Yıl: 2017 Cilt: 9 Sayı: 3 Sayfa Aralığı: 253 - 259 Metin Dili: İngilizce İndeks Tarihi: 29-07-2022

The Relationship Between Perceived Family Climate and Glycemic Control in Type 1 Diabetes Mellitus Adolescent Patients

Öz:
Objective: Type 1 diabetes mellitus (T1DM) is a chronic disease which ranks third in children under age 16 years. Expressed emotion (EE) is a term that indicates a specific family climate including lack of emotional support (LES), irritability, and emotional overinvolvement. It is known that the family environment is highly important for glycemic control in diabetic adolescents. In this study, the relationship between perceived EE and glycemic control in adolescents diagnosed with T1DM not accompanied by psychopathology were investigated.Methods: The study included 49 adolescents with T1DM and 50 adolescents as a control group. Adolescents with psychopathology and intellectual disability were excluded from the study. Perceived EE was measured by the Shortened Level of Expressed Emotion Scale (SLEES) and blood sugar regulation was assessed by HbA1c levels.Results: The adolescents with T1DM showed a significant difference in perceived EE (p=0.020) and LES (p=0.014) when compared with the control group. When diabetic adolescents were compared among themselves, the diabetic adolescents with poor glycemic control perceived greater EE (p=0.033) and less emotional support (p=0.049). In regression analyses, the predictive power of mother's educational level, the employment status of mothers and the subscale "LES" of SLEES combined to explain HbA1c level was determined to be 37.8%.Conclusion: The strong relationship between perceived EE and glycemic control showed us that perceived EE can hinder treatment compliance without causing psychopathology. For this reason, it is recommended that not only patients with psychopathology, but all diabetic adolescents receive psychosocial support and family interventions.
Anahtar Kelime:

Konular: Endokrinoloji ve Metabolizma Pediatri
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Cameron FJ, Amin R, de Beaufort C, Codner E, Acerini CL; International Society for Pediatric and Adolescent Diabetes. 2014;15(Suppl 20):245-256. Epub 2014 Jul 12
  • 2. Dantzer C, Swendsen J, Maurice-Tison S, Salamon R. Anxiety and depression in juvenile diabetes: a critical review. Clin Psychol Rev 2003;23:787-800.
  • 3. Egede LE. Diabetes, major depression, and functional disability among U.S adults. Diabetes Care 2004;27:421-428.
  • 4. Skinner TC, Channon S, Howells L, McEvilley A. Diabetes during adolescence. Psychology in Diabetes Care 2000:25-59.
  • 5. Grabill KM, Geffken GR, Duke D, Lewin A, Williams L, Storch E, Silverstein J. Family functioning and adherence in youth with type 1 diabetes: A latent growth model of glycemic control. Children's Health Care 2010;39:279-295.
  • 6. Helgeson VS, Siminerio L, Escobar O, Becker D. Predictors of metabolic control among adolescents with diabetes: a 4-year longitudinal study. J Pediatr Psychol 2009;34:254-270. Epub 2008 Jul 30
  • 7. Cameron FJ, Skinner TC, de Beaufort CE, Hoey H, Swift PG, Aanstoot H, Aman J, Martul P, Chiarelli F, Daneman D, Danne T, Dorchy H, Kaprio EA, Kaufman F, Kocova M, Mortensen HB, Njølstad PR, Phillip M, Robertson KJ, Schoenle EJ, Urakami T, Vanelli M, Ackermann RW, Skovlund SE; Hvidoere Study Group on Childhood Diabetes. Are family factors universally related to metabolic outcomes in adolescents with Type 1 diabetes? Diabet Med 2008;25:463-468. Epub 2008 Feb 19
  • 8. Seiffge-Krenke I, Laursen B, Dickson DJ, Hartl AC. Declining metabolic control and decreasing parental support among families with adolescents with diabetes: the risk of restrictiveness. J Pediatr Psychol 2013;38:518-530. Epub 2013 Apr 5
  • 9. Asarnow JR, Tompson M, Hamilton EB, Goldstein MJ, Guthrie D. Familyexpressed emotion, childhood-onset depression, and childhood-onset schizophrenia spectrum disorders: is expressed emotion a nonspecific correlate of child psychopathology or a specific risk factor for depression? J Abnorm Child Psychol 1994;22:129-146.
  • 10. Peris TS, Miklowitz DJ. Parental Expressed Emotion and Youth Psychopathology: New Directions for an Old Construct. Child Psychiatry Hum Dev 2015;46:863-873.
