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Advisory Committee Chair

Carol J Dashiff

Advisory Committee Members

Thomas Bevill

Kristi C Guest

Jean B Ivey

Erica R Pryor

Document Type

Dissertation

Date of Award

2010

Degree Name by School

Doctor of Philosophy (PhD) School of Nursing

Abstract

Type 1 diabetes mellitus (T1D) is most commonly diagnosed in children and young adults, and complications may be life-long as well as life threatening. Management of T1D has proven to be very challenging during adolescence, and parental involvement in diabetes management has been shown to improve adherence and glycemic control in children and adolescents. Middle adolescents should become increasingly responsible for diabetes-related tasks under the supervision and guidance of parents (shared management). However, adolescents spend less time with their family as they get older, resulting in parents' being unable to validate effective self-management; this inability may lead to anxiety about being separated from their adolescent (parental separation anxiety) and to retention of diabetes task responsibility that would interfere with an effective transfer of responsibility. The purpose of this study was to examine separation anxiety in parents and couples who were parents of adolescents 15 to 17 years of age who had T1D. Specifically, the relationship investigated was that of parental separation anxiety to parental responsibility for diabetes-related tasks and glycemic control. Second€ary data analysis was used to examine 61 adolescents and their parents from a larger longitudinal study. Maternal separation anxiety was associated with and was a predictor for maternal responsibility only in 2-parent and 2-parent biological families (p = .008). Maternal separation anxiety was associated with glycemic control (p = .042) in the total sample. Findings from multiple regression revealed that maternal separation anxiety was not a significant predictor for maternal responsibility once significant covariates were controlled in the model. Paternal separation anxiety was neither significantly associated with nor a predictor for paternal responsibility or glycemic control. Paired, samples t-tests indicated that maternal separation anxiety and paternal separation anxiety were signifi-cantly different in 2-parent biological families (p = .019) but not in 2-parent stepfamilies. Parental separation anxiety was not significantly associated with parental responsibility or glycemic control in the total sample. Bivariate correlations indicated that shared respon-sibility was not significantly related to glycemic control. Shared responsibility has been associated with improved glycemic control in younger adolescents; however, it does not appear to have the same impact in middle adolescents.

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