Diabetes management mediating effects between diabetes symptoms and health-related quality of life in adolescents and young adults with type 1 diabetes

James W. Varni, Alan M. Delamater, Korey K. Hood, Kimberly A. Driscoll, Jenise C. Wong, Saleh Adi, Joyce P. Yi-Frazier, Ellen K. Grishman, Melissa A. Faith, Sarah D. Corathers, Jessica C. Kichler, Jennifer L. Miller, Jennifer K. Raymond, Elena M. Doskey, Vincent Aguirre, Robert W. Heffer, Don P. Wilson

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objectives: The primary objective was to investigate the mediating effects of diabetes management in the relationship between diabetes symptoms and generic health-related quality of life (HRQOL) in adolescents and young adults (AYAs) with type 1 diabetes. The secondary objective explored patient health communication and perceived treatment adherence barriers as mediators in a serial multiple mediator model. Methods: The PedsQL 3.2 Diabetes Module 15-item diabetes symptoms summary score, 18-item diabetes management summary score, and PedsQL 4.0 generic core scales were completed in a 10-site national field test study by 418 AYA aged 13 to 25 years with type 1 diabetes. Diabetes symptoms and diabetes management were tested for bivariate and multivariate linear associations with overall generic HRQOL. Mediational analyses were conducted to test the hypothesized mediating effects of diabetes management as an intervening variable between diabetes symptoms and generic HRQOL. Results: The predictive effects of diabetes symptoms on HRQOL were mediated in part by diabetes management. In predictive analytics models utilizing multiple regression analyses, demographic and clinical covariates, diabetes symptoms, and diabetes management significantly accounted for 53% of the variance in generic HRQOL (P<0.001), demonstrating a large effect size. Patient health communication and perceived treatment adherence barriers were significant mediators in an exploratory serial multiple mediator model. Conclusions: Diabetes management explains in part the effects of diabetes symptoms on HRQOL in AYA with type 1 diabetes. Patient health communication to healthcare providers and perceived treatment adherence barriers further explain the mechanism in the relationship between diabetes symptoms and overall HRQOL.

Original languageEnglish (US)
JournalPediatric Diabetes
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Type 1 Diabetes Mellitus
Young Adult
Quality of Life
Health Communication
Health Personnel
Therapeutics
Regression Analysis
Demography

Keywords

  • Health-related quality of life
  • Patient-reported outcomes
  • Pediatrics
  • PedsQL
  • Self-management
  • Symptoms
  • Type 1 diabetes

ASJC Scopus subject areas

  • Internal Medicine
  • Pediatrics, Perinatology, and Child Health
  • Endocrinology, Diabetes and Metabolism

Cite this

Diabetes management mediating effects between diabetes symptoms and health-related quality of life in adolescents and young adults with type 1 diabetes. / Varni, James W.; Delamater, Alan M.; Hood, Korey K.; Driscoll, Kimberly A.; Wong, Jenise C.; Adi, Saleh; Yi-Frazier, Joyce P.; Grishman, Ellen K.; Faith, Melissa A.; Corathers, Sarah D.; Kichler, Jessica C.; Miller, Jennifer L.; Raymond, Jennifer K.; Doskey, Elena M.; Aguirre, Vincent; Heffer, Robert W.; Wilson, Don P.

In: Pediatric Diabetes, 01.01.2018.

Research output: Contribution to journalArticle

Varni, JW, Delamater, AM, Hood, KK, Driscoll, KA, Wong, JC, Adi, S, Yi-Frazier, JP, Grishman, EK, Faith, MA, Corathers, SD, Kichler, JC, Miller, JL, Raymond, JK, Doskey, EM, Aguirre, V, Heffer, RW & Wilson, DP 2018, 'Diabetes management mediating effects between diabetes symptoms and health-related quality of life in adolescents and young adults with type 1 diabetes', Pediatric Diabetes. https://doi.org/10.1111/pedi.12713
Varni, James W. ; Delamater, Alan M. ; Hood, Korey K. ; Driscoll, Kimberly A. ; Wong, Jenise C. ; Adi, Saleh ; Yi-Frazier, Joyce P. ; Grishman, Ellen K. ; Faith, Melissa A. ; Corathers, Sarah D. ; Kichler, Jessica C. ; Miller, Jennifer L. ; Raymond, Jennifer K. ; Doskey, Elena M. ; Aguirre, Vincent ; Heffer, Robert W. ; Wilson, Don P. / Diabetes management mediating effects between diabetes symptoms and health-related quality of life in adolescents and young adults with type 1 diabetes. In: Pediatric Diabetes. 2018.
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abstract = "Objectives: The primary objective was to investigate the mediating effects of diabetes management in the relationship between diabetes symptoms and generic health-related quality of life (HRQOL) in adolescents and young adults (AYAs) with type 1 diabetes. The secondary objective explored patient health communication and perceived treatment adherence barriers as mediators in a serial multiple mediator model. Methods: The PedsQL 3.2 Diabetes Module 15-item diabetes symptoms summary score, 18-item diabetes management summary score, and PedsQL 4.0 generic core scales were completed in a 10-site national field test study by 418 AYA aged 13 to 25 years with type 1 diabetes. Diabetes symptoms and diabetes management were tested for bivariate and multivariate linear associations with overall generic HRQOL. Mediational analyses were conducted to test the hypothesized mediating effects of diabetes management as an intervening variable between diabetes symptoms and generic HRQOL. Results: The predictive effects of diabetes symptoms on HRQOL were mediated in part by diabetes management. In predictive analytics models utilizing multiple regression analyses, demographic and clinical covariates, diabetes symptoms, and diabetes management significantly accounted for 53{\%} of the variance in generic HRQOL (P<0.001), demonstrating a large effect size. Patient health communication and perceived treatment adherence barriers were significant mediators in an exploratory serial multiple mediator model. Conclusions: Diabetes management explains in part the effects of diabetes symptoms on HRQOL in AYA with type 1 diabetes. Patient health communication to healthcare providers and perceived treatment adherence barriers further explain the mechanism in the relationship between diabetes symptoms and overall HRQOL.",
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T1 - Diabetes management mediating effects between diabetes symptoms and health-related quality of life in adolescents and young adults with type 1 diabetes