  • 11. Huston SA, Blount RL, Heidesch T, Southwood R. Resilience, emotion processing and emotion expression among youth with type 1 diabetes. Pediatr Diabetes 2016;17:623-631. Epub 2016 Jan 14
  • 12. Koenigsberg HW, Klausner E, Pelino D, Rosnick P, Campbell R. Expressed emotion and glucose control in insulin-dependent diabetes mellitus. Am J Psychiatry 1993;1507:1114-1115.
  • 13. Stevenson K, Sensky T, Petty R. Glycaemic control in adolescents with type I diabetes and parental expressed emotion. Psychother Psychosom 1991;55:170-175.
  • 14. Worrall-Davies A, Owens D, Holland P, Haigh D. The effect of parental expressed emotion on glycaemic control in children with Type 1 diabetes: Parental expressed emotion and glycaemic control in children. J Psychosom Res 2002;52:107-113.
  • 15. Liakopoulou M, Alifieraki T, Katideniou A, Peppa M, Maniati M, Tzikas D, Hibbs ED, Dacou-Voutetakis C. Maternal expressed emotion and metabolic control of children and adolescents with diabetes mellitus. Psychother Psychosom 2001;70:78-85.
  • 16. Peris TS, Miklowitz DJ. Parental expressed emotion and youth psychopathology: New directions for an old construct. Child Psychiatry Hum Dev 2015;46:863-873.
  • 17. Rewers M, Pihoker C, Donaghue K, Hanas R, Swift P, Klingensmith GJ; International Society for Pediatric and Adolescent Diabetes (ISBAD) . Assessment and monitoring of glycemic control in children and adolescents with diabetes. Pediatr Diabetes 2007;8:408-418.
  • 18. Kaufman J, Birmaher B, Brent D, Rao U, Flynn C, Moreci P, Williamson D, Ryan N . Schedule for affective disorders and schizophrenia for schoolage children-present and lifetime version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry 1997;36:980-988.
  • 19. Gökler B, Ünal F, Pehlivantürk B, Kültür EÇ, Akdemir D, Taner Y. Okul Çağı Çocukları İçin Duygulanım Bozuklukları ve Şizofreni Görüşme Çizelgesi-Şimdi ve Yaşam Boyu Şekli-Türkçe Uyarlamasının Geçerlik ve Güvenirliği. Çocuk ve Gençlik Ruh Sağliği Dergisi 2004;11:109-116.
  • 20. Nelis SM, Rae G, Liddell C. The level of expressed emotion scale: A useful measure of expressed emotion in adolescents? J Adolesc 2011;34:311-318. Epub 2010 Jun 8
  • 21. Vural P, Sığırlı D, Eray Ş, Ercan İ, Kiliç EZ. The Reliability and Validity Study of Shortened Level of Expressed Emotion Scale in Adolescents. Turkiye Klinikleri J Med Sci 2013;33:191-199.
  • 22. Gesuita R, Skrami E, Bonfanti R, Cipriano P, Ferrito L, Frongia P, Iafusco D, Iannilli A, Lombardo F, Mozzillo E, Paleari R, Rabbone I, Sabbion A, Salvatoni A, Scaramuzza A, Schiaffini R, Sulli N, Toni S, Carle F . The role of socioeconomic and clinical factors on HbA1c in children and adolescents with type 1 diabetes: an Italian multicentre survey. Pediatr Diabetes 2017;18:241-248. Epub 2016 Mar 16
  • 23. Carter PJ, Cutfield WS, Hofman PL, Gunn AJ, Wilson DA, Reed PW, Jefferies C. Ethnicity and social deprivation independently influence metabolic control in children with type 1 diabetes. Diabetologia 2008;51:1835-1842. Epub 2008 Aug 5
  • 24. Zuijdwijk CS, Cuerden M, Mahmud FH. Social determinants of health on glycemic control in pediatric type 1 diabetes. J Pediatr 2013;162:730-735. Epub 2013 Jan 26
  • 25. Al-Odayani AN, Alsharqi OZ, Ahmad AM, Khalaf Ahmad AM, Al-Borie HM, Qattan AM . Children's glycemic control: mother's knowledge and socioeconomic status. Glob J Health Sci 2013;5:214-226.
  • 26. Hale WW 3rd, Crocetti E, Nelemans SA, Branje SJ, van Lier PA, Koot HM, Meeus WH. Mother and adolescent expressed emotion and adolescent internalizing and externalizing symptom development: a six-year longitudinal study. Eur Child Adolesc Psychiatry 2016;25:615-624. Epub 2015 Sep 29
  • 27. Musser ED, Karalunas SL, Dieckmann N, Peris TS, Nigg JT. Attentiondeficit/hyperactivity disorder developmental trajectories related to parental expressed emotion. J Abnorm Psychol 2016;125:182-195.
