title: The relationship between parenting stress and parent-child interaction with health outcomes in the youngest patients with type 1 diabetes (0-7 years).
abstract: To test whether parenting stress and the quality of parent-child interaction were associated with glycemic control and quality of life (QoL) in young children (0-7 years) with type 1 diabetes (T1DM), we videotaped 77 families with a young child with T1DM during mealtime (including glucose monitoring and insulin administration). Parent-child interactions were scored with a specifically designed instrument. Questionnaires assessed general and disease-related parenting stress and (diabetes-specific (DS)) QoL. HbA(1c) (glycemic control) was extracted from the medical records. Both general and disease-related parenting stress were associated with a lower (DS)QoL (r ranged from -0.39 to -0.70, p < 0.05), but not with HbA(1c) levels. Furthermore, with regard to the parent-child interaction, emotional involvement of parents (r = 0.23, p < 0.05) and expressed discomfort of the child (r = 0.23, p < 0.05) were related to suboptimal HbA(1c) levels. There was no clear pattern in the correlations between parent-child interaction and (DS)QoL.
  
  
  CONCLUSIONS
  The results support the notion that diabetes does not only affect the child with T1DM: T1DM is a family disease, as parenting factors (like stress and parent-child interactions) are associated with important child outcomes. Therefore, it is important for health-care providers to not only focus on the child with T1DM, but also on the family system.
authors.affiliation: Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands. a.m.nieuwesteeg@tilburguniversity.edu.
authors.forename: Anke M
authors.initials: AM
authors.lastname: Nieuwesteeg
authors.affiliation: Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands. e.e.hartman@tilburguniversity.edu.
authors.forename: Esther E
authors.initials: EE
authors.lastname: Hartman
authors.affiliation: Diabeter, 3011 TG, Rotterdam, The Netherlands. h.j.aanstoot@diabeter.nl.
authors.forename: Henk-Jan
authors.initials: HJ
authors.lastname: Aanstoot
authors.affiliation: Department of TRANZO, Scientific Center for Care and Welfare, Tilburg University, Tilburg, The Netherlands. h.j.a.vanbakel@tilburguniversity.edu.
authors.forename: Hedwig J A
authors.initials: HJ
authors.lastname: van Bakel
authors.affiliation: Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands. w.h.m.emons@tilburguniversity.edu.|Department of Methodology and Statistics, Tilburg University, PO Box 90153, 5000 LE, Tilburg, The Netherlands. w.h.m.emons@tilburguniversity.edu.
authors.forename: Wilco H M
authors.initials: WH
authors.lastname: Emons
authors.affiliation: Kidz&Ko, Jeroen Bosch Hospital, 's Hertogenbosch, The Netherlands. e.milvan@jbz.nl.
authors.forename: Edgar
authors.initials: E
authors.lastname: van Mil
authors.affiliation: Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands. f.pouwer@tilburguniversity.edu.
authors.forename: Frans
authors.initials: F
authors.lastname: Pouwer
mesh_terms: D001786:Blood Glucose; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000523:psychology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D010287:Parent-Child Relations; D016487:Parenting / Q000523:psychology*; D010290:Parents / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin
keywords: Behavior; Children; Parents; Parent–child interaction; Type 1 diabetes mellitus