General quality of life in youth with type 1 diabetes: relationship to patient management and diabetes-specific family conflict.
OBJECTIVE
To evaluate self-report and parent proxy report of child/teen general quality of life in youth with type 1 diabetes, compare their responses with those of a general pediatric population, and identify relationships between diabetes management, diabetes-related family behavior, and diabetes-specific family conflict with quality of life in youth with type 1 diabetes.


METHODS
Study participants included 100 children, 8-17 years of age (12.1 +/- 2.3), with type 1 diabetes for 0.5-6 years (2.7 +/- 1.6). Each child and a parent completed the Pediatric Quality of Life Inventory (PedsQL), completed the Diabetes Family Conflict Scale, and provided data on parent involvement in diabetes management. An independent measure of adherence to treatment assessed by the patient's clinician and a measure of glycemic control (HbA(1c)) were also collected.


RESULTS
PedsQL responses from youth with type 1 diabetes were stable over 1 year and similar to norms from a healthy standardization sample for all three scales of the PedsQL: total, physical, and psychosocial quality of life. After controlling for age, duration of diabetes, sex, HbA(1c), and family involvement, child report of diabetes-specific family conflict (P < 0.01) was the only significant predictor of child report of quality of life (model R(2) = 0.21, P < 0.02).


CONCLUSIONS
Youth with type 1 diabetes report remarkably similar quality of life to a nondiabetic youth population. Greater endorsement of diabetes-specific family conflict predicted diminished quality of life for the child. As treatment programs focus on intensifying glycemic control in youth with type 1 diabetes, interventions should include efforts to reduce diabetes-specific family conflict in order to preserve the child's overall quality of life.
Pediatric and Adolescent Unit, Behavioral Research and Mental Health Section, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts 02215, USA. lori.laffel@joslin.harvard.edu
Lori M B
LM
Laffel
Alexa
A
Connell
Laura
L
Vangsness
Ann
A
Goebel-Fabbri
Abigail
A
Mansfield
Barbara J
BJ
Anderson
D000293:Adolescent; D002648:Child; D003220:Conflict, Psychological; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology*; D005192:Family Health; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011788:Quality of Life