Exploring the Mediating Role of Parental Anxiety in the Link between Children’s Mental Health and Glycemic Control in Type 1 Diabetes
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants
2.2. Measurements
2.3. Statistical Data Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
Characteristics of the Individual Factors of Adolescents with T1D (Inner Child Environment) | |
---|---|
Duration of T1D | less than a year |
1–5 years | |
6–10 years | |
more than 10 years | |
Diabetes control level | optimal (HbA1C < 7%) |
suboptimal (HbA1C = 7–9%) | |
poor (HbA1C > 9%) | |
Type of glycemic control | with a glucometer |
with continuous glucose monitoring | |
Method of insulin administration | with insulin pen |
with insulin pump | |
Mocking from the child’s peers | yes |
no | |
Age (years) | 12–15 |
15.1–18 | |
Gender | female |
male | |
Characteristics of the Surrounding Factors (Parental and Socio-Economic Environment) | |
Parental factors | |
Parents’ anxiety level (GAD-7 score) | |
Parents’ depression level (PHQ-9 score) | |
Parents’ self-assessment of health status | excellent |
good | |
satisfactory | |
unsatisfactory | |
Parents’ life satisfaction | fully satisfied |
rather satisfied | |
rather dissatisfied | |
completely unsatisfied | |
Self-assessment of family relationship | good and mutually supportive |
variables could be better | |
problematic | |
Marital status | unmarried |
married | |
divorced | |
widow | |
other | |
Socio-economic factors | |
Number of children in family | 1 |
2 | |
3 and more | |
Number of persons in the household | 2 |
3 | |
4 | |
5 and more | |
Parents’ education | primary |
secondary | |
bachelor’s | |
master’s | |
other | |
Parents’ employment | paid full-time work |
self-employed | |
several places of work | |
unemployed | |
Income per family member per month (EUR) | less than 128.07 |
128.07–300 | |
301–500 | |
501–700 | |
701 and more |
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Study Population (N = 502; 251 Child–Parent Dyads) | |
---|---|
Adolescents with T1D (N = 251) | Parents (N = 251) |
Methods | |
Generalized Anxiety Disorder 7-item (GAD-7) Scale ↓ Symptoms of anxiety | Patient Health Questionnaire 9 (PHQ-9) Scale ↓ Symptoms of depression |
Predictor | Estimate | 95% CI | t | p |
---|---|---|---|---|
Intercept | 7.04 | 6.35–7.73 | 20.12 | <0.001 |
Parent’s GAD-7 score | 0.18 | 0.16–0.20 | 14.86 | <0.001 |
Parental education: | ||||
Secondary—Primary | −0.97 | 0.33–1.61 | −3.00 | 0.003 |
Bachelor’s—Primary | −0.98 | 0.33–1.64 | −2.97 | 0.003 |
Master’s—Primary | −1.11 | 0.42–1.81 | −3.16 | 0.002 |
Other—Primary | −0.83 | 0.04–1.62 | −2.07 | 0.040 |
Type | Effect | Estimate | 95% CI of Estimate | β | z | p | |
---|---|---|---|---|---|---|---|
Lower | Upper | ||||||
Indirect | Child’s GAD-7 → Parent’s GAD-7 → Glycated hemoglobin | 0.096 | 0.052 | 0.139 | 0.366 | 4.319 | <0.001 |
Child’s PHQ-9 → Parent’s GAD-7 → Glycated hemoglobin | 0.022 | 0.004 | 0.038 | 0.098 | 2.565 | 0.010 | |
Component | Child’s GAD-7 → Parent’s GAD-7 | 0.665 | 0.519 | 0.815 | 0.669 | 8.828 | <0.001 |
Parent’s GAD-7 → Glycated hemoglobin | 0.144 | 0.093 | 0.194 | 0.546 | 5.612 | <0.001 | |
Child’s PHQ-9 → Parent’s GAD-7 | 0.151 | 0.035 | 0.263 | 0.179 | 2.607 | 0.009 | |
Direct | Child’s GAD-7 → Glycated hemoglobin | 0.029 | −0.029 | 0.089 | 0.113 | 0.982 | 0.326 |
Child’s PHQ-9 → Glycated hemoglobin | 0.015 | −0.025 | 0.055 | 0.068 | 0.742 | 0.458 | |
Total | Child’s GAD-7 → Glycated hemoglobin | 0.126 | 0.068 | 0.183 | 0.479 | 4.300 | <0.001 |
Child’s PHQ-9 → Glycated hemoglobin | 0.037 | −0.011 | 0.086 | 0.166 | 1.496 | 0.135 |
Study Authors (Year) | Study Population | Independent Variable | Dependent Variable | Mediator |
---|---|---|---|---|
Vesco et al. (2021) [9] | Adolescents with T1D, N = 264 | Anxiety | HbA1c | Diabetes-specific distress |
Frye et al. (2019) [29] | 10–16-year-old children, N = 111 | Sleep duration | Diabetes management | |
Hagger et al. (2018) [7] | Adolescents with T1D, N = 450 | Depressive symptoms | Diabetes-specific distress | |
Thomas et al. (2018) [30] | Youths and their parents, N = 390 | Family income | Parenting constructs | |
Hilliard et al. (2013) [31] | Adolescent–parent dyads, N = 257 | Parental monitoring, family conflict | Diabetes self-care | |
Cunningham et al. (2011) [15] | Adolescents and their caregivers, N = 147 | Caregiver depression | Diabetes-specific burden |
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Silina, E.; Taube, M.; Zolovs, M. Exploring the Mediating Role of Parental Anxiety in the Link between Children’s Mental Health and Glycemic Control in Type 1 Diabetes. Int. J. Environ. Res. Public Health 2023, 20, 6849. https://doi.org/10.3390/ijerph20196849
Silina E, Taube M, Zolovs M. Exploring the Mediating Role of Parental Anxiety in the Link between Children’s Mental Health and Glycemic Control in Type 1 Diabetes. International Journal of Environmental Research and Public Health. 2023; 20(19):6849. https://doi.org/10.3390/ijerph20196849
Chicago/Turabian StyleSilina, Evija, Maris Taube, and Maksims Zolovs. 2023. "Exploring the Mediating Role of Parental Anxiety in the Link between Children’s Mental Health and Glycemic Control in Type 1 Diabetes" International Journal of Environmental Research and Public Health 20, no. 19: 6849. https://doi.org/10.3390/ijerph20196849