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Ready or not? Greater readiness for independent self‐care predicts better self‐management but not HbA 1c in teens with type 1 diabetes
Author(s) -
Goethals Eveline R.,
Volkening Lisa K.,
Tinsley Liane,
Laffel Lori M.
Publication year - 2021
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/dme.14507
Subject(s) - medicine , diabetes mellitus , self management , psychological intervention , bivariate analysis , diabetes management , type 2 diabetes , type 1 diabetes , family medicine , longitudinal study , proxy (statistics) , clinical psychology , nursing , endocrinology , statistics , mathematics , pathology , machine learning , computer science
Objective Prior to the transfer from paediatric to adult health care transition, teens with type 1 diabetes seek increasing independence in diabetes self‐care while parent involvement in care decreases. Yet, few teens attain glycaemic targets. This study aimed to assess changes in perceived readiness for independent self‐care in teens with type 1 diabetes over 18 months, from both teens' and parents' perspectives, and to evaluate its predictive value for diabetes self‐management and haemoglobin A1c (HbA 1c ). Research design and methods At baseline, 6, 12 and 18 months, 178 teens with type 1 diabetes (mean ± SD age 14.9±1.3 years; HbA 1c 8.5 ± 1.0% (69 ± 11 mmol/mol); 48% female) and their parents completed the Readiness for Independent Self‐Care Questionnaire (RISQ‐T and RISQ‐P, respectively) and a measure of self‐management. Chart review provided HbA 1c values. Statistical analyses encompassed bivariate correlations, paired t‐tests and multivariable longitudinal mixed models. Results Teens perceived greater self‐care readiness than their parents at baseline and over 18 months of follow‐up. Both teen and parent perceptions of teen readiness for independent self‐care increased over time, and significantly predicted higher teen self‐ and parent proxy‐reported teen diabetes self‐management, respectively, but not improved HbA 1c . Conclusions The current findings may point to a disconnect between how increased readiness for independent self‐care may translate into better perceived diabetes self‐management, but not into better HbA 1c . In an effort to optimize HbA 1c in teens with type 1 diabetes, future research is needed to design interventions that align perceived readiness for independent self‐care with self‐care behaviours that improve HbA 1c .