Self-management as a mediator of family functioning and depressive symptoms with health outcomes in youth with type 1 diabetes

West J Nurs Res. 2014 Oct;36(9):1254-71. doi: 10.1177/0193945913516546. Epub 2013 Dec 19.

Abstract

This study examined the relationship of family functioning and depressive symptoms with self-management, glycemic control, and quality of life in a sample of adolescents with type 1 diabetes. It also explored whether self-management mediates family functioning, depressive symptoms, and diabetes-related outcomes. Structural equation modeling was used to estimate parameters in the conceptual causal pathway and test mediation effects. Adolescents (n = 320) were primarily female (55%), younger adolescents (58%), and self-identified as White (63%). Self-management mediated the relationship between family conflict, family warmth-caring, parent guidance-control, and youth depressive symptoms with glycosylated hemoglobin (A1C). In addition, self-management mediated the relationship between family conflict and youth depressive symptoms with quality of life. Supporting optimal family functioning and treating elevated depressive symptoms in adolescents with type 1 diabetes has the potential to improve self-management, glycemic control, and quality of life.

Keywords: adolescence; depressive symptoms; family functioning; self-management; type 1 diabetes.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Depression / complications*
  • Depression / psychology
  • Diabetes Mellitus, Type 1 / complications*
  • Diabetes Mellitus, Type 1 / therapy
  • Family Relations / psychology*
  • Female
  • Humans
  • Male
  • Outcome Assessment, Health Care
  • Quality of Life*
  • Self Care / psychology*