title: Self-management as a mediator of family functioning and depressive symptoms with health outcomes in youth with type 1 diabetes.
abstract: This study examined the relationship of family functioning and depressive symptoms with self-management, glycemic control, and quality of life in a sample of adolescents with type 1 diabetes. It also explored whether self-management mediates family functioning, depressive symptoms, and diabetes-related outcomes. Structural equation modeling was used to estimate parameters in the conceptual causal pathway and test mediation effects. Adolescents (n = 320) were primarily female (55%), younger adolescents (58%), and self-identified as White (63%). Self-management mediated the relationship between family conflict, family warmth-caring, parent guidance-control, and youth depressive symptoms with glycosylated hemoglobin (A1C). In addition, self-management mediated the relationship between family conflict and youth depressive symptoms with quality of life. Supporting optimal family functioning and treating elevated depressive symptoms in adolescents with type 1 diabetes has the potential to improve self-management, glycemic control, and quality of life.
authors.affiliation: Yale University School of Nursing, Orange, CT, USA.
authors.forename: Robin
authors.initials: R
authors.lastname: Whittemore
authors.affiliation: Yale University School of Nursing, Orange, CT, USA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Liberti
authors.affiliation: Yale University School of Nursing, Orange, CT, USA.
authors.forename: Sangchoon
authors.initials: S
authors.lastname: Jeon
authors.affiliation: Yale University School of Nursing, Orange, CT, USA Ariana.Chao@yale.edu.
authors.forename: Ariana
authors.initials: A
authors.lastname: Chao
authors.affiliation: Vanderbilt University, Nashville, TN, USA.
authors.forename: Sarah S
authors.initials: SS
authors.lastname: Jaser
authors.affiliation: Yale University School of Nursing, Orange, CT, USA.
authors.forename: Margaret
authors.initials: M
authors.lastname: Grey
mesh_terms: D000293:Adolescent; D002648:Child; D003863:Depression / Q000150:complications* / Q000523:psychology; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000628:therapy; D005195:Family Relations / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D012648:Self Care / Q000523:psychology*
keywords: adolescence; depressive symptoms; family functioning; self-management; type 1 diabetes