Diabetes self-care goals and their relation to children's metabolic control

Undertook a goal systems analysis in order to elucidate the nature of diabetic children's cognitive representations of their health-related activities. Using a modified version of Little's (1983) Personal Projects Analysis methodology, youngsters with Type I diabetes were asked to sort health-care goals into self-selected versus imposed categories. Goal dimension differences were compared via t tests, revealing that children make clear evaluative distinctions among types of diabetes-care activities. Factor analyses further revealed distinct conceptualizations for "told to do" versus "want to do" goals. When metabolic control (as measured by glycosolated hemoglobin assays) was regressed on the derived factors for selected and imposed self-care goals, none of the self-selected (want to do) factors, but two of the three imposed (told to do) factors, contributed significantly to variance in HbAlc. Implications and design limitations are discussed.