TITLE:
Family responsibility dynamics for young adults in transition to adult health care
AUTHORS:
Pat Rapley, Gwen Babel, Joey Kaye, Suzanne Brown
KEYWORDS:
Diabetes; Health-Care Transition; Parent; Adolescent; Transition Coordinator
JOURNAL NAME:
Journal of Diabetes Mellitus,
Vol.3 No.3,
July
22,
2013
ABSTRACT: Aim:
To explore family responsibility dynamics, metabolic control, clinic
attendance, and emergency admissions when young adults (YA) with type 1 diabetes
transition to an adult hospital. Method: A longitudinal mixed method design
with two study groups (parents, n = 28; YA intervention group, n = 23) and a YA
comparison group (n = 20). Sample recruited from an outpatient diabetes centre.
Demographic, clinic attendance, emergency admissions, biodata, and the Diabetes
Family Responsibility Questionnaire (DFRQ) were completed on entry and sixmonths
later as part of an 18-month trial of a diabetes transition coordinator (DTC).
The selfreport DFRQ were analyzed using derived parent-child dyadic variables
to explore differences at baseline and end of study using Wilcoxon Signed Rank
Test. The relationship between metabolic control and the DFRQ patterns was explored
using Spearman’s rho. Results: On completion of the study, the change in HBA1Cfor both adolescent groups was not
significant but was less than ideal for 25% of adolescents in the study. The YA
intervention group had significantly fewer missed appointments between them
compared to the comparison group. The DFRQ indicated that the derived
parent-child dyadic variable of task-discordance increased during the study.
Conclusion: The clinically relevant diabetes-task dissonance between parents
and young adults offers a challenge and a diagnostic opportunity for diabetes
educators.