  • 28. Tompson MC, Pierre CB, Boger KD, McKowen JW, Chan PT, Freed RD. Maternal depression, maternal expressed emotion, and youth psychopathology. J Abnorm Child Psychol 2010;38:105-117.
APA Eray Ş, UÇAR H, ÇETİNKAYA F, Eren E, VURAL A (2017). The Relationship Between Perceived Family Climate and Glycemic Control in Type 1 Diabetes Mellitus Adolescent Patients. , 253 - 259.
Chicago Eray Şafak,UÇAR HALİT NECMİ,ÇETİNKAYA Fatma,Eren Erdal,VURAL AYŞE PINAR The Relationship Between Perceived Family Climate and Glycemic Control in Type 1 Diabetes Mellitus Adolescent Patients. (2017): 253 - 259.
MLA Eray Şafak,UÇAR HALİT NECMİ,ÇETİNKAYA Fatma,Eren Erdal,VURAL AYŞE PINAR The Relationship Between Perceived Family Climate and Glycemic Control in Type 1 Diabetes Mellitus Adolescent Patients. , 2017, ss.253 - 259.
AMA Eray Ş,UÇAR H,ÇETİNKAYA F,Eren E,VURAL A The Relationship Between Perceived Family Climate and Glycemic Control in Type 1 Diabetes Mellitus Adolescent Patients. . 2017; 253 - 259.
Vancouver Eray Ş,UÇAR H,ÇETİNKAYA F,Eren E,VURAL A The Relationship Between Perceived Family Climate and Glycemic Control in Type 1 Diabetes Mellitus Adolescent Patients. . 2017; 253 - 259.
IEEE Eray Ş,UÇAR H,ÇETİNKAYA F,Eren E,VURAL A "The Relationship Between Perceived Family Climate and Glycemic Control in Type 1 Diabetes Mellitus Adolescent Patients." , ss.253 - 259, 2017.
ISNAD Eray, Şafak vd. "The Relationship Between Perceived Family Climate and Glycemic Control in Type 1 Diabetes Mellitus Adolescent Patients". (2017), 253-259.
APA Eray Ş, UÇAR H, ÇETİNKAYA F, Eren E, VURAL A (2017). The Relationship Between Perceived Family Climate and Glycemic Control in Type 1 Diabetes Mellitus Adolescent Patients. Journal of Clinical Research in Pediatric Endocrinology, 9(3), 253 - 259.
Chicago Eray Şafak,UÇAR HALİT NECMİ,ÇETİNKAYA Fatma,Eren Erdal,VURAL AYŞE PINAR The Relationship Between Perceived Family Climate and Glycemic Control in Type 1 Diabetes Mellitus Adolescent Patients. Journal of Clinical Research in Pediatric Endocrinology 9, no.3 (2017): 253 - 259.
MLA Eray Şafak,UÇAR HALİT NECMİ,ÇETİNKAYA Fatma,Eren Erdal,VURAL AYŞE PINAR The Relationship Between Perceived Family Climate and Glycemic Control in Type 1 Diabetes Mellitus Adolescent Patients. Journal of Clinical Research in Pediatric Endocrinology, vol.9, no.3, 2017, ss.253 - 259.
AMA Eray Ş,UÇAR H,ÇETİNKAYA F,Eren E,VURAL A The Relationship Between Perceived Family Climate and Glycemic Control in Type 1 Diabetes Mellitus Adolescent Patients. Journal of Clinical Research in Pediatric Endocrinology. 2017; 9(3): 253 - 259.
Vancouver Eray Ş,UÇAR H,ÇETİNKAYA F,Eren E,VURAL A The Relationship Between Perceived Family Climate and Glycemic Control in Type 1 Diabetes Mellitus Adolescent Patients. Journal of Clinical Research in Pediatric Endocrinology. 2017; 9(3): 253 - 259.
IEEE Eray Ş,UÇAR H,ÇETİNKAYA F,Eren E,VURAL A "The Relationship Between Perceived Family Climate and Glycemic Control in Type 1 Diabetes Mellitus Adolescent Patients." Journal of Clinical Research in Pediatric Endocrinology, 9, ss.253 - 259, 2017.
ISNAD Eray, Şafak vd. "The Relationship Between Perceived Family Climate and Glycemic Control in Type 1 Diabetes Mellitus Adolescent Patients". Journal of Clinical Research in Pediatric Endocrinology 9/3 (2017), 253-259.