Parent and Adolescent
Discrepancies in Diabetes SelfManagement
By: Joanna Price
Mentors:
Dr. Ken Wallston and Dr. Shelagh Mulvaney
Themes

Adolescent self-management during transition
from parent to self-care


Adolescent has more responsibilities
Discrepancy between parents and their
adolescents

Communication about diabetes care
Research Questions



Does the degree of congruency between children’s
and parents’ questionnaire responses relate to the
HbA1c levels of the adolescent?
Will parent-child discrepancy on one questionnaire
be associated with the amount of discrepancy on the
other questionnaire?
Will the age and/or gender of the adolescent play a
role in the amount of discrepancy between
adolescents and their parents?
Participants and Measures

115 Parent-Adolescent Dyads





Adolescents aged 13-17 years old
Diagnosed with Type I Diabetes for at least 6
months
Seen at the Vanderbilt Eskind Diabetes Clinic
Two Questionnaires
Baseline HbA1c Levels
Measures

Diabetes Behavior Management Survey

How often adolescent carried out necessary
diabetes self-management tasks


41 Questions
Problem Solving Behaviors Survey

Ability of adolescents to deal with psychosocial
self-management problems associated with
Diabetes by solving problems

27 Questions
Variables

Mean Scores on each Questionnaire


Simple Discrepancy Scores



D_sm, and D_ps
Squared Discrepancy Scores


Psm, Csm, Pps, Cps
D2_sm, and D2_ps
Child’s Age
Child’s Gender (0= male, 1= female)
Discrepancy Scores

Simple Discrepancy


Parent Mean- Child Mean for each survey question
and then summed across items
Squared Discrepancy

(Parent Mean- Child Mean)^2 for each survey
question and then summed across items
Results

The only questionnaire associated with HbA1c was
the child’s rating of their problem solving ability
(r = -0.21, p< 0.05). The higher the child’s self-rated
ability to problem solve, the lower the HbA1c value
(i.e., diabetes was in better control).
Results

Parent-child dyads were correlated across both
questionnaires meaning that their degree of
discrepancy on one questionnaire was significantly
correlated with their degree of discrepancy on the
other questionnaire for both the simple discrepancy
scores (r = 0.46, p < 0.01) and the squared
discrepancy scores (r = 0.36, p < 0.01).
Results


Adolescent’s gender was positively correlated with
the problem solving simple discrepancy score
(r = 0.20, p < 0.05), meaning that girls were more
likely to be discrepant from their parents on the
problem solving questionnaire
Adolescent’s gender was negatively correlated with
the self-management squared discrepancy score
(r = -0.26, p < 0.01), meaning that boys are more
likely to be discrepant from their parents on the selfmanagement questionnaire
Limitations and Future Directions
Limitations


May not be representative of the whole population of
adolescents with Type I Diabetes
Both questionnaires (self-management and problem
solving) are correlated with each other
Future Research


Ways to measure self-management
Using both types of discrepancy scores to test
validity of results
Acknowledgements




Dr. Ken Wallston
Dr. Shelagh Mulvaney
Professor Craig Smith
My Classmates
Formulas
D_sm= mean((Psm1-Csm1), (Psm2-Csm2), (Psm3-Csm3), (Psm4-Csm4), (Psm5-Csm5), (Psm6-Csm6), (Psm7-Csm7), (Psm8Csm8), (Psm9-Csm9), (Psm10-Csm10), (Psm11-Csm11), (Psm12-Csm12), (Psm13-Csm13), (Psm14-Csm14), (Psm15-Csm15),
(Psm16-Csm16), (Psm17-Csm17), (Psm18-Csm18), (Psm19-Csm19), (Psm20-Csm20), (Psm21-Csm21), (Psm22-Csm22),
(Psm23-Csm23), (Psm24-Csm24), (Psm25-Csm25), (Psm26-Csm26), (Psm29-Csm29), (Psm30-Csm30), (Psm31-Csm31),
(Psm32-Csm32), (Psm33-Csm33), (Psm34-Csm34), (Psm35-Csm35, (Psm36-Csm36), (Psm37-Csm37), (Psm38-Csm38), (Psm39Csm39), (Psm40-Csm40), (Psm41-Csm41))
D2_sm= mean(((Psm1-Csm1)**2), ((Psm2-Csm2)**2), ((Psm3-Csm3)**2), ((Psm4-Csm4)**2), ((Psm5-Csm5)**2), ((Psm6Csm6)**2), ((Psm7-Csm7)**2), ((Psm8-Csm8)**2), ((Psm9-Csm9)**2), ((Psm10-Csm10)**2), ((Psm11-Csm11)**2), ((Psm12Csm12)**2), ((Psm13-Csm13)**2), ((Psm14-Csm14)**2), ((Psm15-Csm15)**2), ((Psm16-Csm16)**2), ((Psm17-Csm17)**2),
((Psm18-Csm18)**2), ((Psm19-Csm19)**2), ((Psm20-Csm20)**2), ((Psm21-Csm21)**2), ((Psm22-Csm22)**2), ((Psm23Csm23)**2), ((Psm24-Csm24)**2), ((Psm25-Csm25)**2), ((Psm26-Csm26)**2), ((Psm29-Csm29)**2), ((Psm30-Csm30)**2),
((Psm31-Csm31)**2), ((Psm32-Csm32)**2), ((Psm33-Csm33)**2), ((Psm34-Csm34)**2), ((Psm35-Csm35)**2), ((Psm36Csm36)**2), ((Psm37-Csm37)**2), ((Psm38-Csm38)**2), ((Psm39-Csm39)**2), ((Psm40-Csm40)**2), ((Psm41-Csm41)**2))
D_ps= mean((Pps1-Cps1), (Pps2-Cps2), (Pps3-Cps3), (Pps4-Cps4), (Pps5-Cps5), (Pps6-Cps6), (Pps7-Cps7), (Pps8-Cps8), (Pps9Cps9), (Pps10-Cps10), (Pps11-Cps11), (Pps12-Cps12), (Pps13-Cps13), (Pps14-Cps14), (Pps15-Cps15), (Pps16-Cps16), (Pps17Cps17), (Pps18-Cps18), (Pps19-Cps19), (Pps20-Cps20), (Pps21-Cps21), (Pps22-Cps22), (Pps23-Cps23), (Pps24-Cps24), (Pps25Cps25), (Pps27-Cps27))
D2_ps= mean(((Pps1-Cps1)**2), ((Pps2-Cps2)**2), ((Pps3-Cps3)**2), ((Pps4-Cps4)**2), ((Pps5-Cps5)**2), ((Pps6-Cps6)**2),
((Pps7-Cps7)**2), ((Pps8-Cps8)**2), ((Pps9-Cps9)**2), ((Pps10-Cps10)**2), ((Pps11-Cps11)**2), ((Pps12-Cps12)**2), ((Pps13Cps13)**2), ((Pps14-Cps14)**2), ((Pps15-Cps15)**2), ((Pps16-Cps16)**2), ((Pps17-Cps17)**2), ((Pps18-Cps18)**2), ((Pps19Cps19)**2), ((Pps20-Cps20)**2), ((Pps21-Cps21)**2), ((Pps22-Cps22)**2), ((Pps23-Cps23)**2), ((Pps24-Cps24)**2), ((Pps25Cps25)**2), ((Pps27-Cps27)**2))