A Cross-Sectional Study of Predictive Factors of Self-Management Among Adolescents with Type 1 Diabetes

Authors

  • Supachai Kajonwiboolpol Graduate Student in the Master of Nursing Science Program (Pediatric Nursing), Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand.
  • Autchareeya Patoomwan Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand.
  • Jiraporn Punyoo Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand.

DOI:

https://doi.org/10.60099/prijnr.2025.272686

Keywords:

Adolescents, Parenting styles, Predicting factors, Self-management, Type 1 diabetes

Abstract

Uncontrolled blood glucose in adolescents with type 1 diabetes leads to many complications that are life-threatening and affect their quality of life. Self-management is an approach that allows adolescents to achieve good glycemic control. Therefore, this predictive correlation study aimed to investigate self-management among adolescents with type 1 diabetes and to examine the predictive power of age, parenting styles, and patient-provider relationship satisfaction on self-management. Purposive sampling was employed to recruit 93 adolescents aged 10 to 19 years with type 1 diabetes who were receiving follow-up care at two tertiary hospitals in Bangkok, Thailand. The research instruments used were The Self-Management Behavior of Adolescents with T1DM, The Parenting Style, and The Thai version of the Medical Interview Satisfaction Scale (MISS-21). Descriptive statistics and multiple regression were employed to analyze the data.

The results found that the mean score of self-management behaviors was high. All variables, including age, authoritative, authoritarian, permissive, and uninvolved parenting styles, as well as patient-provider relationship satisfaction, explained 49.4% of the variance in self-management behaviors. However, only authoritative, uninvolved parenting style, and patient-provider relationship satisfaction were statistically significant predictors of self-management, with patient-provider relationship satisfaction being the strongest. Nurses can use this finding to design and test an intervention program that emphasizes encouraging authoritative parenting while discouraging uninvolved parenting and promoting the patient-provider relationship in the management of diabetes. Future studies should investigate the cultural variations of parenting styles, self-management, and glycemic control in adolescents from more diverse cultural and ethnic backgrounds.

References

American Diabetes Association Professional Practice Committee. 2. Diagnosis and classification of diabetes: standards of care in diabetes—2024. Diabetes Care. 2024;47 (Supplement_1):S20–S42. doi:10.2337/dc24-S002. DOI: https://doi.org/10.2337/dc24-S002

Gregory GA, Robinson TIG, Linklater SE, Wang F, Colagiuri S, de Beaufort C, et al. Global incidence, revalence, and mortality of type 1 diabetes in 2021 with projection to 2040: a modelling study. Lancet Diabetes Endocrinol. 2022;10(10):741–60. doi: 10.1016/S2213-8587(22)00218-2. Erratum in: Lancet Diabetes Endocrinol. 2022;10(11):e11. doi: 10.1016/S2213-8587(22)00280-7. DOI: https://doi.org/10.1016/S2213-8587(22)00279-0

American Diabetes Association. 11. Microvascular complications and foot care: standards of medical care in diabetes−2020. Diabetes Care. 2020;43(Supplement_1):S135–51. doi:10.2337/dc20-S011. DOI: https://doi.org/10.2337/dc20-S011

Oluchina S. The effectiveness of an education intervention based on self-care model on diabetes self-management behaviors and glycemic control. IJANS. 2022;17:1-8. doi:10.1016/j.ijans.2022.100505. DOI: https://doi.org/10.1016/j.ijans.2022.100505

Deng C, Xie Y, Liu F, Tang X, Fan L, Chen Y, Zhou Z, & Li X. Simplified integration of optimal self-management behaviors is associated with improved HbA1c in patients with type 1 diabetes. J Endocrin Invest. 2024;47:2691–99. doi: 10.1007/s40618-024-02357-8. DOI: https://doi.org/10.1007/s40618-024-02357-8

Dejkhamron P, Santiprabhob J, Likitmaskul S, Deerochanawong C, Rawdaree P, Tharavanij T, et al. Type 1 diabetes management and outcomes: A multicenter study in Thailand. J. Diabetes Investig. 2021;12(4):516–26. doi:10.1111/jdi.13390 (in Thai). DOI: https://doi.org/10.1111/jdi.13390

