Anderson,18 2004 | Qualitative review | NA | NA |
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High levels of diabetes-related family conflict and authoritarian parental style were related to lower levels of treatment adherence and poorer glycemic control -
Emotional expressiveness within the family and steady parental involvement were related to better glycemic control
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Duke et al,19 2008 | Cross-sectional | 120 young people and their caregivers (low income) | DFBS* DFBC,† DSMP‡ (adherence to treatment measurement) |
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Family behaviour measurement explained 11.8% of the variability in glycemic control, controlling for demographic variables -
Young people who reported judgmental parental style with regard to diabetes management had higher blood glucose levels
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Laffel et al,20 2003 | Cohort | 104 children or adolescents and their families | Child quality of life,§ DFCS‖ |
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Semistructured interviews of family involvement in T1DM management -
Clinician-rated adherence scale -
Family involvement in diabetes treatment can reinforce family conflict, but not when it is included in positive family communication -
Duration of diabetes did not predict quality of life -
The parents of children with T1DM reported a slight and statistically important reduction in quality of life compared with the parents of patients without diabetes -
Family conflict was a prognostic factor for quality of life -
Child report regarding family conflict was the most important factor in predicting quality of life initially and 1 y later -
Special family factors, such as family conflict with regard to diabetes, were strongly related to the quality of life of individuals with T1DM
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Lewin et al,21 2006 | Cohort | 109 children (aged 8-18 y) and 1 parent each | DFBS* DFBC,† DFRQ¶ |
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Specific family factors were strongly related to metabolic control -
Negative family function negatively influenced metabolic control -
Negative and judgmental relationships with parents were related to worse metabolic control
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Viner et al,22 1996 | Cross-sectional | 43 children and adolescents and their mothers | FILE# |
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Family stress was strongly related to worse glycemic control in children and adolescents -
The relationship between family stress and diabetes control was bidirectional; poorer diabetes control produced family stress and family stress increased poor control
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Jacobson et al,23 1994 | Cohort | 61 children and adolescents (aged 9-16 y) and their mothers | FES** |
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Patients coming from less expressive families had greater deterioration of glycemic control during the 4-y cohort study -
In boys, family cohesion and conflict were related to the glycemic control's deterioration; in girls, low family cohesion and high family conflict were related to worse glycemic control in the initial clinical examination, but did not continue during the follow-up -
There was no relationship between family organization and glycemic control, as the family's sentimental tone and not its rules and structure influenced metabolic control in adolescent patients with diabetes
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Grey et al,24 2011 | Cohort | 181 parents and their children | Issues in Coping With IDDM–Parent Scale,†† CES-D,‡‡ Diabetes Responsibility and Conflict Scale, Parents DQoL§§ |
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Improvements in parental coping were associated with decreased parental responsibility for diabetes management and improvement in glycemic control in the short term; premature relinquishment of parental responsibility for diabetes management can lead to deterioration in metabolic control -
On the other hand, prolonged overmanagement by parents can lead to increased parent-child conflict; helping parents manage this transition through training in coping skills might lead to a smoother transfer of responsibility for diabetes management and, ultimately, to better metabolic control
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Williams et al,25 2009 | Cohort | 187 children and adolescents | DFCS,‖ CES-D,‡‡ STAI,‖‖ CDI¶¶ |
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Findings suggested a close link between psychological distress in parents and children or adolescents, and reports of increased diabetes-specific family conflict; in the presence of suboptimal glycemic control, children or adolescents and parents reported more family conflict; adherence was not significantly associated with family conflict
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Pereira et al,26 2008 | Cross-sectional | 157 children and adolescents (age 10-18 y) and their parents | DFBS,* FES,** DQoL§§ |
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As the duration of diabetes increased, adherence to treatment and metabolic control decreased -
High family conflict was related to lower quality of life and worse metabolic control -
Increased family support increased the quality of life for boys and girls; additionally, for the girls, higher family support was related to better adherence to treatment and better glycemic control -
Quality-of-life factors that directly influenced metabolic control were influenced by different family factors that depended on social class -
Family conflict was presented as more critical to girls and patients of lower social status; family conflict influenced patients of higher social classes more directly in terms of metabolic control and more indirectly in terms of quality of life -
Family environment was part of a wider cultural context that strongly influenced metabolic control
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Stallwood,27 2005 | Cohort | 73 caregivers and children | PAID,## ADS,*** CHIP,††† DSMP‡ |
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