Effects of Family Environment and Parenting Behavior on Glycemic Control and Depressive Symptoms in Children with Type 1 Diabetes

Kwon, Eun Young; Jung, Hyo Jin; Kim, Hyun Ji; Choi, Im Jeong; Lee, Jung Hyun; Yoo, Jae Ho

Abstract

PURPOSE: 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.
RESULTS
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.
CONCLUSION
Improvements in family environment and parenting behavior may help improve metabolic control and reduce depressive symptoms in children with type 1 DM.