Kelsey MM, Zeitler PS. Insulin resistance of puberty. Curr. Diabetes Rev. 2016;16(7):64. doi:10.1007/s11892-016-0751-5. DOI: https://doi.org/10.1007/s11892-016-0751-5

Whittemore R, Jaser S, Guo J, Grey M. A conceptual model of childhood adaptation to type 1 diabetes. Nurs. Outlook. 2010;58(5):242-51. doi:10.1016/j.outlook.2010.05.001. DOI: https://doi.org/10.1016/j.outlook.2010.05.001

Hamilton K, Stanton-Fay SH, Chadwick PM, Lorencatto F, de Zoysa N, Gianfrancesco C, et al. Sustained type 1 diabetes self-management: Specifying the behaviours involved and their influences. Diabet Med. 2021;38(5):e14430. doi:10.1111/dme.14430 DOI: https://doi.org/10.1111/dme.14430

Chaladlon P, Anansirikasem P, klinjampa V. The effect of self-management support on glycemic control behaviors in type II diabetes patients. NJPH. 2023;33(1):90-101.

Shiel EV, Hemingway S, Burton K, King N. Self-management of type 1 diabetes in young adults: Is it impeded by aspects of everyday life? A scoping review. Diabetes Metab Syndr. 2023;17(12):102918. doi:10.1016/j.dsx.2023.102918 DOI: https://doi.org/10.1016/j.dsx.2023.102918

Verchota G, Sawin KJ. Testing components of a self-management theory in adolescents with type 1 diabetes mellitus. Nurs Res. 2016;65(6):487-495. doi:10.1097/NNR.0000000000000180. DOI: https://doi.org/10.1097/NNR.0000000000000180

Keough L, Sullivan-Bolyai S, Crawford S, Schilling L, Dixon J. Self-management of type 1 diabetes across adolescence. Diabetes Educ. 2011;37(4):486-500. doi:10.1177/0145721711406140. DOI: https://doi.org/10.1177/0145721711406140

Geneti Y, Wondwossen K, Adimasu M, Deressa D, Aga F, Lami M, et al. Adherence to diabetes self-management and its associated factors among adolescents living with type 1 diabetes at public hospitals in Addis Ababa, Ethiopia: A cross-sectional study. Diabetes Metab Syndr Obes. 2022;15:659-70. doi:10.2147/DMSO.S350168. DOI: https://doi.org/10.2147/DMSO.S350168

Putdivarnichapong W, Phahuwatanakorn W, & Soonthornchaiya R. Development of Thai Family Functioning Model (TFFM): grounded theory method. Journal of MCU Peace Studies.2020;8(5):1639-52. (in Thai).

Liu S. The Influences of Parenting Style on Child Self-regulation. Lecture notes in education psychology and public media. 2023;24(1):77-82. doi: 10.54254/2753-7048/24/20230597. DOI: https://doi.org/10.54254/2753-7048/24/20230597

Ontrakrai N, Jintrawet U, Chotibang J. Factors related to self-management behaviors in adolescent with type 1 diabetes. Nursing Journal CMU. 2021;48(2):246-58. (in Thai).

Radcliff Z, Weaver P, Chen R, Streisand R, Holmes C. The role of authoritative parenting in adolescent type 1 diabetes management. J. Pediatr. Psychol. 2018;43(2):185-94. doi:10.1093/jpepsy/jsx107. DOI: https://doi.org/10.1093/jpepsy/jsx107

Lee SL, Tsai MC, Chang SC, Chen JL, Wang RH. Modelling individual, parental and peer factors to glycaemic control in adolescents with type 1 diabetes: A prospective study. J. Adv. Nurs. 2020;76(5):1162-71. doi:10.1111/jan.14317. DOI: https://doi.org/10.1111/jan.14317

Noser AE, Majidi S, Finch J, Clements MA, Youngkin EM, Patton SR. Authoritarian parenting style predicts poorer glycemic control in children with new-onset type 1 diabetes. Pediatr. Diabetes. 2018;19(7):1315-21. doi:10.1111/pedi.12726. DOI: https://doi.org/10.1111/pedi.12726

