Self-report and parent-report of physical and psychosocial well-being in Dutch adolescents with type 1 diabetes in relation to glycemic control.
BACKGROUND
To determine physical and psychosocial well-being of adolescents with type 1 diabetes by self-report and parent report and to explore associations with glycemic control and other clinical and socio-demographic characteristics.


METHODS
Demographic, medical and psychosocial data were gathered from 4 participating outpatient pediatric diabetes clinics in the Netherlands. Ninety-one patients completed the Child Health Questionnaire-CF87 (CHQ-CF87), Centre for Epidemiological Studies scale for Depression (CES-D), and the DFCS (Diabetes-specific Family Conflict Scale). Parents completed the CHQ-PF50, CES-D and the DFCS.


RESULTS
Mean age was 14.9 years (+/- 1.1), mean HbA1c 8.8% (+/- 1.7; 6.2-15.0%). Compared to healthy controls, patients scored lower on CHQ subscales role functioning-physical and general health. Parents reported less favorable scores on the behavior subscale than adolescents. Fewer diabetes-specific family conflicts were associated with better psychosocial well-being and less depressive symptoms. Living in a one-parent family, being member of an ethnic minority and reporting lower well-being were all associated with higher HbA1c values.


CONCLUSIONS
Overall, adolescents with type 1 diabetes report optimal well-being and parent report is in accordance with these findings. Poor glycemic control is common, with single-parent families and ethnic minorities particularly at risk. High HbA1c values are related to lower social and family functioning.
de Wit
Maartje
M
Department of Medical Psychology, VU University Medical Center Amsterdam, The Netherlands. m.dewit@vumc.nl
Delemarre-van de Waal
Henriette A
HA
Bokma
Jan Alle
JA
Haasnoot
Krijn
K
Houdijk
Mieke C
MC
Gemke
Reinoud J
RJ
Snoek
Frank J
FJ
D000293:Adolescent; D000554:Ambulatory Care Facilities; D001294:Attitude to Health; D003922:Diabetes Mellitus, Type 1 / Q000208:ethnology / Q000503:physiopathology* / Q000523:psychology*; D005191:Family Characteristics; D005260:Female; D006442:Glycated Hemoglobin / Q000187:drug effects; D006801:Humans; D008297:Male; D009426:Netherlands; D010290:Parents / Q000523:psychology; D010372:Pediatrics; D011594:Psychometrics / Q000295:instrumentation; D011788:Quality of Life; D012649:Self Concept; D018434:Sickness Impact Profile; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
D006442:Glycated Hemoglobin