Lawrence, Kelly Ann (2010-08). The Relation Between Family Functioning, Health-related Quality of Life, and Metabolic Control in Children and Adolescents with Type 1 Diabetes. Doctoral Dissertation.
The purpose of this study was to examine the relationship between family functioning, health-related quality of life, and metabolic control in order to identify areas for intervention that can improve medical and psychosocial outcomes for children and adolescents with type 1 diabetes. Children (N = 45) ages 8-17, both male and female, with type 1 diabetes, along with one caregiver (parent or legal guardian) (N = 45) were asked to complete the Pediatric Quality of Life Inventory (PedsQL) generic and diabetes-specific form to assess health-related quality of life along with the Diabetes Family Behavior Checklist and the Family Relationship Index of the Family Environment Scale to assess family functioning. Recent Hemoglobin A1c (A1c) was obtained from the physician at their visit or by parent report to assess metabolic control.
Results indicated a significant relationship with poorer metabolic control relating to poorer physical health-related quality of life, as reported by children. All reports indicated a significant correlation between metabolic control and both general and diabetes specific health-related quality of life. There was a significant relationship with mother's educational level on the outcome variables; educational level was therefore used as a control variable in all regression analyses. Child-reported general family functioning accounted for a significant amount of variance in child reported general health-related quality of life. Parent score on the non-supportive scale for diabetes specific family functioning accounted for a significant amount of variance in parent reported general health-related quality of life and diabetes specific health-related quality of life for their child. Results demonstrated the importance of obtaining both child and parent perspectives on issues regarding general family functioning and health-related quality of life and diabetes specific family functioning and health-related quality of life. In addition, they illustrated the importance of assessing health-related quality of life for children with diabetes as opposed to merely looking at the physical effects.