Skip to main content
SpringerLink
Log in

Algemene ouder-kindrelatie en diabetesgerelateerde ouder-kindrelatie in de adolescentie

Relatie met glykemische controle en de rol van adherence

  • Artikelen
  • Published:
Tijdschrift voor Kindergeneeskunde

Samenvatting

Succesvolle behandeling van diabetes mellitus type 1 (insulindependent diabetes mellitus, IDDM) is van groot belang gedurende de kinderjaren en adolescentie met het oog op preventie van complicaties op de langere termijn. Adherence blijkt de belangrijkste voorspeller te zijn voor glykemische controle. Adherence blijkt ook samen te hangen met factoren die samenhangen met de relatie tussen ouders en adolescent. De relatie tussen deze drie factoren onderling is echter onbekend. In een studie onder 53 adolescenten (leeftijd 10-15 jaar) met diabetes en hun ouders zijn vragenlijsten afgenomen met betrekking tot algemene en diabetesspecifieke relaties tussen ouders en adolescent. Uitkomsten op deze vragenlijsten zijn gerelateerd aan adherence en glykemische controle (HbA1c). Aangetoond is dat de algemene kwaliteit van de relatie tussen ouder en jonge adolescent van invloed is op adherence en door middel van deze relatie ook van belang voor glykemische controle. De directe relatie tussen de kwaliteit van de ouder-kindrelatie met glykemische controle is relatief zwak; alleen diabetesgerelateerde conflicten hangen samen met glykemische controle. Dit geeft aan dat om de gezondheid te optimaliseren, het zinvol is om ouder-kindfactoren bij de diagnostiek te betrekken. Doelgerichte interventies kunnen geïntroduceerd worden om een positieve relatie tussen ouder en kind te faciliteren en een niet-conflictueuze communicatie te bevorderen.

Summary

Successful treatment of insulin-dependent diabetes mellitus (IDDM) is important during childhood and adolescence in preventing long-term complications. Adherence appears to be the main predictor for glycaemic control. Adherence is also related to the relationship between parent and child. The exact relationship between the three factors is unknown. In this study 53 adolescents (ages 10-15 yr) with IDDM and their parents completed questionnaires assessing general and diabetes-specific parentchild relationship. These measures were related to regimen adherence and glycaemic control (HbA1c). The quality of the relationship between parent and adolescent is strongly related to adherence and by means of this relation also important for glycaemic control. The direct impact of the parent-child relationship on glycaemic control is weak; only diabetes related conflicts are related to glycaemic control. This indicates that for optimising a child’s health status, an assessment of family functioning is useful and an important factor in understanding glycaemic control. Specific interventions can be introduced to facilitate a positive parent-child relationship and to promote a non-conflictuous communication.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Literatuur

  1. American Diabetes Association. Standards of medical care for patients with diabetes mellitus. Diabetes Care. 2003;26:S33-50.

    Google Scholar 

  2. DCCT Research Group. Effect of intensive diabetes treatment on the development and progression of long-term complications in adolescents with insulin-dependent diabetes mellitus: Diabetes Control and Complications Trial. J. Pediatr. 1994;125:177-88.

    Google Scholar 

  3. Davis CL, Delamater AM, Shaw KH, et al. Parenting styles, regimen adherence, and glycaemic control in 4- to 10-year-old children with diabetes. J Pediatr Psychol. 2001;26:123-9.

    Google Scholar 

  4. Schafer LC, McCaul KD, Glasgow RE. Supportive and nonsupportive family behaviors: relationships to adherence and metabolic control in persons with type I diabetes. Diabetes Care. 1986;9:179-85.

    Google Scholar 

  5. Anderson BJ, Vangsness L, Connell A, et al. Family conflict, adherence, and glycaemic control in youth with short duration type 1 diabetes. Diabet Med. 2002;19:635-42.

    Google Scholar 

  6. Miller-Johnson S, Emery RE, Marvin RS, et al. Parent-child relationships and the management of insulin-dependent diabetes mellitus. J Consult Clin Psychol. 1994;62:603-10.

    Google Scholar 

  7. Rubin R, Young-Hyman D, Peyrot M. Parent-child responsibility and conflict in diabetes care. Diabetes. 1989;38(suppl.2):28.

    Google Scholar 

  8. Lewin AB, Heidgerken AD, Geffken GR, et al. The relation between family factors and metabolic control: the role of diabetes adherence. J Pediatr Psychol. 2006;31(2):174-83.

    Google Scholar 

  9. Jacobson AM, Hauser ST, Lavori Ph, et al. Adherence among children and adolescents with insulin-dependent diabetes mellitus over a four-year longitudinal follow-up: I. The influence of patient coping and adjustment. J Pediatr Psychol. 1990; 15(4):511-26.

  10. Lange A. De ouder-kind interactie vragenlijst – revised (OKIV-R): Verantwoording en handleiding. Houten: Bohn Stafleu van Loghum, 2001.

  11. Anderson BJ, Auslander WF, Jung KC, et al. Assessing family sharing of diabetes responsibilities. J Pediatr Psychol. 1990;15:477-92.

    Google Scholar 

  12. Laffel LMB, Vangsness L, Connell A, et al. Impact of ambulatory, family-focused teamwork intervention on glycemic control in youth with type 1 diabetes. J Pediatr. 2003;142:409-16.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. www.bsl.nl/shop/tydschrift-vkindergeneeskunde-0376-7442.html

    L. van Dongen

Authors
  1. L. van Dongen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C. Westerlaken
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C. Verhaak
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. E. Bazelmans
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to L. van Dongen.

Additional information

Mw. drs. L. van Dongen, klinisch psycholoog-psychotherapeut, vakgroep Medische Psychologie, Amphia Ziekenhuis, Breda. Mw. dr. C. Westerlaken, endocrinoloog-kinderarts, Canisius-Wilhelmina Ziekenhuis, Nijmegen. Mw. dr. C. Verhaak, GZ-psycholoog, mw. dr. E. Bazelmans, GZ-psycholoog, vakgroep Medische Psychologie. UMC St. Radboud, Nijmegen.

Correspondentieadres: L. van Dongen, Amphia Ziekenhuis Locatie Langendijk, Postbus 90157, 4800 RL Breda,

Rights and permissions

Reprints and permissions

About this article

Cite this article

van Dongen, L., Westerlaken, C., Verhaak, C. et al. Algemene ouder-kindrelatie en diabetesgerelateerde ouder-kindrelatie in de adolescentie. KIND 76, 16–22 (2008). https://doi.org/10.1007/BF03078170

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03078170

Search

Navigation