AU - Varni, James W.

AU - Delamater, Alan M.

AU - Hood, Korey K.

AU - Driscoll, Kimberly A.

AU - Wong, Jenise C.

AU - Adi, Saleh

AU - Yi-Frazier, Joyce P.

AU - Grishman, Ellen K.

AU - Faith, Melissa A.

AU - Corathers, Sarah D.

AU - Kichler, Jessica C.

AU - Miller, Jennifer L.

AU - Raymond, Jennifer K.

AU - Doskey, Elena M.

AU - Aguirre, Vincent

AU - Heffer, Robert W.

AU - Wilson, Don P.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Objectives: The primary objective was to investigate the mediating effects of diabetes management in the relationship between diabetes symptoms and generic health-related quality of life (HRQOL) in adolescents and young adults (AYAs) with type 1 diabetes. The secondary objective explored patient health communication and perceived treatment adherence barriers as mediators in a serial multiple mediator model. Methods: The PedsQL 3.2 Diabetes Module 15-item diabetes symptoms summary score, 18-item diabetes management summary score, and PedsQL 4.0 generic core scales were completed in a 10-site national field test study by 418 AYA aged 13 to 25 years with type 1 diabetes. Diabetes symptoms and diabetes management were tested for bivariate and multivariate linear associations with overall generic HRQOL. Mediational analyses were conducted to test the hypothesized mediating effects of diabetes management as an intervening variable between diabetes symptoms and generic HRQOL. Results: The predictive effects of diabetes symptoms on HRQOL were mediated in part by diabetes management. In predictive analytics models utilizing multiple regression analyses, demographic and clinical covariates, diabetes symptoms, and diabetes management significantly accounted for 53% of the variance in generic HRQOL (P<0.001), demonstrating a large effect size. Patient health communication and perceived treatment adherence barriers were significant mediators in an exploratory serial multiple mediator model. Conclusions: Diabetes management explains in part the effects of diabetes symptoms on HRQOL in AYA with type 1 diabetes. Patient health communication to healthcare providers and perceived treatment adherence barriers further explain the mechanism in the relationship between diabetes symptoms and overall HRQOL.

AB - Objectives: The primary objective was to investigate the mediating effects of diabetes management in the relationship between diabetes symptoms and generic health-related quality of life (HRQOL) in adolescents and young adults (AYAs) with type 1 diabetes. The secondary objective explored patient health communication and perceived treatment adherence barriers as mediators in a serial multiple mediator model. Methods: The PedsQL 3.2 Diabetes Module 15-item diabetes symptoms summary score, 18-item diabetes management summary score, and PedsQL 4.0 generic core scales were completed in a 10-site national field test study by 418 AYA aged 13 to 25 years with type 1 diabetes. Diabetes symptoms and diabetes management were tested for bivariate and multivariate linear associations with overall generic HRQOL. Mediational analyses were conducted to test the hypothesized mediating effects of diabetes management as an intervening variable between diabetes symptoms and generic HRQOL. Results: The predictive effects of diabetes symptoms on HRQOL were mediated in part by diabetes management. In predictive analytics models utilizing multiple regression analyses, demographic and clinical covariates, diabetes symptoms, and diabetes management significantly accounted for 53% of the variance in generic HRQOL (P<0.001), demonstrating a large effect size. Patient health communication and perceived treatment adherence barriers were significant mediators in an exploratory serial multiple mediator model. Conclusions: Diabetes management explains in part the effects of diabetes symptoms on HRQOL in AYA with type 1 diabetes. Patient health communication to healthcare providers and perceived treatment adherence barriers further explain the mechanism in the relationship between diabetes symptoms and overall HRQOL.

KW - Health-related quality of life

KW - Patient-reported outcomes

KW - Pediatrics

KW - PedsQL

KW - Self-management

KW - Symptoms

KW - Type 1 diabetes

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