Diabetes Problem Solving by Youths with Type 1 Diabetes and their Caregivers: Measurement, Validation, and Longitudinal Associations with Glycemic Control

摘要

Objectives This article introduces a new measure of problem-solving skills of youths with type 1 diabetes (T1DM) and adult caregivers in correcting glycemic fluctuations. Methods The Diabetes Problem Solving Interview (DPSI), a structured interview, was validated during a pilot study of a behavioral intervention. DPSI data and measures of diabetes management were obtained at baseline from 114 youths (ages 9–14.5) and 109 caregivers. Glycosylated hemoglobin (HbA_1c) was measured quarterly over 9 months. Results Results confirmed the psychometric adequacy of the DPSI. For caregivers, but not youths, low DPSI scores (indicating poor problem-solving skills) were significantly associated with worse HbA_1c over 9 months. Conclusions The DPSI has clinical and research utility as a measure of diabetes problem-solving skills. Identification and targeted remediation of caregivers’ deficient diabetes problem-solving skills or promotion of youths’ utilization of these skills could possibly enhance glycemic control in youths with T1DM.