疾病控制責任知覺與父母管教方式對第一型糖尿病青少年疾病管理和血糖控制的效果

The Effect of Diabetes Management Responsibility and Parenting Style on Type 1 Diabetes Adolescents’ Diabetes Management and Metabolic Control

蔡蕙晴(Huei-Ching Tsai)

指導教授 ： 黃君瑜

中原大學/理學院/心理學研究所/碩士(2009年)

https://doi.org/10.6840/cycu200901022

摘要

研究背景與目的：研究證據指出青春期為糖尿病疾病管理由好轉壞的重要階段，影響青少年疾病管理的因素，大多研究家庭功能與疾病管理之間的關係，鮮少研究探討父母和青少年間如何分擔疾病控制責任。在父母與青少年分擔疾病控制責任時，父母管教方式會造成親子和諧或衝突，進而影響青少年的疾病管理和血糖控制。因此，本研究欲以疾病控制責任知覺與父母管教方式來看對第一型糖尿病青少年疾病管理和血糖控制的效果。
研究方法：本研究以罹患第一型糖尿病青少年和其主要照顧者（父親或母親）為研究對象。參與本研究的受試者有107名，其主要照顧者100人，符合本研究所需的青少年與其主要照顧者配對共計82組，其中男生36 名，女生46名。研究工具為基本資料表、糖尿病家庭責任分擔量表、父（母）親管教方式量表和糖尿病自我照顧量表。以相關分析、共變數分析與多元迴歸分析，進行假設考驗。
研究結果：本研究發現父母對青少年的要求與反應愈多，青少年的疾病管理愈好。當父母採開明權威的管教方式，青少年自評疾病管理會優於父母採寬鬆放任、忽視冷漠之管教方式；而開明權威或專制權威的管教方式在青少年評估其疾病管理上則沒有差異。但父母管教方式在青少年的血糖控制效果上沒有差異，疾病控制責任知覺之責任公平、責任重疊模式對青少年疾病管理和血糖控制效果亦無差異。進行多元迴歸分析發現，父母管教方式的要求向度可以預測青少年疾病管理，父母管教方式的反應向度、疾病管理則可以預測血糖控制的效果。
結論：本研究於疾病控制責任知覺有責任公平和責任重疊模式兩組，缺少不負責任模式組，建議未來研究應包含三組，以比較其對疾病管理和血糖控制效果的差異。研究結果發現開明權威的管教方式，能使青少年疾病管理最佳，可以提供臨床工作者，予宣導及衛教時參考。

關鍵字

父母管教方式 ； 疾病控制責任知覺

並列摘要

Background and purpose：Adolescence was the turning point of diabetes management. While studies considered that the reasons influenced adolescent diabetes management, most studies were curious about the relationship between family function and diabetes management. Few studies discussed the diabetes management responsibility between parents and adolescents. When parents and adolescents shared the diabetes management responsibility, parenting style could cause family cohesion or conflict and then influenced adolescents’ diabetes management and metabolic control. Consequently, the present study examines the effect of diabetes management responsibility and parenting style on type 1 diabetes adolescents’ diabetes management and metabolic control
Methods：Type 1 diabetes adolescents and their major care taker（father or mother）were subjects of study. The subjects participating in this study were 107 type 1 diabetes adolescents and 100 major care takers. Among subjects and their care takers, 82 parents-child dyads were suitable for this study. The subjects of this study included 36 adolescent boys and 46 adolescent girls. The instruments are the basic information questionnaire, Diabetes Family Responsibility Questionnaire, Parenting Style Scale, and the Chinese version of Self-Care Inventory. The statistical analyses included correlation, analysis of covariance, and multiple regression.
Results：This study discovered while parents provided more demand and response toward their adolescent children, adolescents’ diabetes management were better. Regarding adolescents’ evaluation of their degree of diabetes management, the effect of authoritative parenting style was better than the effect of indulgent or neglecting parenting style, but there was no difference between the effect of authoritative parenting style and authoritarian parenting style. Parenting style made no difference in adolescents’ metabolic control; both the perfect agreement pattern and overlap pattern of diabetes management responsibility made no difference in adolescents’ diabetes management and metabolic control. The multiple regression results were that the demanding dimension of parenting style can predict adolescents’ diabetes management and the responsive dimension of parenting style and adolescents’ diabetes management could predict adolescents’ metabolic control.
Conclusion：This study included perfect agreement pattern and overlap pattern of diabetes management responsibility, but did not include no-one-takes-responsibility- pattern of diabetes management responsibility. There was a need for further research to include three patterns in order to contrast the difference in adolescents’ diabetes management and metabolic control. The research result indicated that authoritative parenting style caused the best adolescents’ diabetes management. Clinicians could provide this kind of information to parents.

並列關鍵字

diabetes management responsibility ； parenting style

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