title: Self-management of Type 1 Diabetes Across Adolescence.
abstract: The purpose of this study was to examine differences in self-management behaviors (Collaboration with Parents, Diabetes Care Activities, Diabetes Problem Solving, Diabetes Communication, and Goals) between early, middle, and late adolescence. The role of regimen and gender as covariates in self-management behaviors was also examined.
  
  
  
  This was a secondary analysis with a cross-sectional descriptive survey design. A sample of 504 participants ages 13 to 21 years from the Self-Management of Diabetes-Adolescent instrument development study were analyzed to determine self-management behaviors in early, middle, and late adolescence. This study was partially guided by the Self and Family Management Framework. This framework contains broad conceptual areas that are thought to pose a risk to or have a protective influence on self-management and family management behaviors and associated outcomes.
  
  
  
  Significant findings included a decline between early, middle, and late adolescence in the Collaboration with Parents scale as well as an increase between early and late adolescence on the Diabetes Problem Solving scale. Regimen was a significant covariate for Collaboration with Parents, Diabetes Care Activities, and Diabetes Problem Solving, and gender was a significant covariate for Diabetes Care Activities and Diabetes Communication.
  
  
  
  Clinicians should consider the influence of adolescent stage and development on self-management when educating adolescents. Youth and their families should be educated to consider the implications that regimen will have on daily self-management when making treatment decisions. Furthermore, gender variations can necessitate different educational approaches to meet different needs. Future research should identify other variables that can influence self-management at different points across adolescence.
authors: The University of Massachusetts–College of Nursing, Dartmouth, Massachusetts (Dr Keough)
authors: Lori
authors: L
authors: Keough
authors: University of Massachusetts–Graduate School of Nursing & Department of Pediatrics, Worcester, Massachusetts (Dr Sullivan-Bolyai)
authors: Susan
authors: S
authors: Sullivan-Bolyai
authors: University of Massachusetts Medical School, Department of Medicine, Worcester, Massachusetts (Dr Crawford)
authors: Sybil
authors: S
authors: Crawford
authors: Yale University–School of Nursing (Dr Schilling, Dr Dixon)
authors: Lynne
authors: L
authors: Schilling
authors: Yale University–School of Nursing (Dr Schilling, Dr Dixon)
authors: Jane
authors: J
authors: Dixon