Parenting, autonomy and self-care of adolescents with Type 1 diabetes.
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.
Dashiff
C
C
School of Nursing, University of Alabama at Birmingham, 1530 3rd South Avenue, Birmingham, AL 35294-1210, USA. dashiffc@uab.edu
Vance
D
D
Abdullatif
H
H
Wallander
J
J
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*