School-age children with diabetes: The role of maternal self-efficacy, environment, and diabetes management behaviors

Type 1 diabetes mellitus is the most common metabolic disorder of childhood. Mothers typically are the primary care providers for school-age children with diabetes. This research sought to identify factors that influence a mother's diabetes management behaviors. The cross-sectional correlational design included 41 mothers of children ages 6-10 at three outpatient clinics in the midwest.; Bandura's Theory of Self-Efficacy was the conceptual framework that guided this study. The research examined the following variables: (a) maternal coping resources, (b) child behavior, (c) maternal diabetes self-efficacy, (d) maternal diabetes management behavior, and (e) child glycemic control. The corresponding scales were: (a) Coping Resources Inventory, (b) Behavioral Assessment System for Children-Parent Report, (c) Maternal Self-Efficacy for Diabetes Scale, (d) included the Diabetes Management Scale-Parent; 24-Hour Diabetes Behavior Recall; and downloaded glucose data; and (e) child HgbA1c.; The influence of the mother's environment, as defined as child behavior and coping resources, on her diabetes self-efficacy and her diabetes management behaviors was examined. Results indicated that only coping resources contributed significantly to mothers' diabetes self-efficacy, R2 = .225, adjusted R2 = .205; F(1,38) = 11.059, p < .002. No significant relationship was found between the mothers' environment and diabetes management behavior. This finding, however, is important and suggests that mothers were able to follow through with diabetes management regardless of how their child was behaving. Self-efficacy did not predict maternal diabetes management behaviors.; Significant correlations were found between two measures of maternal diabetes management behaviors and child metabolic control. The number of blood glucose tests performed in the past month was negatively correlated to metabolic control, r (27) = -.71, p < .01. Specifically, a child with more blood glucose tests had a lower HgbA1c. The maternal 24-hour recall of diabetes behaviors was positively correlated to metabolic control, r (41) = .39, p < .05.; The results of this study confirmed that mothers with consistent diabetes management behaviors have children in better metabolic control. Nurses need to understand the factors that influence a mother's diabetes management behaviors to assist mothers in improving the child's metabolic control.