Junge C, Valkenburg PM, Deković M, & Branje S. The building blocks of social competence: contributions of the consortium of individual development. Dev Cogn Neurosci. 2020;45:100861. doi:10.1016/j.dcn.2020.100861. DOI: https://doi.org/10.1016/j.dcn.2020.100861

Eton DT, Ridgeway JL, Linzer M, Boehm DH, Rogers EA, Yost KJ, et al. Healthcare provider relational quality is associated with better self-management and less treatment burden in people with multiple chronic conditions. Patient Prefer Adherence. 2017;11:1635-46. doi:10.2147/PPA.S145942. DOI: https://doi.org/10.2147/PPA.S145942

Taylor CJ, La Greca A, Valenzuela JM, Hsin O, Delamater AM. Satisfaction with the health care provider and regimen adherence in minority youth with type 1 diabetes. J Clin Psychol Med Settings. 2016;23(3):257-68. doi:10.1007/s10880-016-9460-0. DOI: https://doi.org/10.1007/s10880-016-9460-0

Cohen J. (1988). Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale: Lawrence Erlbaum Associates; 1988.

Gray JR, Grove SK, Sutherland S. Burns & Grove’s the practice of nursing research: appraisal, synthesis, and generation of evidence. 8th ed. St. Louis: Elsevier; 2017.

Schilling LS, Dixon JK, Knafl KA, et al. A new self-report measure of self-management of type 1 diabetes for adolescents. Nurs Res. 2009;58(4):228-36. doi:10.1097/NNR.0b013e3181ac142a DOI: https://doi.org/10.1097/NNR.0b013e3181ac142a

Ponpichai W, Uieng J. Factors predicting to violent behavior of youth in Muang District, Trang Province. Asia Social Issues. 2023;16(6):e259262. doi:10.48048/asi.2023.259262. DOI: https://doi.org/10.48048/asi.2023.259262

Baumrind D. Current patterns of parental authority. Dev. Psychol. 1971;4(1):1-103. doi: 10.1037/h0030372. DOI: https://doi.org/10.1037/h0030372

Mussen PH (Ed.). (1983). Socialization in the context of family: parent-child interaction. Handbook of Child Psychology (4th ed.). New York: Wiley.

Papachristou Nadal I, Aramrat C, Jiraporncharoen W, Pinyopornpanish K, Wiwatkunupakarn N, Quansri O, et al. Process evaluation protocol of a cluster randomised trial for a scalable solution for delivery of diabetes self-management education in Thailand (DSME-T). BMJ Open. 2021;11(12):e056141. doi:10.1136/bmjopen-2021-056141 (in Thai). DOI: https://doi.org/10.1136/bmjopen-2021-056141

Meakin R, Weinman J. The 'medical interview satisfaction scale' (MISS-21) adapted for British general practice. Fam Pract. 2002;19(3):257-263. doi:10.1093/fampra/19.3.257. DOI: https://doi.org/10.1093/fampra/19.3.257

Peimani M, Nasli-Esfahani E, Sadeghi R. Patients' perceptions of patient-provider communication and diabetes care: A systematic review of quantitative and qualitative studies. Chronic Illn. 2020;16(1):3-22. doi:10.1177/1742395318782378. DOI: https://doi.org/10.1177/1742395318782378

Chitayasothorn D. Diana Baumrinds parenting styles. UTCC IJBE. 2009;29(4):173-187.

Sanvictores T, Mendez MD. Types of parenting styles and effects on children. Treasure Island (FL): StatPearls Publishing; 2024.

Downloads

Published

2025-06-09

How to Cite

1.
Kajonwiboolpol S, Patoomwan A, Punyoo J. A Cross-Sectional Study of Predictive Factors of Self-Management Among Adolescents with Type 1 Diabetes . PRIJNR [internet]. 2025 Jun. 9 [cited 2025 Dec. 5];29(3):605-18. available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/272686