Parental involvement, family conflict, and quality of life among adolescents with type 1 diabetes

Objective. To examine the relationship between parent monitoring and involvement in diabetes management, family diabetes-related conflict, demographic and medical variables, and health-related quality of life (QOL) among early adolescents with type 1 diabetes.;Methods. Emotion and behavior rating scales and self-care behavior interviews completed by 162 parent-adolescent dyads were collected. Relationships between the variables of interest were examined utilizing structural equation modeling. It was hypothesized that parent- and youth-reports of conflict and QOL would be modestly correlated and that parents would endorse greater youth responsibility for diabetes management than their children would endorse. Further, it was hypothesized that family conflict related to diabetes would moderate the relationship between parent involvement in diabetes management and adolescent QOL. Covarying demographic and medical variables (e.g., age, medical regimen, metabolic control) were explored, and two alternate models were evaluated.;Results. Parent- and youth-reports of conflict and QOL were moderately correlated and were reliably measured across families with varying levels of conflict. Partial support was found for the moderation hypothesis, suggesting that the relationship between parental involvement in diabetes management and adolescent QOL appears to differ for families experiencing less versus more diabetes-related conflict.;Conclusions. Family relationships related to diabetes management appear to play a central role in adolescents' health-related QOL. The associations between these constructs are complex and multifaceted, indicating the need for continued examination of comprehensive theoretical models. Clinically, it is important to recognize that optimal diabetes self-care and positive health-related adjustment in adolescence may involve not only the promotion of parent involvement in diabetes management, but also the prevention or minimization of family conflict.