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12-09-2014 | Psychosocial care | Article

Good Cop, Bad Cop: Quality of Parental Involvement in Type 1 Diabetes Management in Youth

Journal: Current Diabetes Reports

Authors: Mackenzie T. Young, Jadienne H. Lord, Niral J. Patel, Meredith A. Gruhn, Sarah S. Jaser

Abstract

Sustained parental involvement in diabetes management has been generally advised to counteract the deteriorating adherence and glycemic control often seen during adolescence, yet until recently, little attention has been given to the optimal amount, type, and quality of parental involvement to promote the best health outcomes for adolescents with type 1 diabetes (T1D). This review synthesizes research regarding the involvement of caregivers—primarily mothers and fathers—of youth with T1D, with a focus on biopsychosocial outcomes. The recent literature on parental involvement in diabetes management highlights a shift in focus from not only amount but also the types (e.g., monitoring, problem-solving) and quality (e.g., warm, critical) of involvement in both mothers and fathers. We provide recommendations for ways that both parents can remain involved to facilitate greater collaboration in shared direct and indirect responsibility for diabetes care and improve outcomes in youth with T1D.

Whittemore R et al. Psychological experience of parents of children with type 1 diabetes a systematic mixed-studies review. The Diabetes Educ. 2012;38(4):562–79.CrossRef

Helgeson VS et al. Parent and adolescent distribution of responsibility for diabetes self-care: links to health outcomes. J Pediatr Psychol. 2008;33(5):497–508.PubMedCentralPubMedCrossRef

Wysocki T et al. Collaborative involvement of primary and secondary caregivers: associations with youths’ diabetes outcomes. J Pediatr Psychol. 2009;34(8):869–81.PubMedCentralPubMedCrossRef

4.••

Wiebe DJ, et al. Developmental processes associated with longitudinal declines in parental responsibility and adherence to type 1 diabetes management across adolescence. J. Pediatr Psychol. 2014: p. jsu006. This study provides some of the first longitudinal evidence of the association between declines in parental responsibility and deteriorating adolescent adherence, while emphasizing the important role of adolescent self-efficacy.

Kovacs M et al. Psychological functioning among mothers of children with insulin-dependent diabetes mellitus: a longitudinal study. J Consult Clin Psychol. 1990;58(2):189.PubMedCrossRef

Swallow V et al. Fathers’ contributions to the management of their child’s long-term medical condition: a narrative review of the literature. Health Expect. 2012;15(2):157–75.PubMedCrossRef

Wysocki T, Gavin L. Paternal involvement in the management of pediatric chronic diseases: associations with adherence, quality of life, and health status. J Pediatr Psychol. 2006;31(5):501–11.PubMedCrossRef

Gavin L, Wysocki T. Associations of paternal involvement in disease management with maternal and family outcomes in families with children with chronic illness. J Pediatr Psychol. 2006;31(5):481–9.PubMedCrossRef

King PS et al. Longitudinal trajectories of parental involvement in type 1 diabetes and adolescents’ adherence. Health Psychol. 2014;33(5):424–32.PubMedCrossRef

10.

Berg CA et al. Parental persuasive strategies in the face of daily problems in adolescent type 1 diabetes management. Health Psychol. 2013;32(7):719.PubMedCrossRef

11.

Hilliard ME et al. Fathers’ involvement in preadolescents’ diabetes adherence and glycemic control. J Pediatr Psychol. 2011;36(8):911–22.PubMedCentralPubMedCrossRef

12.•

Hansen JA et al. Paternal involvement in pediatric type 1 diabetes: fathers’ and mothers’ psychological functioning and disease management. Fam Syst Health. 2012;30(1):47. This study offers evidence that increased paternal support is related to better maternal and child adjustment outcomes, but findings suggest that fathers may only become involved in response to poor glycemic control. PubMedCrossRef

13.••

Hilliard ME et al. Patterns and predictors of paternal involvement in early adolescents’ type 1 diabetes management over 3 years. J Pediatr Psychol. 2014;39(1):74–83. This study provides longitudinal evidence that different aspects of paternal involvement can predict youths’ diabetes self-management and extends previous findings that fathers may become more involved as need arises. PubMedCrossRef

14.•

Berg CA et al. Parental involvement and adolescents’ diabetes management: the mediating role of self-efficacy and externalizing and internalizing behaviors. J Pediatr Psychol. 2011;36(3):329–39. This study offers evidence indicating that both monitoring and a high quality parent-child relationship are important in promoting adherence and glycemic control in adolescents through better self-efficacy for diabetes management. PubMedCentralPubMedCrossRef

15.••

King PS et al. Longitudinal trajectories of metabolic control across adolescence: associations with parental involvement, adolescents’ psychosocial maturity, and health care utilization. J Adolesc Health. 2012;50(5):491–6. This study provides longitudinal evidence demonstrating that adolescents with rapidly deteriorating glycemic control reported lower parental monitoring and frequency of help with diabetes care, lower levels of autonomy and greater number of hospitalizations. PubMedCrossRef

16.

