Factors that Affect the Health Outcomes of Taiwanese Adolescents with Type 1 Diabetes: Path Model Constructing

Monday, 30 July 2012

Ruey-Hsia Wang, PhD, RN
College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
Hsiu-Yueh Hsu, PhD, RN
Department of Nursing & Long-term Care Program, Meiho Institute of Technology, Pingtung, Taiwan
Chia-Chan Kao, RN, PhD
Department of Healthcare Administration, I-Shou University, Kaohsiung, Taiwan

Learning Objective 1: The learner will be able to understand the factors that affect HbA1C and quality of life in adolescents with type 1 diabetes.

Learning Objective 2: The learner will be able to learn the suggestion of improving health outcomes of adolescents with type 1 diabetes.

Purpose: To construct path models addressing the influence of school support, conflicting with parent, resilience, and self-care behavior to glycemic control (HbA1c) and different aspects of quality of life (QOL)  in Taiwanese adolescents with Type 1 diabetes. 

Methods: This was a cross-sectional study. A structured questionnaire was used to collect information about school support, conflict with parent, resilience, self-care behavior, and QOL. The latest Glycosylated hemoglobin (HbA1c) was also collected. Data from 371 adolescents with type 1 diabetes and aged 9-19 years were analyzed with structural equation modeling to test the fit of the hypothesized path models to the data.

Results: Self-care behavior and resilience directly positively influenced HbA1c. School support did not directly influence HbA1c, but positively influence HbA1c through the mediating of self-care behaviors. Conflict with parents did not influence HbA1c. Total 11.7% variances of HbA1c were explained by the final model. School support and self-care behavior both directly influenced satisfaction QOL, impact QOL, and worry QOL. Resilience only directly positively influenced satisfaction QOL and impact QOL. Conflict with parents only directly negatively influenced worry QOL. Total 36.1%, 11.2%, and 7.50 % variances of satisfaction QOL, impact QOL, and worry QOL respectively were explained by the final models.

Conclusion: Individual (self-care behavior, resilience) and school factors (school support) are more important than family factor to influence health outcome of adolescents with type 1 diabetes. School nurses should provide supportive school environment for adolescents with Type 1 diabetes. Pediatric nurse and school nurses should cooperative to improve the resilience and self-care behaviors of adolescents with Type 1 diabetes.