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. 2009 Jan;35(1):79-88.
doi: 10.1111/j.1365-2214.2008.00892.x.

Parenting, autonomy and self-care of adolescents with Type 1 diabetes

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Parenting, autonomy and self-care of adolescents with Type 1 diabetes

C Dashiff et al. Child Care Health Dev. 2009 Jan.

Abstract

Background: During adolescence diabetes creates a juncture of very complex disease management demands with developmental needs, including the striving of adolescents for greater autonomy. Parents' concerns and fears about the teen's diabetes self-management abilities during this time can heighten parental attachment behaviour and affect the parents' ability to support autonomy development necessary for effective self-care. Maternal parenting processes may be especially important for those adolescents who have Type 1 diabetes because mothers are the primary caregivers.

Purpose: Based on attachment theory, the aim was to test a model of the influence of mother-adolescent developmental conflict, maternal separation anxiety and maternal inhibition of autonomy and relatedness on cognitive autonomy and self-care of adolescents with Type 1 diabetes.

Method: A total of 131 families with an adolescent, aged 11-15 years, contributed data annually across three waves. Mothers and adolescents completed paper-and-pencil measures and two interaction scenarios that were coded by trained staff from audio-tapes. The adolescent also completed a structured interview and questionnaire to assess self-care.

Results: Maternal separation anxiety when adolescents were 11-15 years of age directly predicted cognitive autonomy at 1-year follow-up, and that cognitive autonomy was directly related to self-care 1 year later, but did not mediate between separation anxiety and self-care.

Conclusions: Future investigation of the influence of separation anxiety of parents on adolescent autonomy development is warranted, as well as the contribution of autonomy development to diabetes self-management behaviours of adolescents.

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Figures

Figure 1
Figure 1. Full (Hypothesized) Causal Structural Equation Model. For these paths of interest, “+” indicates a positive expected value, “-” indicates a negative expected value
Figure 2
Figure 2. Trimmed Structural Equation Model Predicting Self-Care (standardized solution). All solid lines represent significant paths (p < .05). Dotted lines represent hypothesized paths that were not significant

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