Predictors of Glycemic Control in Adolescents of Various Age Groups With Type 1 Diabetes
Shu-Li Lee1, Fu-Sung Lo, Yann-Jinn Lee
11MSN, RN, Instructor, College of Nursing, Kaohsiung Medical University, and Doctoral Student, School of Nursing, Kaohsiung Medical University 2MD, MS, Attending Physician, Division of Endocrinology, Department of Pediatrics, Chang Gung Memorial Hospital 3MD, Attending Physician, Division of Endocrinology, Department of Pediatrics, Mackay Memorial Hospital 4MD, PhD, Attending Physician, Department of Pediatrics, Kaohsiung Medical University Hospital 5PhD, RN, Professor, College of Nursing, Kaohsiung Medical University.
Background:
Understanding the predictors of glycemic control in adolescents of various age groups with type 1 diabetes (T1D) is crucial for nurses to cultivate developmental-specific interventions to improve glycemic control in this age group. However, research has rarely addressed this issue, particularly in the context of Asian populations.
Purpose:
We explored the predictive influence of demographic characteristics, self-care behaviors, family conflict, and parental involvement on glycosylated hemoglobin (HbA1C) levels 6 months after the baseline measurement in adolescents of various age groups with T1D in Taiwan.
Methods:
A prospective survey design was applied. At baseline, adolescents with T1D completed a self-care behavior scale. Parents or guardians finished scales of parental involvement and family conflict. The HbA1C levels 6 months after baseline measurement were collected from medical records. Two hundred ten adolescent-parent/guardian pairs were enrolled as participants. Multiple stepwise regressions examined the significant predictors of HbA1C levels 6 months after the baseline measurement in the three adolescent age groups: 10-12, 13-15, and 16-18 years.
Results:
Family conflict was a significant predictor of HbA1C level within the 10-12 years of age group 6 months after the baseline measurement. Self-care behaviors were a significant predictor of HbA1C level within the 13-15 years of age group 6 months after the baseline measurement. Being female and self-care behaviors were each significant predictors of HbA1C level in the 16-18 years of age group 6 months after the baseline measurement.
Conclusions/Implications For Practice:
Nurses should design specific interventions to improve glycemic control in adolescents of various age groups with T1D that are tailored to their developmental needs. For adolescents with T1D aged 10-12 years, nurses should actively assess family conflict and provide necessary interventions. For adolescents with T1D aged 13-18 years, nurses should exert special efforts to improve their self-care behaviors. In addition, female adolescents aged 16-18 years should be considered an at-risk group.
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