Testing Components of a Self-Management Theory in Adolescents With Type 1 Diabetes Mellitus

• Published in: Nursing research (New York) Vol. 65; no. 6; p. 487
• Main Authors: Verchota, Gwen, Sawin, Kathleen J
• Format: Journal Article
• Language: English
• Published: United States 01.11.2016
• Subjects: Adolescent; Adolescent Behavior; Adult; Attitude to Health; Child; Cross-Sectional Studies; Diabetes Mellitus, Type 1 - therapy; Female; Glycated Hemoglobin A - analysis; Humans; Male; Middle Aged; Midwestern United States; Parents - psychology; Quality of Life - psychology; Self Care - psychology; Self Efficacy; Surveys and Questionnaires
• ISSN: 1538-9847
• DOI: 10.1097/NNR.0000000000000180

The role of self-management in adolescents with type 1 diabetes mellitus is not well understood. 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. 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. 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. 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.