title: Testing Components of a Self-Management Theory in Adolescents With Type 1 Diabetes Mellitus.
abstract: BACKGROUND
  The role of self-management in adolescents with type 1 diabetes mellitus is not well understood.
  
  
  OBJECTIVE
  The purpose of the research was to examine the relationship of key individual and family self-management theory, context, and process variables on proximal (self-management behaviors) and distal (hemoglobin A1c and diabetes-specific health-related quality of life) outcomes in adolescents with type 1 diabetes.
  
  
  METHODS
  A correlational, cross-sectional study was conducted to identify factors contributing to outcomes in adolescents with Type 1 diabetes and examine potential relationships between context, process, and outcome variables delineated in individual and family self-management theory. Participants were 103 adolescent-parent dyads (adolescents ages 12-17) with Type 1 diabetes from a Midwest, outpatient, diabetes clinic. The dyads completed a self-report survey including instruments intended to measure context, process, and outcome variables from individual and family self-management theory.
  
  
  RESULTS
  Using hierarchical multiple regression, context (depressive symptoms) and process (communication) variables explained 37% of the variance in self-management behaviors. Regimen complexity-the only significant predictor-explained 11% of the variance in hemoglobin A1c. Neither process variables nor self-management behaviors were significant. For the diabetes-specific health-related quality of life outcome, context (regimen complexity and depressive symptoms) explained 26% of the variance at step 1; an additional 9% of the variance was explained when process (self-efficacy and communication) variables were added at step 2; and 52% of the variance was explained when self-management behaviors were added at Step 3. In the final model, three variables were significant predictors: depressive symptoms, self-efficacy, and self-management behaviors.
  
  
  CONCLUSIONS
  The individual and family self-management theory can serve as a cogent theory for understanding key concepts, processes, and outcomes essential to self-management in adolescents and families dealing with Type 1 diabetes mellitus.
authors: Gwen Verchota, PhD, CNP, is Nurse Scientist and Care Delivery Manager, virtuwell by HealthPartners, St. Paul, Minnesota. Kathleen J. Sawin, PhD, CPNP-PC, FAAN, is Professor Emerita, University of Wisconsin-Milwaukee College of Nursing, and Nurse Scientist, Children's Hospital of Wisconsin, Milwaukee, Wisconsin.
authors: Gwen
authors: G
authors: Verchota
authors: Kathleen J
authors: KJ
authors: Sawin
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D001294:Attitude to Health; D002648:Child; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000628:therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015146:Midwestern United States; D010290:Parents / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D012648:Self Care / Q000523:psychology*; D020377:Self Efficacy; D011795:Surveys and Questionnaires
chemical_list: D006442:Glycated Hemoglobin