Parent and Adolescent Discrepancies in Diabetes Self-Management

By: Joanna Price

Mentors:

Dr. Ken Wallston and Dr. Shelagh Mulvaney

Themes Adolescent self-management during transition

from parent to self-care Adolescent has more responsibilities

Discrepancy between parents and their adolescents

Communication about diabetes care

Research Questions Does the degree of congruency between children’s

and parents’ questionnaire responses relate to the HbA1c levels of the adolescent?

Will parent-child discrepancy on one questionnaire be associated with the amount of discrepancy on the other questionnaire?

Will the age and/or gender of the adolescent play a role in the amount of discrepancy between adolescents and their parents?

Participants and Measures 115 Parent-Adolescent Dyads

Adolescents aged 13-17 years old Diagnosed with Type I Diabetes for at least 6

months Seen at the Vanderbilt Eskind Diabetes Clinic

Two Questionnaires Baseline HbA1c Levels

Measures Diabetes Behavior Management Survey

How often adolescent carried out necessary diabetes self-management tasks 41 Questions

Problem Solving Behaviors Survey Ability of adolescents to deal with psychosocial

self-management problems associated with Diabetes by solving problems 27 Questions

Variables Mean Scores on each Questionnaire

Psm, Csm, Pps, Cps Simple Discrepancy Scores

D_sm, and D_ps Squared Discrepancy Scores

D2_sm, and D2_ps Child’s Age Child’s Gender (0= male, 1= female)

Discrepancy Scores Simple Discrepancy

Parent Mean- Child Mean for each survey question and then summed across items

Squared Discrepancy (Parent Mean- Child Mean)^2 for each survey

question and then summed across items

Results The only questionnaire associated with HbA1c was

the child’s rating of their problem solving ability (r = -0.21, p< 0.05). The higher the child’s self-rated ability to problem solve, the lower the HbA1c value (i.e., diabetes was in better control).

Results Parent-child dyads were correlated across both

questionnaires meaning that their degree of discrepancy on one questionnaire was significantly correlated with their degree of discrepancy on the other questionnaire for both the simple discrepancy scores (r = 0.46, p < 0.01) and the squared discrepancy scores (r = 0.36, p < 0.01).

Results Adolescent’s gender was positively correlated with

the problem solving simple discrepancy score (r = 0.20, p < 0.05), meaning that girls were more likely to be discrepant from their parents on the problem solving questionnaire

Adolescent’s gender was negatively correlated with the self-management squared discrepancy score (r = -0.26, p < 0.01), meaning that boys are more likely to be discrepant from their parents on the self-management questionnaire

Limitations and Future Directions Limitations May not be representative of the whole population of

adolescents with Type I Diabetes Both questionnaires (self-management and problem

solving) are correlated with each other

Future Research Ways to measure self-management Using both types of discrepancy scores to test

validity of results

Acknowledgements Dr. Ken Wallston Dr. Shelagh Mulvaney Professor Craig Smith My Classmates

D_sm= mean((Psm1-Csm1), (Psm2-Csm2), (Psm3-Csm3), (Psm4-Csm4), (Psm5-Csm5), (Psm6-Csm6), (Psm7-Csm7), (Psm8-Csm8), (Psm9-Csm9), (Psm10-Csm10), (Psm11-Csm11), (Psm12-Csm12), (Psm13-Csm13), (Psm14-Csm14), (Psm15-Csm15), (Psm16-Csm16), (Psm17-Csm17), (Psm18-Csm18), (Psm19-Csm19), (Psm20-Csm20), (Psm21-Csm21), (Psm22-Csm22), (Psm23-Csm23), (Psm24-Csm24), (Psm25-Csm25), (Psm26-Csm26), (Psm29-Csm29), (Psm30-Csm30), (Psm31-Csm31), (Psm32-Csm32), (Psm33-Csm33), (Psm34-Csm34), (Psm35-Csm35, (Psm36-Csm36), (Psm37-Csm37), (Psm38-Csm38), (Psm39-Csm39), (Psm40-Csm40), (Psm41-Csm41))

D2_sm= mean(((Psm1-Csm1)**2), ((Psm2-Csm2)**2), ((Psm3-Csm3)**2), ((Psm4-Csm4)**2), ((Psm5-Csm5)**2), ((Psm6-Csm6)**2), ((Psm7-Csm7)**2), ((Psm8-Csm8)**2), ((Psm9-Csm9)**2), ((Psm10-Csm10)**2), ((Psm11-Csm11)**2), ((Psm12-Csm12)**2), ((Psm13-Csm13)**2), ((Psm14-Csm14)**2), ((Psm15-Csm15)**2), ((Psm16-Csm16)**2), ((Psm17-Csm17)**2), ((Psm18-Csm18)**2), ((Psm19-Csm19)**2), ((Psm20-Csm20)**2), ((Psm21-Csm21)**2), ((Psm22-Csm22)**2), ((Psm23-Csm23)**2), ((Psm24-Csm24)**2), ((Psm25-Csm25)**2), ((Psm26-Csm26)**2), ((Psm29-Csm29)**2), ((Psm30-Csm30)**2), ((Psm31-Csm31)**2), ((Psm32-Csm32)**2), ((Psm33-Csm33)**2), ((Psm34-Csm34)**2), ((Psm35-Csm35)**2), ((Psm36-Csm36)**2), ((Psm37-Csm37)**2), ((Psm38-Csm38)**2), ((Psm39-Csm39)**2), ((Psm40-Csm40)**2), ((Psm41-Csm41)**2))

D_ps= mean((Pps1-Cps1), (Pps2-Cps2), (Pps3-Cps3), (Pps4-Cps4), (Pps5-Cps5), (Pps6-Cps6), (Pps7-Cps7), (Pps8-Cps8), (Pps9-Cps9), (Pps10-Cps10), (Pps11-Cps11), (Pps12-Cps12), (Pps13-Cps13), (Pps14-Cps14), (Pps15-Cps15), (Pps16-Cps16), (Pps17-Cps17), (Pps18-Cps18), (Pps19-Cps19), (Pps20-Cps20), (Pps21-Cps21), (Pps22-Cps22), (Pps23-Cps23), (Pps24-Cps24), (Pps25-Cps25), (Pps27-Cps27))

D2_ps= mean(((Pps1-Cps1)**2), ((Pps2-Cps2)**2), ((Pps3-Cps3)**2), ((Pps4-Cps4)**2), ((Pps5-Cps5)**2), ((Pps6-Cps6)**2), ((Pps7-Cps7)**2), ((Pps8-Cps8)**2), ((Pps9-Cps9)**2), ((Pps10-Cps10)**2), ((Pps11-Cps11)**2), ((Pps12-Cps12)**2), ((Pps13-Cps13)**2), ((Pps14-Cps14)**2), ((Pps15-Cps15)**2), ((Pps16-Cps16)**2), ((Pps17-Cps17)**2), ((Pps18-Cps18)**2), ((Pps19-Cps19)**2), ((Pps20-Cps20)**2), ((Pps21-Cps21)**2), ((Pps22-Cps22)**2), ((Pps23-Cps23)**2), ((Pps24-Cps24)**2), ((Pps25-Cps25)**2), ((Pps27-Cps27)**2))

Formulas