from developmentally appropriate self-care autonomy moderated the effects of intensive therapy (IT) or usual care (UC) on glycosylated hemoglobin (HbA(1C)) in 142 youths with diabetes. METHODS: Youths received an autonomy/maturity ratio (AMR) score at baseline that was a ratio of standardized scores on measures of self-care autonomy to standardized scores on measures of psychological maturity and were categorized by tertile split into low, moderate, and high AMR. RESULTS: Higher baseline AMR was associated with higher baseline HbA(1C) for IT and UC. Baseline AMR scores predicted glycemic outcomes from UC; the high AMR tertile showed deteriorating glycemic control over time, whereas the low AMR tertile maintained better glycemic control. All three AMR groups derived equal glycemic benefit from IT. CONCLUSION:Children with inordinate diabetes self-care autonomy may fare poorly in UC but these same children may realize less glycemic deterioration during IT.
Authors: Deborah J Wiebe; Chong Man Chow; Debra L Palmer; Jonathan Butner; Jorie M Butler; Peter Osborn; Cynthia A Berg Journal: J Pediatr Psychol Date: 2014-03-06
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Authors: Tim Wysocki; Tonja R Nansel; Grayson N Holmbeck; Rusan Chen; Lori Laffel; Barbara J Anderson; Jill Weissberg-Benchell Journal: J Pediatr Psychol Date: 2008-12-26
Authors: Dennis Drotar; Richard Ittenbach; Jennifer M Rohan; Resmi Gupta; Jennifer Shroff Pendley; Alan Delamater Journal: J Behav Med Date: 2012-05-09