Hsin O et al. Adherence and glycemic control among Hispanic youth with type 1 diabetes: role of family involvement and acculturation. J Pediatr Psychol. 2010;35(2):156–66.PubMedCentralPubMedCrossRef

17.

Ingerski LM et al. Blood glucose monitoring and glycemic control in adolescence: contribution of diabetes-specific responsibility and family conflict. J Adolesc Health. 2010;47(2):191–7.PubMedCentralPubMedCrossRef

18.

Vesco AT et al. Responsibility sharing between adolescents with type 1 diabetes and their caregivers: importance of adolescent perceptions on diabetes management and control. J Pediatr Psychol. 2010;35(10):1168–77.PubMedCentralPubMedCrossRef

19.

Palmer DL et al. Mothers’, fathers’, and children’s perceptions of parental diabetes responsibility in adolescence: Examining the roles of age, pubertal status, and efficacy. J Pediatr Psychol. 2009;34(2):195–204.PubMedCentralPubMedCrossRef

20.

Hanna KM, Decker CL. A concept analysis: assuming responsibility for self‐care among adolescents with type 1 diabetes. J Specialists Pediatr Nurs. 2010;15(2):99–110.CrossRef

21.

Berg CA et al. Role of parental monitoring in understanding the benefits of parental acceptance on adolescent adherence and metabolic control of type 1 diabetes. Diabetes Care. 2008;31(4):678–83.PubMedCrossRef

22.

Ellis DA et al. Toward conceptual clarity in a critical parenting construct: parental monitoring in youth with chronic illness. J Pediatr Psychol. 2008;33(8):799–808.PubMedCentralPubMedCrossRef

23.

Cemeroglu AP, et al. Comparison of the expectations of caregivers and children with type 1 diabetes mellitus for independence in diabetes care-related tasks. Endocrine Practice. 2014; p. 1-22.

24.

Horton D et al. The role of parental monitoring in metabolic control: effect on adherence and externalizing behaviors during adolescence. J Pediatr Psychol. 2009;34(9):1008–18.PubMedCentralPubMedCrossRef

25.•

Hilliard ME et al. Disentangling the roles of parental monitoring and family conflict in adolescents’ management of type 1 diabetes. Health Psychol. 2013;32(4):388. This study offers evidence that the risk of poorer glycemic control associated with decreasing parental monitoring is greater than that of elevated family conflict, supporting the importance of maintaining sufficient levels of monitoring, even with the possibility of increased conflict. PubMedCrossRef

26.

Robinson EM. Assessing parental involvement in type 1 diabetes management during adolescence. 2011, Virginia Commonwealth University Richmond, VA.

27.

Palmer DL et al. The structure of parental involvement and relations to disease management for youth with type 1 diabetes. J Pediatr Psychol. 2011;36(5):596–605.PubMedCentralPubMedCrossRef

28.

Spera C. A review of the relationship among parenting practices, parenting styles, and adolescent school achievement. Educ Psychol Rev. 2005;17(2):125–46.CrossRef

29.

Jaser SS, Grey M. A pilot study of observed parenting and adjustment in adolescents with type 1 diabetes and their mothers. J Pediatr Psychol. 2010;35(7):738–47.PubMedCentralPubMedCrossRef

30.

Lloyd SM et al. Brief report: Hope, perceived maternal empathy, medical regimen adherence, and glycemic control in adolescents with type 1 diabetes. J Pediatr Psychol. 2009;34(9):1025–9.PubMedCrossRef

31.

Mlynarczyk SM. Adolescents’ perspectives of parental practices influence diabetic adherence and quality of life. Pediatr Nurs. 2013;39(4):181–9.PubMed

32.

Geffken GR et al. Family functioning processes and diabetic ketoacidosis in youths with type I diabetes. Rehabil Psychol. 2008;53(2):231.CrossRef

33.

Shorer M et al. Role of parenting style in achieving metabolic control in adolescents with type 1 diabetes. Diabetes Care. 2011;34(8):1735–7.PubMedCentralPubMedCrossRef

34.

