Paauglių, sergančių I tipo cukriniu diabetu, subjektyviai suvokiamų santykių su tėvais ir ligos valdymo ypatumai ; The aspects of subjectively perceived parent-child relationships and disease management in adolescents with type I diabetes

The problem of the research. In the light of a disease, parent-adolescent interaction, affected and aggravated by the psychological development aspects, may cause frequent conflicts and have an impact on the adolescents’ health locus of control. The health locus of control is a critical factor in disease management, revealing whether adolescents take responsibility for their own health or rather tend to lay it on others. Therefore, it is important to analyse the correlation between the health locus of control and the relationship with parents, aiming to understand the aspects of disease management in terms of type I diabetes and focusing both on medical and psychosocial aspects. Participants and methods. 85 adolescents, aged from 12 to 17 years old and hospitalised in the children’s section of Institute of Endocrinology, Hospital of Lithuanian University of Health Sciences Kaunas Clinics, participated in this study. The average age of adolescents is 14,4 years (SD=1,9).The instrument of this study includes: Multidimensional Health Locus of Control Scale, Diabetes Family Conflict Scale – Revised (DFCS) and the questionnaire Parent-Child interaction. Social and clinical aspects were evaluated with 6 additional questions. In order to analyse the data in the two-dimensional statistical analysis, nonparametric tests were used: Spearman’s correlation coefficient and Mann-Whitney test. The logistic regression model was used in the multidimensional statistical analysis. Results. Boys rated their external others locus of control higher than girls (p=0.001). The external others locus of control (r=0,243; p=0,025) and the duration of disease (r=0,267; p=0,013) proved to be related to the frequency of conflicts. The glycemic measurement rate was related to the insulin injections rate (r=0,539; p=0,001). Boys rated their relationship with father higher than girls: cooperation (p=0.049), authority (p=0,05) and relationship satisfaction (p=0,05). There proved to be a direct correlation between the types of parent-child interaction (p<0,001). A higher rate of conflicts was related to the rigidity (r=0,268; p=0,016) and control (r=0,426; p=0,001) in the relationship with mother. Longer hospitalization was related to higher strictness of mother (r=0,406; p=0,001) and father (r=0.301; p=0.013), higher rigidity of mother (r=0,257; p=0,028), poorer emotional closeness with mother (r=-0,244; p=0,038) and father (r=-0,264; p=0,031), cooperation with mother (r=-0,305; p=0.009) and father (r=-0,342; p=0,005), authority of mother (r=-0,252; p=0,031), acceptance of father (r=-0,247; p=0,044) and the satisfaction of a relationship with mother (r=-0,344; p=0,003). Higher inconsistency of father (r=-0,231; p=0,048) was related to higher external chance locus of control. Higher external others locus of control was related to higher cooperation with mother (r=0,264; p=0,018) and higher control (r=0,253; p=0,03), emotional closeness (r=0,333; p=0,004), cooperation (r=0,262; p=0,025), authority (r=0,31; p=0,007) and relationship satisfaction (r=0,289; p=0,012) with father. The aspects of relationship with parents were not considered to be statistically important factors while predicting health locus of control in adolescents (p>0,05). Conclusions. Boys rate their external others locus of control, father’s cooperation, authority and relationship satisfaction with father higher than girls. Adolescents with higher external others locus of control and longer duration of illness tend to experience more frequent conflicts due to diabetes. Types of parent-child interactions are related with each other. Longer hospitalization and higher rates of external others locus of control are related to the aspects of relationship with parents. Numerous conflicts are related to higher rigidity and control of mother, whereas higher inconsistency of father is related to higher external chance locus of control. The aspects of relationship with parents are not statistically important factors while predicting the locus of health control in adolescents.