Diabetes problem solving by youths with type 1 diabetes and their caregivers: measurement, validation, and longitudinal associations with glycemic control.
OBJECTIVE
This article introduces a new measure of problem-solving skills of youths with type 1 diabetes (T1DM) and adult caregivers in correcting glycemic fluctuations.


METHODS
The Diabetes Problem Solving Interview (DPSI), a structured interview, was validated during a pilot study of a behavioral intervention. DPSI data and measures of diabetes management were obtained at baseline from 114 youths (ages 9-14.5) and 109 caregivers. Glycosylated hemoglobin (HbA(1c)) was measured quarterly over 9 months.


RESULTS
Results confirmed the psychometric adequacy of the DPSI. For caregivers, but not youths, low DPSI scores (indicating poor problem-solving skills) were significantly associated with worse HbA(1c) over 9 months.


CONCLUSIONS
The DPSI has clinical and research utility as a measure of diabetes problem-solving skills. Identification and targeted remediation of caregivers' deficient diabetes problem-solving skills or promotion of youths' utilization of these skills could possibly enhance glycemic control in youths with T1DM.
Wysocki
Tim
T
Center for Pediatric Psychology Research, Nemours Children's Clinic, 807 Children's Way, Jacksonville, FL 32207-8426, USA. twysocki@nemours.org
Iannotti
Ronald
R
Weissberg-Benchell
Jill
J
Laffel
Lori
L
Hood
Korey
K
Anderson
Barbara
B
Chen
Rusan
R
D000223:Adaptation, Psychological; D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism*; D017028:Caregivers / Q000523:psychology*; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000523:psychology*; D004493:Education; D005240:Feasibility Studies; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D055809:Illness Behavior; D008137:Longitudinal Studies; D008297:Male; D010865:Pilot Projects; D011340:Problem Solving
D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human