Greene MS et al. Metabolic control, self-care behaviors, and parenting in adolescents with type 1 diabetes a correlational study. Diabetes Educ. 2010;36(2):326–36.PubMedCrossRef

35.

Céspedes-Knadle YM, Munoz CE. Development of a group intervention for teens with type 1 diabetes. J Specialists Group Work. 2011;36(4):278–95.CrossRef

36.

Nansel TR et al. Development and validation of the collaborative parent involvement scale for youths with type 1 diabetes. J Pediatr Psychol. 2009;34(1):30–40.PubMedCentralPubMedCrossRef

37.

Weissberg-Benchell J et al. Generic and diabetes-specific parent–child behaviors and quality of life among youth with type 1 diabetes. J Pediatr Psychol. 2009;34(9):977–88.PubMedCentralPubMedCrossRef

38.

Butner J et al. Parent–adolescent discrepancies in adolescents’ competence and the balance of adolescent autonomy and adolescent and parent well-being in the context of type 1 diabetes. Dev Psychol. 2009;45(3):835.PubMedCentralPubMedCrossRef

39.

Osborn P et al. What mom and dad don’t know can hurt you: adolescent disclosure to and secrecy from parents about type 1 diabetes. J Pediatr Psychol. 2013;38(2):141–50.PubMedCentralPubMedCrossRef

40.

Pomerantz EM, Eaton MM. Maternal intrusive support in the academic context: transactional socialization processes. Dev Psychol. 2001;37(2):174.PubMedCrossRef

41.

Weinger K, O’Donnell KA, Ritholz MD. Adolescent views of diabetes-related parent conflict and support: a focus group analysis. J Adolesc Health. 2001;29(5):330–6.PubMedCentralPubMedCrossRef

42.

Hood KK et al. Updated and revised diabetes family conflict scale. Diabetes Care. 2007;30(7):1764–9.PubMedCrossRef

43.

Lewin AB et al. The relation between family factors and metabolic control: the role of diabetes adherence. J Pediatr Psychol. 2006;31(2):174–83.PubMedCrossRef

44.

Cameron F et al. Are family factors universally related to metabolic outcomes in adolescents with type 1 diabetes? Diabet Med. 2008;25(4):463–8.PubMedCrossRef

45.

Duke DC et al. Glycemic control in youth with type 1 diabetes: family predictors and mediators. J Pediatr Psychol. 2008;33(7):719–27.PubMedCrossRef

46.

Sweenie R, Mackey ER, and R. Streisand, parent–child relationships in type 1 diabetes: associations among child behavior, parenting behavior, and pediatric parenting stress. Families, Systems, & Health. 2014;32(1):31.

47.

Seiffge-Krenke I et al. Declining metabolic control and decreasing parental support among families with adolescents with diabetes: the risk of restrictiveness. J Pediatr Psychol. 2013;38(5):518–30.PubMedCentralPubMedCrossRef

48.

Butler JM et al. Maternal parenting style and adjustment in adolescents with type I diabetes. J Pediatr Psychol. 2007;32(10):1227–37.PubMedCrossRef

49.•

Armstrong B, Mackey ER, Streisand R. Parenting behavior, child functioning, and health behaviors in preadolescents with type 1 diabetes. J Pediatr Psychol. 2011;36(9):1052–61. This study offers evidence for the association between parenting behaviors, particularly critical parenting behaviors, and child depressive symptoms and self-efficacy, both factors linked to diabetes outcomes. PubMedCentralPubMedCrossRef

50.

Ivey JB, Wright A, Dashiff CJ. Finding the balance: adolescents with type 1 diabetes and their parents. J Pediatr Health Care. 2009;23(1):10–8.PubMedCrossRef

51.

Dashiff C, et al. Parents’ experiences supporting self-management of middle adolescents with type 1 diabetes mellitus. Pediatr Nurs. 2011. 37(6).

52.

Bureau, U.S.C. America’s children: key national indicators of well-being, 2013. Family Structure and Children’s Living Arrangements 2013 [cited 2014; Available from: http://www.childstats.gov/americaschildren/famsoc1.asp.

53.

Blau DM, Van der Klaauw W. What determines family structure? Econ Inq. 2013;51(1):579–604.CrossRef

54.

Blau DM, Van der Klaauw W. A demographic analysis of the family structure experiences of children in the United States. Rev Econ Househ. 2008;6(3):193–221.CrossRef

55.

Thompson SJ, Auslander WF, White NH. Comparison of single-mother and two-parent families on metabolic control of children with diabetes. Diabetes Care. 2001;24(2):234–8.PubMedCrossRef

56.

