Abstract
BackgroundBeing the parents of children with diabetes is demanding. Jay Belsky's determinants of parenting model emphasizes both the personal psychological resources, the characteristics of the child and contextual sources such as parents' work, marital relations and social network support as important determinants for parenting. To better understand the factors influencing parental functioning among parents of children with type 1 diabetes, we aimed to investigate associations between the children's glycated hemoglobin (HbA1c) and 1) variables related to the parents' psychological and contextual resources, and 2) frequency of blood glucose measurement as a marker for diabetes-related parenting behavior.MethodsMothers (n = 103) and fathers (n = 97) of 115 children younger than 16 years old participated in a population-based survey. The questionnaire comprised the Life Orientation Test, the Oslo 3-item Social Support Scale, a single question regarding perceived social limitation because of the child's diabetes, the Relationship Satisfaction Scale and demographic and clinical variables. We investigated associations by using regression analysis. Related to the second aim hypoglycemic events, child age, diabetes duration, insulin regimen and comorbid diseases were included as covariates.ResultsThe mean HbA1c was 8.1%, and 29% had HbA1c ≤ 7.5%. In multiple regression analysis, lower HbA1c was associated with higher education and stronger perceptions of social limitation among the mothers. A higher frequency of blood glucose measurement was significantly associated with lower HbA1c in bivariate analysis. Higher child age was significantly associated with higher HbA1c both in bivariate and multivariate analysis. A scatterplot indicated this association to be linear.ConclusionsMost families do not reach recommended treatment goals for their child with type 1 diabetes. Concerning contextual sources of stress and support, the families who successfully reached the treatment goals had mothers with higher education and experienced a higher degree of social limitations because of the child's diabetes. The continuous increasing HbA1c by age, also during the years before puberty, may indicate a need for further exploring the associations between child characteristics, context-related variables and parenting behavior such as factors facilitating the transfer of parents' responsibility and motivation for continued frequent treatment tasks to their growing children.
Highlights
Being the parents of children with diabetes is demanding
Based on previous research and inspired by the Belsky’s determinants of parenting model the objectives of our study were 1) to examine associations between glycemic control among children with type 1 diabetes and variables related to the parents’ personal psychological resources and contextual sources of stress and support and 2) to examine the association between glycemic control among the children and the frequency of blood glucose measurement as a marker for good quality of care related to the diabetes-specific parenting behavior
Characteristics of parents and child HbA1c Regarding the first hypothesis of associations between the children’s HbA1c and the parents personal psychological resources and contextual sources of stress and support, the analyses indicated no significant associations between the children’s HbA1c and the parents’ trait of optimism or pessimism as measured by the Life Orientation Test, the fathers’ experience of social support (Oslo 3-item Social Support Scale) and the parents’ satisfaction with the marital relationship (Relationship Satisfaction Scale) (Table 2)
Summary
Jay Belsky’s determinants of parenting model emphasizes both the personal psychological resources, the characteristics of the child and contextual sources such as parents’ work, marital relations and social network support as important determinants for parenting. Sherifali & Ciliska [8] claimed that most of the parenting research literature as related to children with diabetes lacks a conceptualization of the determinants influencing parental functioning. They suggested Jay Belsky’s determinants of parenting model as a conceptual framework to guide future research on parenting children with diabetes. The model emphasizes 1) the parents’ personal psychological resources, 2) the characteristics of the child and 3) contextual sources of stress and support as three important domains influencing the parenting process and subsequently the child’s development. The contextual sources of stress and support include work, marital relations and social network support [9]
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