ABSTRACT
Background: Understanding the predictors of glycemic control in adolescents of various age groups with type 1 diabetes (T1D) is crucial for nurses to cultivate developmental-specific interventions to improve glycemic control in this age group. However, research has rarely addressed this issue, particularly in the context of Asian populations.
Purpose: We explored the predictive influence of demographic characteristics, self-care behaviors, family conflict, and parental involvement on glycosylated hemoglobin (HbA1C) levels 6 months after the baseline measurement in adolescents of various age groups with T1D in Taiwan.
Methods: A prospective survey design was applied. At baseline, adolescents with T1D completed a self-care behavior scale. Parents or guardians finished scales of parental involvement and family conflict. The HbA1C levels 6 months after baseline measurement were collected from medical records. Two hundred ten adolescent-parent/guardian pairs were enrolled as participants. Multiple stepwise regressions examined the significant predictors of HbA1C levels 6 months after the baseline measurement in the three adolescent age groups: 10-12, 13-15, and 16-18 years.
Results: Family conflict was a significant predictor of HbA1C level within the 10-12 years of age group 6 months after the baseline measurement. Self-care behaviors were a significant predictor of HbA1C level within the 13-15 years of age group 6 months after the baseline measurement. Being female and self-care behaviors were each significant predictors of HbA1C level in the 16-18 years of age group 6 months after the baseline measurement.
Conclusions/Implications for Practice: Nurses should design specific interventions to improve glycemic control in adolescents of various age groups with T1D that are tailored to their developmental needs. For adolescents with T1D aged 10-12 years, nurses should actively assess family conflict and provide necessary interventions. For adolescents with T1D aged 13-18 years, nurses should exert special efforts to improve their self-care behaviors. In addition, female adolescents aged 16-18 years should be considered an at-risk group.