OBJECTIVE: Prior to the transfer from paediatric to adult health care transition, teens with type 1 diabetes seek increasing independence in diabetes self-care while parent involvement in care decreases. Yet, few teens attain glycaemic targets. This study aimed to assess changes in perceived readiness for independent self-care in teens with type 1 diabetes over 18 months, from both teens' and parents' perspectives, and to evaluate its predictive value for diabetes self-management and haemoglobin A1c (HbA1c ). RESEARCH DESIGN AND METHODS: At baseline, 6, 12 and 18 months, 178 teens with type 1 diabetes (mean ± SD age 14.9±1.3 years; HbA1c 8.5 ± 1.0% (69 ± 11 mmol/mol); 48% female) and their parents completed the Readiness for Independent Self-Care Questionnaire (RISQ-T and RISQ-P, respectively) and a measure of self-management. Chart review provided HbA1c values. Statistical analyses encompassed bivariate correlations, paired t-tests and multivariable longitudinal mixed models. RESULTS: Teens perceived greater self-care readiness than their parents at baseline and over 18 months of follow-up. Both teen and parent perceptions of teen readiness for independent self-care increased over time, and significantly predicted higher teen self- and parent proxy-reported teen diabetes self-management, respectively, but not improved HbA1c . CONCLUSIONS: The current findings may point to a disconnect between how increased readiness for independent self-care may translate into better perceived diabetes self-management, but not into better HbA1c . In an effort to optimize HbA1c in teens with type 1 diabetes, future research is needed to design interventions that align perceived readiness for independent self-care with self-care behaviours that improve HbA1c .
OBJECTIVE: Prior to the transfer from paediatric to adult health care transition, teens with type 1 diabetes seek increasing independence in diabetes self-care while parent involvement in care decreases. Yet, few teens attain glycaemic targets. This study aimed to assess changes in perceived readiness for independent self-care in teens with type 1 diabetes over 18 months, from both teens' and parents' perspectives, and to evaluate its predictive value for diabetes self-management and haemoglobin A1c (HbA1c ). RESEARCH DESIGN AND METHODS: At baseline, 6, 12 and 18 months, 178 teens with type 1 diabetes (mean ± SD age 14.9±1.3 years; HbA1c 8.5 ± 1.0% (69 ± 11 mmol/mol); 48% female) and their parents completed the Readiness for Independent Self-Care Questionnaire (RISQ-T and RISQ-P, respectively) and a measure of self-management. Chart review provided HbA1c values. Statistical analyses encompassed bivariate correlations, paired t-tests and multivariable longitudinal mixed models. RESULTS: Teens perceived greater self-care readiness than their parents at baseline and over 18 months of follow-up. Both teen and parent perceptions of teen readiness for independent self-care increased over time, and significantly predicted higher teen self- and parent proxy-reported teen diabetes self-management, respectively, but not improved HbA1c . CONCLUSIONS: The current findings may point to a disconnect between how increased readiness for independent self-care may translate into better perceived diabetes self-management, but not into better HbA1c . In an effort to optimize HbA1c in teens with type 1 diabetes, future research is needed to design interventions that align perceived readiness for independent self-care with self-care behaviours that improve HbA1c .
Authors: Eveline R Goethals; Rebecca O La Banca; Peter W Forbes; Gabriela H Telo; Lori M Laffel; Katharine C Garvey Journal: Diabetes Educ Date: 2020-06 Impact factor: 2.140
Authors: Sue A Brown; Boris P Kovatchev; Dan Raghinaru; John W Lum; Bruce A Buckingham; Yogish C Kudva; Lori M Laffel; Carol J Levy; Jordan E Pinsker; R Paul Wadwa; Eyal Dassau; Francis J Doyle; Stacey M Anderson; Mei Mei Church; Vikash Dadlani; Laya Ekhlaspour; Gregory P Forlenza; Elvira Isganaitis; David W Lam; Craig Kollman; Roy W Beck Journal: N Engl J Med Date: 2019-10-16 Impact factor: 91.245
Authors: Anthony T Vesco; Barbara J Anderson; Lori M B Laffel; Lawrence M Dolan; Lisa M Ingerski; Korey K Hood Journal: J Pediatr Psychol Date: 2010-05-05
Authors: Kellee M Miller; Nicole C Foster; Roy W Beck; Richard M Bergenstal; Stephanie N DuBose; Linda A DiMeglio; David M Maahs; William V Tamborlane Journal: Diabetes Care Date: 2015-06 Impact factor: 19.112
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
Authors: Nicole C Foster; Roy W Beck; Kellee M Miller; Mark A Clements; Michael R Rickels; Linda A DiMeglio; David M Maahs; William V Tamborlane; Richard Bergenstal; Elizabeth Smith; Beth A Olson; Satish K Garg Journal: Diabetes Technol Ther Date: 2019-01-18 Impact factor: 6.118
Authors: Lindsay M Anderson; Jaclyn L Papadakis; Anthony T Vesco; Jenna B Shapiro; Marissa A Feldman; Meredyth A Evans; Jill Weissberg-Benchell Journal: J Pediatr Psychol Date: 2020-04-01
Authors: Lori M Laffel; Lauren G Kanapka; Roy W Beck; Katherine Bergamo; Mark A Clements; Amy Criego; Daniel J DeSalvo; Robin Goland; Korey Hood; David Liljenquist; Laurel H Messer; Roshanak Monzavi; Thomas J Mouse; Priya Prahalad; Jennifer Sherr; Jill H Simmons; R Paul Wadwa; Ruth S Weinstock; Steven M Willi; Kellee M Miller Journal: JAMA Date: 2020-06-16 Impact factor: 56.272