Urbach SL et al. Predictors of glucose control in children and adolescents with type 1 diabetes mellitus. Pediatr Diabetes. 2005;6(2):69–74.PubMedCrossRef

57.

Johns C, Faulkner MS, Quinn L. Characteristics of adolescents with type 1 diabetes who exhibit adverse outcomes. Diabetes Educ. 2008;34(5):874–85.PubMedCentralPubMedCrossRef

58.

Swift EE et al. Demographic risk factors, mediators, and moderators in youths’ diabetes metabolic control. Ann Behav Med. 2006;32(1):39–49.PubMedCrossRef

59.

Frey MA et al. Predicting metabolic control in the first 5 yr after diagnosis for youths with type 1 diabetes: the role of ethnicity and family structure. Pediatr Diabetes. 2007;8(4):220–7.PubMedCrossRef

60.

Edmonds-Myles S, Tamborlane WV, Grey M. Perception of the impact of type 1 diabetes on low-income families. Diabetes Educ. 2010;36(2):318–25.PubMedCrossRef

61.

Gallegos‐Macias AR et al. Relationship between glycemic control, ethnicity and socioeconomic status in Hispanic and white non‐Hispanic youths with type 1 diabetes mellitus. Pediatr Diabetes. 2003;4(1):19–23.PubMedCrossRef

62.

Jacobsen JJ, et al. Race/ethnicity and measures of glycaemia in the year after diagnosis among youth with type 1 and type 2 diabetes mellitus. J Diabetes Complicat. 2014.

63.

Drew LM et al. Depleted parental psychological resources as mediators of the association of income with adherence and metabolic control. J Fam Psychol. 2011;25(5):751.PubMedCrossRef

64.

Lord JH, et al. Effect of race and marital status on mothers’ observed parenting and adolescent adjustment in youth with type 1 diabetes. J Pediatr Psychol. In press.

65.

Anderson BJ. Parenting styles and parenting practices in pediatric diabetes. Diabetes Care. 2011;34:1885–6.PubMedCentralPubMedCrossRef

66.

Carcone AI, Ellis DA, Naar-King S. Linking caregiver strain to diabetes illness management and health outcomes in a sample of adolescents in chronically poor metabolic control. J Dev Behav Pediatr. 2012;33(4):343–51.PubMedCrossRef

67.

Eckshtain D et al. The effects of parental depression and parenting practices on depressive symptoms and metabolic control in urban youth with insulin dependent diabetes. J Pediatr Psychol. 2010;35(4):426–35.PubMedCentralPubMedCrossRef

68.

Williams L, Laffel L, Hood K. Diabetes‐specific family conflict and psychological distress in paediatric type 1 diabetes. Diabet Med. 2009;26(9):908–14.PubMedCrossRef

69.

Rodrigues N, Patterson JM. Impact of severity of a child's chronic condition on the functioning of two-parent families. J Pediatr Psychol. 2007;32(4):417–26.PubMedCrossRef

70.

Soliday E, Kool E, Lande MB. Family environment, child behavior, and medical indicators in children with kidney disease. Child Psychiatry Hum Dev. 2001;31(4):279–95.PubMedCrossRef

71.

Worrall-Davies A et al. The effect of parental expressed emotion on glycaemic control in children with type 1 diabetes: parental expressed emotion and glycaemic control in children. J Psychosom Res. 2002;52(2):107–13.PubMedCrossRef

72.

Mayberry LS and Osborn CY. Family members’ supportive and obstructive behaviors are associated with the self-care behaviors of adults with diabetes. 2014: Philadelphia, PA.

73.

Hilliard ME, Harris MA, Weissberg-Benchell J. Diabetes resilience: a model of risk and protection in type 1 diabetes. Curr Diabetes Rep. 2012;12(6):739–48.CrossRef

74.

Carroll AE et al. Contracting and monitoring relationships for adolescents with type 1 diabetes: a pilot study. Diabetes Technol Ther. 2011;13(5):543–9.PubMedCentralPubMedCrossRef

75.

Alderfer MA et al. Evidence-based assessment in pediatric psychology: family measures. J Pediatr Psychol. 2008;33(9):1046–61.PubMedCentralPubMedCrossRef

76.

Anderson BJ et al. An office-based intervention to maintain parent-adolescent teamwork in diabetes management. Impact on parent involvement, family conflict, and subsequent glycemic control. Diabetes Care. 1999;22(5):713–21.PubMedCrossRef

77.

Wysocki T et al. Randomized, controlled trial of behavioral family systems therapy for diabetes: maintenance and generalization of effects on parent-adolescent communication. Behav Ther. 2008;39(1):33–46.PubMedCrossRef

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