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Ann Pediatr Endocrinol Metab > Volume 14(2); 2009 > Article
Effects of Family Environment and Parenting Behavior on Glycemic Control and Depressive Symptoms in Children with Type 1 Diabetes.
Eun Young Kwon, Hyo Jin Jung, Hyun Ji Kim, Im Jeong Choi, Jung Hyun Lee, Jae Ho Yoo
1Department of Pediatrics, College of Medicine, Dong-A University, Busan, Korea. pedendo@dau.ac.kr
2Department of Pediatrics, Wallace Memorial Baptist Hospital, Busan, Korea.
3Department of Pediatrics, Maryknoll Medical Center, Busan, Korea.
4Department of Pediatrics, Kosin University College of Medicine, Busan, Korea.
We aimed to evaluate the influence of family environment, parenting behavior, and psychological characteristics on metabolic control in children with type 1 diabetes mellitus (DM). METHODS: We performed a statistical survey among Korean children (adolescents; age, 11-17 years) undergoing treatment for type 1 DM for more than a year and the parents of these children. We obtained the glycosylated hemoglobin (HbA1c) levels; children's depression inventory (CDI) scores; family affection, partnership, growth, adaptation, resolve (APGAR) scores; parenting behavior inventory (PBI) scores; and scores of the Korean version of family environment scale (FES-K) for these families. The results of the survey were collected and analyzed using statistical methods.
We found a statistically significant evidence of a positive relationship between HbA1c levels and depressive symptoms (r=0.43, P=0.001). However, there was no relationship between HbA1c levels and family APGAR scores. FES-cohesion scale (beta=-0.422, P=0.005), achievement orientation scale (beta=-0.323, P=0.013), and control scale (beta=0.356, P=0.009)-were significant predictors of HbA1c levels. In the family APGAR index, low CDI score (P=0.001) were indicative of a highly functional family. Furthermore, the family APGAR scale showed a statistically significant association with the reasoning and affection subscales of the PBI scale and inverse association with the inconsistency subscale of the PBI scale. Multiple-regression analysis of the data revealed that the monitoring (beta=-0.325, P=0.045) and reasoning (beta=-0.507, P=0.011) variables of the paternal and maternal PBI scale, respectively, were significant predictors of a child's depressive symptoms.
Improvements in family environment and parenting behavior may help improve metabolic control and reduce depressive symptoms in children with type 1 DM.
Keywords: Type 1 diabetes mellitus;Family relations;Parenting;Social environment;Depression


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