title: Parenting, autonomy and self-care of adolescents with Type 1 diabetes.
abstract: BACKGROUND
  During adolescence diabetes creates a juncture of very complex disease management demands with developmental needs, including the striving of adolescents for greater autonomy. Parents' concerns and fears about the teen's diabetes self-management abilities during this time can heighten parental attachment behaviour and affect the parents' ability to support autonomy development necessary for effective self-care. Maternal parenting processes may be especially important for those adolescents who have Type 1 diabetes because mothers are the primary caregivers.
  
  
  OBJECTIVE
  Based on attachment theory, the aim was to test a model of the influence of mother-adolescent developmental conflict, maternal separation anxiety and maternal inhibition of autonomy and relatedness on cognitive autonomy and self-care of adolescents with Type 1 diabetes.
  
  
  METHODS
  A total of 131 families with an adolescent, aged 11-15 years, contributed data annually across three waves. Mothers and adolescents completed paper-and-pencil measures and two interaction scenarios that were coded by trained staff from audio-tapes. The adolescent also completed a structured interview and questionnaire to assess self-care.
  
  
  RESULTS
  Maternal separation anxiety when adolescents were 11-15 years of age directly predicted cognitive autonomy at 1-year follow-up, and that cognitive autonomy was directly related to self-care 1 year later, but did not mediate between separation anxiety and self-care.
  
  
  CONCLUSIONS
  Future investigation of the influence of separation anxiety of parents on adolescent autonomy development is warranted, as well as the contribution of autonomy development to diabetes self-management behaviours of adolescents.
authors.affiliation: School of Nursing, University of Alabama at Birmingham, 1530 3rd South Avenue, Birmingham, AL 35294-1210, USA. dashiffc@uab.edu
authors.forename: C
authors.initials: C
authors.lastname: Dashiff
authors.forename: D
authors.initials: D
authors.lastname: Vance
authors.forename: H
authors.initials: H
authors.lastname: Abdullatif
authors.forename: J
authors.initials: J
authors.lastname: Wallander
mesh_terms: D000293:Adolescent; D001010:Anxiety, Separation / Q000523:psychology*; D003220:Conflict, Psychological; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology*; D016487:Parenting / Q000523:psychology*; D026684:Personal Autonomy; D012648:Self Care / Q000523:psychology*