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Child and parental executive functioning in type 1 diabetes: Their unique and interactive role toward treatment adherence and glycemic control
Author(s) -
Goethals Eveline R,
de Wit Maartje,
Van Broeck Nady,
Lemiere Jurgen,
Van Liefferinge Dagmar,
Böhler Susanne,
De wulf Marian,
Dello Elke,
Laridaen Jolien,
Van Hecke Lynn,
Van Impe Shana,
Casteels Kristina,
Luyckx Koen
Publication year - 2018
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/pedi.12552
Subject(s) - glycemic , moderation , medicine , neuropsychology , clinical psychology , developmental psychology , multilevel model , type 1 diabetes , diabetes mellitus , cognition , psychology , psychiatry , social psychology , machine learning , computer science , endocrinology
Objective Managing type 1 diabetes ( T1D ) requires the ability to make complex and critical decisions regarding treatment, to execute complex tasks accurately, and to make adjustments when problems arise. This requires effective neuropsychological competences of patients and their families, especially in the domain of executive functioning ( EF ): the ability to self‐monitor, plan, solve problems, and set priorities. Previous research focused mainly on child EF , neglecting the impact of parental EF . This study included both mothers and fathers and examined associations between child and parental EF and treatment adherence to T1D in a broad age range of patients. Methods Parents of 270 patients (6‐18 years) with T1D (mean age 12.7 years; 52.6% female) were included. Mothers ( N = 232) and fathers ( N = 168) completed questionnaires on child and parental EF and on treatment adherence. Analyses examined the associations linking child and parental EF to treatment adherence and glycemic control (and potential moderation effects in these associations) using hierarchical linear regression. Results Child EF problems were negatively associated with treatment adherence. As an indication of moderation, this effect was stronger in older children. Better treatment adherence and glycemic control were reported when both child and parent showed less EF problems. Effects were more pronounced in mothers than in fathers. Conclusions This study demonstrated a significant interplay between child and parental EF in the association with treatment adherence and glycemic control. Researchers and clinicians should remain attentive toward the role of neuropsychological concepts such as EF . Implementation in clinical practice seems meaningful.