Virtuwell Health Promoters, USA
Title: Testing components of a self-management theory in adolescents with type 1 diabetes mellitis
Gwen Verchota is working in Virtuwell Health Promoters located in USA and is very interested in the field of Nursing.
Background: The role of self-management (SM) in adolescents with Type 1 Diabetes Mellitus (T1DM) is not well understood. Purpose: Examine the relationship of key Individual and Family Self-management Theory (IFSMT) context and process variables on proximal (self-management behaviors [SMB]) and distal (hemoglobin A1c [HgbA1c] and diabetes-specific health-related quality of life [DQOL]) outcomes in adolescents with T1DM. Methods: A correlational, cross-sectional study was undertaken to identify factors contributing to outcomes in adolescents with T1DM and further examine potential direct and mediating relationships that exist between context, process, and outcome variables delineated in the IFSMT. Participants included 103 adolescent-parent dyads (adolescents aged 12-17 years with T1DM) from a Midwest outpatient diabetes clinic. The dyads each completed a self-report survey including instruments intended to measure context, process, and outcome variables from the IFSMT. Results: Using hierarchical multiple regression, context (depressive symptoms) and process (communication) variables explained 37 % of the variance in SMB. Regimen complexity explained 11% of the variance in metabolic control. Only regimen complexity was significant at Step 1. Neither process variables nor SMB was significant. For the DQOL 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 (SE and communication) variables were added at Step 2 and a total of 52% of the variance was explained when SMB were added at Step 3. In the final model, three variables were significant: depressive symptoms, SE, and SMB. The criteria for mediation were not met. Conclusions: IFSMT can serve as a cogent theory for understanding key concepts, processes, and outcomes essential to SM in adolescents and families dealing with T1DM.